REGO – Urgent Referral Update

Dear Optometry Colleagues,

Electronic Eyecare Referral System (EeRS) – Direct referral requirement

You will be aware that as part of the national requirements in the 2023/24 operational planning guidance, ICBs were asked to ‘expand direct access and self- referral where GP involvement is not clinically necessary’ by 1 September 2023.

Systems were asked to put in place direct referral pathways from community optometrists to ophthalmology services for all urgent and elective eye consultations.

We began migrating the referral system to an electronic referral system (REGO) with a launch date of 1 September 2023. This recognises the responsibility of community Optometry practices to refer directly to secondary care providers, to improve patient experience and remove the burden on GPs to pass referrals on as intermediaries who have no clinical responsibility for the referral.

As part of this launch, we have devoted time to improving how REGO works operationally, clarifying processes, and making sure there are appropriate governance systems in place. We started with routine referrals and have now extended this to Urgent referrals, using the following priority classification criteria:

• Routine referrals: Referrals for patients who can wait more than 2 weeks.
• Urgent referrals: Referrals for patients who need to be seen from 48 hours to 2 weeks due to risk of sight loss (including wet AMD) or a suspected cancer referral.
• Emergency referrals (patients needing to be seen within 48hrs due to serious risk to patients’ sight or health) have their own local pathways

Emergency referrals, i.e. those which need to be seen within one/two days can not be processed via REGO, optometrists must use the appropriate pathways operating in their geographical place e.g. the use of emergency departments or eye casualty.

This will also apply to optical services providing domiciliary care within the BOB area. If you do not currently have access to the REGO system and need to refer patients onto secondary care services within the BOB system, please contact NEC at who will arrange access. Please copy in Scarlett Hooper or Naveen Sankighatta  into your request for access.

A training session on how to use the systems is available via:

https://youtu.be/-Sjcye94kpQ

This has been a collaborative program, achieved with the help and agreement of the Local Optical Committee representatives from Buckinghamshire, Oxfordshire and Berkshire West (BOB), secondary care providers and the NHS England South East Regional Specialty Lead for Optometry. All optometrists in BOB now have access to REGO. Feedback has been positive with reported improvement to the referral process.

Implementation of the routine and urgent pathway will take place from W/C 13th May 2024. GPs will no longer forward on referrals to secondary care on behalf of optometrists. If a GP receives a request for onward referral, they will return it to the optometrist who must make the referral via REGO or in the case on an emergency referral, via their usual route to eye casualty or Emergency Department. GPs will only make referrals to ophthalmology for those patients they have seen and assessed as clinically appropriate.

If you have any technical problems with the system please contact the EeRS Rego support team: rego.support@necsws.com

If you have queries relating to the process or the system, please contact Dimple Mehta who will assist you or sign post you to support.

We appreciate your cooperation and assistance with the migration of this process. We acknowledge the challenges and we are committed to improving patient experience by making the most of our system capacity while streamlining local processes.

Yours faithfully,

Dr David Chapman, ICB Clinical Lead for POD

Dimple Mehta, NHSE Southeast Specialty Lead for Optometry

Dr Abid Irfan, Director of Primary Care and Deputy Chief Medical Officer Buckingham, Oxfordshire and Berkshire West Integrated Care Board