Primary eye care welcomes new GIRFT glaucoma guidance

Organisations across primary eye care have welcomed the publication of NHS England’s Getting It Right First Time (GIRFT) Best Practice Guidance for Glaucoma Services.

A joint statement was issued by the Association of Optometrists, the College of Optometrists, Association of British Dispensing Opticians (ABDO), the Local Optical Committee Support Unit (LOCSU), and the Federation of Optometrists and Dispensing Opticians (FODO).

In the statement, the organisations acknowledge the importance of the new guidance in setting a “positive direction” for shared care and fair funding of the enhanced clinical roles involved for primary eye care providers.

The organisations also remarked that the new guidance, if implemented by integrated care boards (ICBs) as intended, should mark a key step in the delivery of “safe, integrated, and collaborative” glaucoma care across England.

The GIRFT report sets out a framework for early detection, risk-based follow-up and effective multidisciplinary working.

The report places an emphasis on the role of primary care optometry in identifying and managing patients closer to home.

In a joint response to the new guidance, the professional bodies and organisations shared: “The primary eye care sector supported the GIRFT team in ensuring the contribution of community eye care to safe and effective glaucoma pathways was captured and will be funded through this framework for the benefit of patients and hospital colleagues.”

Included in the guidance is support for stronger public health messaging to promote the need for regular eye examinations for early detection of raised pressures and glaucoma.

Dr Peter Hampson, clinical and policy director for the AOP, commented: “Optometrists in primary care are uniquely placed to support early detection and ongoing monitoring of glaucoma patients.”

“The AOP welcomes this guidance as recognition of that role and of the importance of ensuring that primary care is appropriately resourced and supported to deliver it. We look forward to working with ICBs and our partners to make the vision set out in this document a reality for patients,” he added.

The guidance also recognises the case for repeat measures and enhanced case finding services to be commissioned in primary eye care across England.

This would free-up capacity in hospital glaucoma services and support the shift of care closer to home for patients.

The role of optometrists in follow-up care after hospital discharge is also referenced.

Zoe Richmond, clinical director for LOCSU, suggested the guidance provides a “clear and credible framework” for the sector to build on.

She highlighted that local optical committees and their support networks “stand ready” to work with commissioners and NHS England to ensure the pathway improvements recommended can be funded and embedded across England.

“Optometrists and their practice teams are already delivering accessible glaucoma care; this guidance recognises that and gives us the tools to go further,” Richmond said.

The report highlights that glaucoma remains one of the leading causes of irreversible sight loss in the UK and currently affects more than one million people. This is predicted to rise to 1.06 million people by 2030.

With the numbers of patients affected by glaucoma set to rise, the primary eye care organisations emphasised that the guidance “arrives at a critical time for NHS eye care in England.”

Ophthalmology outpatient waiting lists are one of the largest contributors to the NHS backlog in England, with glaucoma accounting for approximately 20–25% of hospital eye service outpatient activity.

Dr Paramdeep Bilkhu, clinical adviser at The College of Optometrists, commented: “This GIRFT guidance reflects the clinical evidence and supports the kind of multidisciplinary, community-based care that can genuinely reduce the burden of preventable sight loss.”

Bilkhu added that the College is committed to supporting optometrists to implement the recommendations safely and effectively.

Kirsten Ross, clinical optometry officer at FODO suggested: “The new guidance should help more patients access care closer to home and most importantly prevent avoidable sight loss due to delays in the hospital eye care service.”

Welcoming the guidance’s recognition that “safe, effective glaucoma care depends on integrated, multidisciplinary working across the eye care pathway,” Max Halford, clinical and policy director for ABDO, emphasised the key role of dispensing opticians in primary eye care teams.

The full GIRFT glaucoma services guidance can be found online.