Access To Eyecare:National Ophthalmology Workstream

Alex BowermanScottish Government, Access Support Team

Scottish Vision Strategy Conference18th March 2015

Challenging Times

• Waiting Times Pressures

• New Treatments• Aging population• Workforce issues• New: return capacity • Flows & Bottlenecks• Primary / secondary

care interface

In Scotland we do many things really well …..

…just not everywhere…

…and just not all of the time

Creating the Right Conditions and Profile Nationally & Locally

• Articulating what ‘good’ looks like• Clarifying the Focus – ‘what’• Empowering and working with stakeholders –

‘who’• Helping with the ‘how’ and avoiding re-

inventing the wheel• Building the culture and expectation across

each Board and each Health Community

Addressing Core Capacity

WorkforceCompetencies and capacity Extending roles of Nurses, Optometrists and AHPs

Information and Capacity

Plans

Booking Practices

Primary/Secondary Care

Pathways

— Managing queues and sub-specialty capacity

— Revisiting booking arrangements

Managing Demand into Secondary CareRolling out alternative models for surveillanceWorking together: shared care

Understanding Capacity and Demand (locally, regionally and nationally)Managing ‘return slots’ successfully

Start Small, Aim Big..

Workforce LothianDumfrie

s & Galloway

Greater Glasgow & Clyde

Highland

Forth Valley

Fife

Tayside

Lanarkshire

Lothian

Dumfries & Galloway

Booking Practices

Information and Capacity

Plans

Greater Glasgow & Clyde

Dumfries & Galloway

Lothian

Forth Valley

Tayside

Lanarkshire

Primary/Secondary Care

PathwaysGreater Glasgow & Clyde

Borders

Forth Valley

Fife

Ayrshire & Arran

GrampianHighland

Systematic Action• Real time information to sub-specialty level to inform strategic and

operational decisions• Effective booking processes and training which acknowledge sub-

specialty variation• Flexible use of accommodation • Job plans / clinic templates to reflect demands of each service• Up-skill AHPs/nurses and extend roles• Strengthen work across primary/secondary care (appropriateness of

care settings)• Reduce the number of appropriately assessed patients returning to 2

care for monitoring by senior medical staff• Use modern technology to improve patient pathways• Measure impact of successes

Embedding the Changes …..permanently

• Patient• Priorities• Parity• Partnership