title: A review of 1000 referrals to Walsall's hospital eye service.
abstract: Referrals to ophthalmology are predominantly made from general practitioners (GPs) and optometrists. These two groups of referrers receive differing types and levels of training and are equipped with different instrumentation. The purpose of this study was to determine whether the quality of referrals to the hospital eye service (HES) differs between GPs and optometrists in Walsall.
  
  
  
  Referrals into the HES were identified from Q1 2014 retrospectively until 1000 notes had been reached. Each record was scrutinized using a standard template. Data were analysed and summary statistics produced including positive predictive values and interobserver agreement.
  
  
  
  We achieved our target of auditing 1000 records. The false-positive rate (patients being discharged from HES with a 'normal vision' diagnosis) was 7.7% of referrals from GPs and 6.2% of referrals from optometrists. Concordance between referred condition and diagnosed condition at HES between optometrists and ophthalmologists was 76.1%, and between GPs and ophthalmologists was 67.2%.
  
  
  
  In view of findings from this study, it is important for commissioners in the new reconfigured National Health Service to ensure that enhanced ophthalmic services are commissioned only on the basis of hard evidence sourced from local data rather than opinion or on data from another geographical area.
authors.affiliation: Public Health Department, Walsall Council, Walsall WS1 1TP, UK.
authors.forename: M
authors.initials: M
authors.lastname: Fung
authors.affiliation: Public Health Department, Walsall Council, Walsall WS1 1TP, UK.
authors.forename: P
authors.initials: P
authors.lastname: Myers
authors.affiliation: Public Health Department, Walsall Council, Walsall WS1 1TP, UK.
authors.forename: P
authors.initials: P
authors.lastname: Wasala
authors.affiliation: Academic Unit of Public Health, University of Leeds, Leeds LS2 9JT, UK.
authors.forename: N
authors.initials: N
authors.lastname: Hirji
mesh_terms: D004739:England; D058005:General Practitioners / Q000706:statistics & numerical data; D006748:Hospital Departments / Q000706:statistics & numerical data*; D006801:Humans; D009885:Ophthalmology / Q000706:statistics & numerical data*; D000072162:Optometrists / Q000706:statistics & numerical data; D012017:Referral and Consultation / Q000592:standards / Q000706:statistics & numerical data*; D012189:Retrospective Studies
keywords: eye disorders; primary care; secondary and tertiary services