Healthi Electronic Referrral System
All referrals by practitioners within Greater Manchester for a patient with a Greater Manchester GP should be made through the Healthi electronic referral platform. This will route the referral appropriately and also enable GP look-up. The referral information below is for information and for the use of practitioners outside Greater Manchester who have a GM patient, or for practitioners within GM if Healthi is unavailable for some reason.
You can find information on the urgency of referrals in Greater Manchester here:
Download pdf Guidance on the Urgency of Referrals in GM
This page provides referral details for patients registered with a GP in Stockport CCG. For patients outside this area, use the GP search to find which CCG area protocols to follow and then consult that area's referral page
Click on the headings below for more information.
- Routine referrals
Routine referrals that are not part of an enhanced service (e.g. cataract, ocular hypertension) generally go via the GP. Remember that only routine referrals go to the GP and you should assume it will be up to 3 months before the patient is seen. "Soon" is not generally recognised by GPs or by HES appointments, so for anything that you feel is more urgent you should phone eye casualty for advice.
Patients already under care In cases where a patient is already under the care of an ophthalmologist and a new routine condition has arisen, you should write to the ophthalmologist rather than re-refer.
An electronic GOS18 template is available here for those areas without access to Healthi:
Learn More Electronic GOS18 template
- General urgent referrals
Stepping Hill Eye Casualty clinic Tel: 0161 419 5689 Fax for letters 0161 419 4979.
If you feel a patient requires to be seen urgently you can phone the Stepping Hill Ophthalmic Urgency Service on 0161 419 5689 and speak to one of the nurse practitioners. They will issue an appointment time. You should give a referral letter to the patient to take with them. If you need to fax a letter the number to use is 0161 419 4979. Always phone before sending the patient.
- Wet AMD
Fax referrals to Optegra on 0207 022 1651 (this is a change of fax number as of June 2018).Or NHSMail: firstname.lastname@example.org For confirmation of receipt you may phone 0161 240 0700
The wet AMD service has been contracted out in Stockport and with effect from 3rd August 2015 is provided from the Optegra Eye Hospital in Didsbury. Any patient over the age of 50 suspected of having wet AMD should be referred to Optegra. If the patient is under the age of 50 and macular pathology is suspected please urgently refer them to NHS Stockport FT (Stepping Hill), please see Urgent referral information. The referral criteria for the Wet AMD service are a less than 3 month history of any of the following:
• Visual loss.
• Spontaneously reported distortion.
• Onset of a missing patch/blurring in the central vision.
• The patient should be over the age of 50.
There is no treatment threshold at the better vision end for Stockport patients so you should not follow the NICE threshold. The vision in the affected eye must be better than 6/96 but it does not have to be worse than 6/12.
Fax the referral to Optegra on 0207 022 1651 using the referral form. For confirmation of receipt you may phone 0161 240 0700Download Form WetAmd July 2018.doc
Or NHS email to Optegra at email@example.com using the referral form.
Request confirmation of receipt by asking the recipient to acknowledge by return email or add a read receipt to your email.
It is important to note that this service is only for patients registered with a Stockport GP. If the patient does not have a Stockport Gp then the referral will be returned to you. You can find details of other Greater Manchester wet AMD pathways by looking at the relevant area's LOC pages. For other areas look for the relevant area's LOC website for information.
The referral form (a Word doc) can be filled electronically or printed. To edit the form, if you wish to add your practice details as a template, choose 'Tools' or 'Review' then 'Unprotect'. In protected mode use TAB to move between fields.
Information for patients about the referral process in Stockport and what to expect can be found here:
Download Form WetAMD Px info sheet for referred patients.pdf
Cataract referral is via the extended service provided by GM Primary Eyecare. Any patient with cataract who you feel will require surgery should be managed using the Optomanager online IT system. The referral will be directed automatically by the system to the chosen treatment centre. For further information
Post-operative cataract assessment and reporting is also via the GMPEC service and Optomanager
If you do not participate in the service or are out of the area, please send the patient to one of the accredited optometrists with a copy of the referral letter.
For further information see the GMPEC website.Learn More GMPEC
- Referrals for Retinal Vein Occlusions
Any CRVO or BRVO should be referred for assessment at Stepping Hill and an urgent referral made to the patient's GP practice for assessment for any underlying cause of RVO. The HES appointment is not normally urgent.
If there are any unusual features (such as patient is unwell, optic nerve head swelling is present or the patient is of a young age) then please ring the urgent clinic to discuss the case. Hospital referrals should be faxed to Fax: 0161 419 4263 or emailed to NHSMail: firstname.lastname@example.org for the attention of Mr Desai.
