title: Evaluation of a minor eye conditions scheme delivered by community optometrists.
abstract: The establishment of minor eye conditions schemes (MECS) within community optometric practices provides a mechanism for the timely assessment of patients presenting with a range of acute eye conditions. This has the potential to reduce waiting times and avoid unnecessary referrals to hospital eye services (HES).
  
  
  
  To evaluate the clinical effectiveness, impact on hospital attendances and patient satisfaction with a minor eye service provided by community optometrists.
  
  
  
  Activity and outcome data were collected for 12 months in the Lambeth and Lewisham MECS. A patient satisfaction questionnaire was given to patients at the end of their MECS appointment. A retrospective difference-in-differences analysis of hospital activity compared changes in the volume of referrals by general practitioners (GPs) from a period before (April 2011-March 2013) to after (April 2013-March 2015) the introduction of the scheme in Lambeth and Lewisham relative to a neighbouring area (Southwark) where the scheme had not been commissioned. Appropriateness of case management was assessed by consensus using clinical members of the research team.
  
  
  
  A total of 2123 patients accessed the scheme. Approximately two-thirds of patients (67.5%) were referred by their GP. The commonest reasons for patients attending for a MECS assessment were 'red eye' (36.7% of patients), 'painful white eye' (11.1%) and 'flashes and floaters' (10.2%). A total of 64.1% of patients were managed in optometric practice and 18.9% were referred to the HES; of these, 89.2% had been appropriately referred. First attendances to HES referred by GPs reduced by 26.8% (95% CI -40.5% to -13.1%) in Lambeth and Lewisham compared to Southwark.
  
  
  
  The Lambeth and Lewisham MECS demonstrates clinical effectiveness, reduction in hospital attendances and high patient satisfaction and represents a successful collaboration between commissioners, local HES units and primary healthcare providers.
authors: Centre for Public Health Research, School of Health Sciences, City University London, London, UK.
authors: E
authors: E
authors: Konstantakopoulou
authors: Centre for Public Health Research, School of Health Sciences, City University London, London, UK.
authors: D F
authors: DF
authors: Edgar
authors: Manchester Academic Health Science Centre, Manchester Royal Eye Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK.
authors: R A
authors: RA
authors: Harper
authors: Centre for Public Health Research, School of Health Sciences, City University London, London, UK Institute of Ophthalmology, University College London, London, UK.
authors: H
authors: H
authors: Baker
authors: Manchester Centre for Health Economics, Institute of Population Health, University of Manchester, Manchester, UK.
authors: M
authors: M
authors: Sutton
authors: Ophthalmology Department, St Thomas' Hospital, London, UK.
authors: S
authors: S
authors: Janikoun
authors: Ophthalmology Department, King's College Hospital, London, UK.
authors: G
authors: G
authors: Larkin
authors: Centre for Public Health Research, School of Health Sciences, City University London, London, UK.
authors: J G
authors: JG
authors: Lawrenson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003153:Community Health Services; D003695:Delivery of Health Care; D005128:Eye Diseases / Q000175:diagnosis* / Q000628:therapy; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009885:Ophthalmology; D009907:Optometry; D017060:Patient Satisfaction; D012017:Referral and Consultation; D013222:State Medicine; D006113:United Kingdom; D055815:Young Adult
keywords: PRIMARY CARE