SMDRSS, the past year…

1. South Manchester Diabetic Retinopathy Screening Service SMDRSS, the past year… Headlines & Highlights Angela Chicamisse Programme Manager

2. Issues to discuss SMDRSS • Programme performance • Service improvements • Day to Day service management • Contractual issues (PCT-Optom SLA) • National pathway changes • Future provision

3. Programme Performance SMDRSS • New National Standards • EQA recommendations implemented • Incident reporting and follow-up of failsafe issues • Team staffing

5. Service Improvements SMDRSS • Failsafe – robust processes to minimise risk • Vector Medical Retina reconfiguration – improving HES clinical data completeness • Minimising list of exclusions • Better data quality & validation • Review of SMDRSS core team functions & processes

6. Day to Day Core Service Management SMDRSS

7. Core Service issues SMDRSS • Unnecessary reminders • Inappropriate DNA letters • Unknown missing images/episodes • Inappropriate appointments • Images not graded • Screening inactive or ineligible patients • Adds to the inefficiencies within the service

8. DRS Service Contract SMDRSS The DRS service comprises: • measuring a patients visual acuity; • taking a minimum of two digital photographs per eye in accordance with National Screening Committee Guidelines; • undertaking a First Full Disease Grade in respect of each of the digital photographs obtained from a Patient or as may otherwise be required by the Commissioner; • recording the Retinopathy Grade in respect of such First Full Disease Grade; • where required by the Commissioner, the Relevant Associate PCT or SMDRS, undertaking a Second Full Disease Grade in respect of the digital photographs obtained from a Relevant Patient; • recording the Retinopathy Grade in respect of such Second Full Disease Grade; • where authorised, undertaking SLBIO immediately following digital imaging in respect of those Patients where the images are Ungradeable

9. Providerobligations: equipment, premises • private consultation area • access to a broadband connection • fully sourced and operational digital retinal camera – PASA approved • IT hardware • high resolution monitors • notify SMDRS within twenty four (24) hours of any serious faults in DRS software system

10. Providerobligations:services • notify the Programme of any changes in the identity of the Qualified Personnel prior to such changes taking place (minimum of 30 days notice of a Qualified Personnel leaving) • ensure that only Qualified Personnel provide the Services • QP is C&G qualified or enrolled on the course – and completes within 2 years • Keep the Programme notified about that personnel’s progress on the relevant course • If miss deadlines, the Commissioner can require such personnel to be removed from the Provider’s list of Qualified Personnel

11. Providerobligations:services • provide any necessary information relating to the Provider’s provision of the Services as may be required by SMDRS Manager from time to time; • input as soon as reasonably possible all necessary information onto the diabetic retinopathy screening software system and inform the Commissioner or the Relevant Associate PCT of any changes to the Patient Information; • input onto the central database the details of any Patient appointments which it has completed and any Patients that did not attend their appointment with the Provider;

12. Providerobligations:services • not allow an unreasonable waiting list or backlog to develop (it being agreed that for the purpose of this clause, 60 days is to be considered a reasonable period of time); • provide a choice of appointment times to its Patients; • not link sight tests with the provision of the Services • If screening another Practice’s patient, not solicit further business from that Patient (e.g. a sight test) • Not solicit referral of patients from GP practices, health centres, diabetes clinics, etc

13. Qualified Personnel: obligations • 2 images each eye, FDG, immediate SLBIO, patient consent • Minimum 500 imagesets, online EQA test sets, C&G qualification, maintain competence & accreditation • Comply with national timescales & targets • Do not solicit business

14. Core Service issues Unnecessary reminders Inappropriate DNA letters Unknown missing images/episodes Inappropriate appointments Images not graded Screening inactive or ineligible patients Adds to the inefficiencies within the service how can we improve? SMDRSS

17. SMDRSS Communications

18. SMDRSS Communications

19. Going forward…. SMDRSS Objectives2012-13 Remove inefficiencies Eliminate risks More robust contract performance management SMDRSS • We need your cooperation!! • Remember…. • National screening service, National standards

20. National pathway changes National programme – new name NDESP National Diabetic Eye Screening Programme Eliminate variation in pathways between programmes in England – no ‘postcode lottery’ Will bring consistency, comparable data, better benchmarking Avoid confusion, minimise risks SMDRSS

22. Local Changes • Implement NDESP common pathway • Grading protocol • Local name change • Transition to a new provider, new location • New Commissioners • New contract

23. Finally • Bear in mind…. • We have a very busy year ahead • Wider changes within the NHS • Keep up the good work!

24. Thank you Any questions?