The PDF file below can be filled electronically or printed.Download Form RVO Referral Stockport.pdf
You can phone 0161 419 4018 (Mr Desai's secretary) to confirm receipt of the fax.
The Adobe Acrobat pdf file above can be filled electronically or printed. Use the Tab Key to move between fields.
- Suspect Glaucoma / Repeat Measures
Repeat Measures In cases of raised IOP in the absence of any other signs of glaucoma the pressures should be repeated on one or two occasions using Goldmann or Perkins tonometry as per the extended service provided by GM Primary Eyecare. The results are reported, and fees claimed, via the Optomanager online IT system.
If you have a patient with raised pressure only, and you do not take part on the extended service, you must refer them to a participating optometrist for further assessment. You can find participating practices on the GMPEC website. Ask the patient where they wish to go and ensure they know. Use a referral letter and provide full details as you would for a GP referral.Learn More Find a practice GMPEC
In Stockport, where there are signs of glaucoma, with or without raised IOP, the patient should be referred routinely in the normal way. Acute closed angle glaucoma is an urgent referral.
- Minor Eye Conditions
If your practice does not participate in this service, then minor eye problems such as red eyes, dry eye, flashes and floaters, foreign bodies etc should be referred to one of the MECS accredited optometry practices.
Learn More A list of practices is available on the GMPEC website:
- Safeguarding Children & Adults
Stockport has websites dedicated to safeguarding:Learn More Safeguarding Children:
Learn More Safeguarding Adults:
Stockport CCG Head of Safeguarding and children is Sue Gaskell 0161 426 5057
All Stockport local contacts and information are contained in the following document from page 64 onwards. The earlier pages contain a lot of general information and resources related to safeguarding.Download GM Primary Care Safeguarding Resource.pdf
The Optical Confederation has guidance on safeguarding:
Download Guidance on Safeguarding
Confirmation of reading this OC guidance is equivalent to Level 1 training for non-professional practice staff.
The NICE link for a child maltreatment quick reference guide is:Learn More Child Maltreatment Guidance
Online training packages for both children and adults are available from DOCET free of charge for all practitioners with GOC registration atLearn More Enrol Children Safeguarding Level 2
Learn More Enrol Adults Safeguarding Level 2
Female Genital Mutilation
As of 31 October 2015, the Department of Health has introduced a duty for all healthcare professionals to report any case of female genital mutilation in girls
(FGM) under the age of 18 to the police. FGM is considered as child abuse, and is illegal under UK law. It is now a legal duty for healthcare professionals to report any cases they may suspect or be made aware of. For optometrists and dispensing opticians, one scenario in which FGM could come to their attention is if a child tells them that it has happened to them.
Full guidance, posters and other resources can be found on the Department of Health's website at:Learn More FGM Mandatory Reporting in Healthcare
- Strokes & TIAs
Current symptoms of an acute stroke or acute TIA require a 999 call and emergency transfer of the patient to hospital.
Where a patient has a past history of a TIA, with symptoms that have fully resolved, they should be advised to consult their GP as soon as possible.
See: Learn More Stroke: Act FAST
You can refer a child directly to the orthoptic department at Stepping Hill using Healthi if you believe a full orthoptic assessment is required.
NHSMail: snt-tr.SKpaediatricophthalmology@nhs.net(only send from an NHSMail address)
Exceptions would be
- White pupil or problem with red reflex
- Sudden onset squint at age 6 years plus i.e. history of waking up with eso, especially with headache, sickness, tilt to head that they didn’t have before
These should go to the eye casualty clinic as urgent referrals.Sight Tests for young children
If a young child is referred to you for a sight test and you are unable to see them, please ensure that you find them an alternative practice that can see them. Young children are screened for poor vision and squints at the local community clinics by orthoptists. If they suspect a problem they are seen by the optometrists at Stepping Hill Hospital. They may later be discharged for refraction in community practices under GOS, with follow up at the hospital. It is helpful to provide a report to the orthoptists following a sight test and the following form may be used:Download Form Children's Follow Up Form.pdf
- Low Vision
The preferred method of referring visually impaired people to social services, whether self-referral by the patient or by a health professional, is by use of this on-line form:
Alternatively, the Low Vision Leaflet (LVL) can be used and can be downloaded here.
Download Form Low Vision Leaflet
The address to send it to is:
Services to People
Tel: 0161 217 6029
Fax: 0161 474 4666
The Sightline Directory allows you to search for support services for a patient by town or postcode, and by type of service if you wish.Learn More Sightline Directory