Northern Ireland independent prescribing pilot delivers care close to home

An evaluation for a pilot that saw patients redirected from secondary care to be managed by independent prescribing (IP) optometrists in the community shows a reduction in the weekly workload of Belfast Eye Casualty.

The pilot was an extension of the Northern Ireland Primary Eyecare Assessment and Referral Service (PEARS).

PEARS Plus saw optometrists with independent prescribing qualifications from 18 practices in Northern Ireland manage patients with foreign bodies, dendritic ulcers, acute unilateral anterior uveitis and marginal keratitis.

The majority of patients were referred to PEARS Plus by Belfast Eye Casualty, with a smaller group of patients referred to the initiative by optometry practices.

In total, 841 patients were seen through the pilot, with 1331 appointments provided including follow-up appointments.

An evaluation report on the service, which ran between April and December 2023, noted that close to nine in ten patients (88.5%) were able to be managed in primary care.

Over the 32-week pilot period, there was a median 10% reduction in the number of patients attending eye casualty each week.

Belfast Trust specialist optometrist, Deirdre Burns, was a team lead for the project at Belfast Eye Casualty.

“I was very pleased to be involved in this pilot project and I believe that it holds great promise for patient care in the future,” she emphasised.

“I would like to thank the community IP optometrists, the multi-disciplinary team within Belfast Trust and the Strategic Planning and Performance Group, Department of Health, Northern Ireland for working so well together on this project,” Burns added.

IP optometrist, Brian McKeown, who participated in PEARS Plus, shared that the initiative helped to reduce pressure on secondary care while also utilising the skills of IP optometrists in practice.

He highlighted that patient feedback was overwhelmingly positive on the service.

“Patients were very grateful that we were able to manage them to resolution in practice and they didn’t have to travel,” McKeown said.

The service evaluation revealed that close to half (49%) of patients who were seen through PEARS Plus lived further than 20 miles away from Belfast Eye Casualty.

McKeown shared that staff working within secondary care also expressed their gratitude for the pressure that the service has taken off eye casualty.

“There is a real human impact for those people working in a high-pressure hospital environment. If you can make their life happier, then that's good too,” he said.