Services for people at risk of developing glaucoma

This is an extract from the commissioning guide. The complete commissioning guide is available at www.nice.org.uk/guidance/cmg44

7 Further Information

Table 4 summarises national drivers that are relevant to commissioning services for people at risk of developing glaucoma. Local service redesign may address only one or two of them.

Table 4 National policy relevant to glaucoma

Document	Author	Year	Significance
Public health outcomes framework for England, 2013–2016	Department of Health	2012	Includes indicator for 'preventable sight loss' under domain 4 – healthcare public health and preventing premature mortality.
NHS outcomes framework for 2012/13	Department of Health	2012	Includes domains on enhancing quality of life for people with long-term conditions, and ensuring that patients have a positive experience of care.
Using the Commissioning for Quality and Innovation (CQUIN) payment framework – a summary guide	Department of Health	2010	Makes a proportion of providers' income conditional on quality and innovation.
Guidance on the referral of glaucoma suspects by community optometrists	The College of Optometrists and The Royal College of Ophthalmologists	2010	Guidance on referral of people with suspected glaucoma by community-based practitioners.
Primary care and community services: Improving eye health services	Department of Health	2009	Commissioning guidance for primary care and community eye health services.
Rapid response report. Preventing delay to follow up for patients with glaucoma	National Patient Safety Agency	2009	Requests that organisations review their systems and processes for the identification and management of glaucoma, in line with NICE guidance, to prevent avoidable sight loss.
UK Vision Strategy: Setting the direction for eye health and sight loss services	Led by the Royal National Institute of Blind People	2008	Sets out vision for eliminating avoidable sight loss.
Commissioning toolkit for community based eye care services	Department of Health	2007	Provides commissioners with practical advice on commissioning community-based eye care services, drawing on evidence from pilot pathways including for glaucoma services.

Useful sources of information for developing a service specification may include:

the standard NHS contracts for acute hospital, mental health, community and ambulance services
The Local Optical Committee (LOC) Support Unit's 'Glaucoma referral refinement and OHT enhanced service pathways following NICE guidance – glaucoma referral refinement, ocular hypertension monitoring and ocular hypertension diagnosis'
The Royal College of Ophthalmologists' 'New to follow up (N:F) ratios in ophthalmology outpatient services'
NHS Evidence provides free access to clinical and non-clinical information – local, regional, national and international. Includes a QIPP library with case studies
NICE and British Medical Journal online education tool for the diagnosis and management of chronic open angle glaucoma and ocular hypertension
NICE pathway for glaucoma
Skills for Health/National Occupational Standard for glaucoma.

Sources of further information to help you in assessing local health needs and reducing health inequalities include:

NHS Evidence provides free access to clinical and non-clinical information – local, regional, national and international. Includes a QIPP library with case studies
NHS IC Indicator Portal website gathers together a number of health and social care indicators
NHS Comparators provides comparator data for NHS commissioning and provider organisations to enable users to investigate aspects of local activity, costs and outcomes
PRIMIS+ provides support to general practices on information management, recording for, and analysis of, data quality, plus a comparative analysis service focused on key clinical topics
SHAPE (Strategic health asset planning and evaluation) application provides support to strategic health authorities and primary care trusts on strategic planning across a whole health economy.