Salford Referrals

Opera Electronic Referrral System

All referrals by practitioners within Greater Manchester for a patient with a Greater Manchester GP should be made through the Opera electronic referral platform. This will route the referral appropriately and also enables patient demographic and 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 only if Opera 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 Salford 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 with routine referrals 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.

Routine referrals for patients outside Salford should use the referral route for their area – check the relevant area referral page.

An electronic GOS18 template is available here for those without access to Healthi:

Learn More Electronic GOS18 template
Emergency Eye referrals
If you feel a patient needs to be seen urgently you can refer to MREH or Bolton (see end of section):

You should always phone to request confirmation of receipt of a faxed referral.

Manchester Royal Eye Hospital Emergency Eye Department (EED)
Patients should be sent to MREH EED only after the patient case has been discussed with the department or where the presenting complaint falls under the red section of the referral guidance document.

Optometrists, who have referred a patient via Opera for an EED opinion should wait for feedback via Opera - more detail below.

Please give the the patient a referral letter to take with them.

Download pdf Guidance on the Urgency of Referrals in GM

Contact details:
08:00 - 20:00 every day including Bank Holidays
Tel: 0161 276 5597/5599 for advice only

Please consult this webpage frequently for updates regarding the telephone numbers as the phone system is currently under review

CUES
If you are not providing CUES in your practice you should consider whether the CUES service could meet your patient’s needs, eg. does this patient meet CUES suitability criteria and could this patient be dealt with by an Independent Prescribing Optometrist in CUES. If this is the case please refer the patient into CUES. More information is available on the ,Primary Eyecare's CUES webpage here.

EED opinion via Opera,
If referring by Opera the referral will go by eRS and you should expect feedback within 1 hour, Monday-Friday 9:00-17:00. If you have not heard within 1 hour, please phone the department or CUES telephone line (if you are a CUES optometrist) to verify that the department have received the case for review via eRS. The patient can leave your practice, but you should advise the patient you will contact them once a decision has been made by the hospital and before they attend EED.

EMAC
Emergency macula referrals can be made direct to the EMAC service, so the patients can have scans and images taken quickly to make a diagnosis and initiate a treatment plan.

Call the EMAC team while the patient is still with you to organise an urgent appointment for that patient.

Telephone number - 0161 701 3419

Then send clinical details to the EMAC team using one of the following methods:
- • MREH EMAC referrals via Opera - for those with access to Opera you should always send EMAC referrals this way, following a phone call to arrange an appointment.
  
  • For Optometrists without access to Opera, you should refer patients by completing the below form and send via your nhs.net email account.
Download Form EMAC Referral Fillable Form.pdf

Email: mft.macular@nhs.net - only secure if sent from an nhs.net account

The NHS has been told to remove all fax machines. MREH will not receive supporting clinical details to the EMAC fax (0161 701 0262) from 1st April 2021.

*retinal vein occlusions with macular oedema may also be sent via this pathway. All retinal vein occlusions regardless of referral pathway require a referral to GP for systemic work up.

MREH Macular
Optometrists with access to the necessary imaging equipment, who are confident of a diagnosis and that there is treatable pathology can refer via the MREH Macular pathway on Opera.

This type of referral enables patients to be booked directly into a clinic for a first treatment, rather than attending initially for diagnostic imaging. In order to refer to this service optometrists must:
- • Provide full OCT image files (not just slices) and colour fundus images for both eyes via the opera system
  
  • Have identified wet AMD, Myopic CNV or * retinal vein occlusion with macular oedema and you are confident the pathology is treatable
If the 2 points above are not met, then send the patient to the EMAC pathway. You can still attach images to assist triage.

The clinical team can then assess the referral and images and book the patient in for treatment if criteria is met.

If the referral does not meet the criteria above, the referral will be rejected with instructions on what to do next; this may be to refer to the EMAC service with a telephone call and sharing the clinical information as above.

Please note it is sometimes decided that patients will need images repeated in EMAC if an OCT A is required or the images need repeating.

* All retinal vein occlusions regardless of referral pathway require a referral to GP for systemic work up.

Bolton NHS Foundation Trust
Tel: 01204 390 333
Fax Number: 01204 390 051 (Urgent)
NHSMail: Boh-tr.BoltonAcuteOphthalmicReferrals@nhs.net

If you feel a patient requires to be seen urgently you can phone the Bolton Eye Unit on 01204 390 333 and ask for advice.
Wet AMD
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 scotoma (or blurred spot) in central vision.
The vision should be better than 6/96 in the affected eye.

If your patient meets the criteria for potential wet AMD treatment, then you can refer to the MREH Emergency Macula Service (EMAC) or to Bolton.

EMAC
If your patient meets the criteria for potential wet AMD treatment, then you can refer to the MREH Emergency Macula Service (EMAC). You should phone to make the patient an appointment so the patients can have scans and images taken quickly to make a diagnosis and initiate a treatment plan.

Call the EMAC team while the patient is still with you to organise an urgent appointment for that patient.

Telephone number - 0161 701 3419

Then send clinical details to the EMAC team using one of the following methods:
- • MREH EMAC referrals via Opera - for those with access to Opera you should always send EMAC referrals this way, following a phone call to arrange an appointment.
  
  • For Optometrists without access to Opera, you should refer patients by completing the below form and send via your nhs.net email account.
Download Form EMAC Referral Fillable Form.pdf

Email: mft.macular@nhs.net - only secure if sent from an nhs.net account

The NHS has been told to remove all fax machines. MREH will not receive supporting clinical details to the EMAC fax (0161 701 0262) from 1st April 2021.

*retinal vein occlusions with macular oedema may also be sent via this pathway. All retinal vein occlusions regardless of referral pathway require a referral to GP for systemic work up.

MREH Macular
Optometrists with access to the necessary imaging equipment, who are confident of a diagnosis and that there is treatable pathology can refer via the MREH Macular pathway on Opera.

This type of referral enables patients to be booked directly into a clinic for a first treatment, rather than attending initially for diagnostic imaging. In order to refer to this service optometrists must:
- • Provide full OCT image files (not just slices) and colour fundus images for both eyes via the opera system
  
  • Have identified wet AMD, Myopic CNV or * retinal vein occlusion with macular oedema and you are confident the pathology is treatable
If the 2 points above are not met, then send the patient to the EMAC pathway. You can still attach images to assist triage.

The clinical team can then assess the referral and images and book the patient in for treatment if criteria is met.

If the referral does not meet the criteria above, the referral will be rejected with instructions on what to do next; this may be to refer to the EMAC service with a telephone call and sharing the clinical information as above.

Please note it is sometimes decided that patients will need images repeated in EMAC if an OCT A is required or the images need repeating.

Bolton NHS Foundation Trust
Tel: 01204 390 333
Fax Number: 01204 390 051 (Urgent)
NHSMail: Boh-tr.BoltonAcuteOphthalmicReferrals@nhs.net

Email contacts:

You should always phone to request confirmation of receipt of a faxed referral.
- Ann Haughton - ann.haughton@boltonft.nhs.uk
- Wendy Dawson - wendy.dawson@boltonft.nhs.uk
Tel: 01204 390 390 ext 3529

Patient identifiable information should only be sent by email if both ends are NHSMail (i.e. xx@nhs.net)

Bolton Royal Hospital is involved in the management of Wet ARMD using Lucentis injections. In order for referrals to be accurately processed the hospital has developed a dedicated form for referral. This will ensure that referrals for Wet ARMD are clearly visible to the triage staff which should facilitate a better service for those patients.

Use this WET AMD Rapid Access form:

Download Bolton WetAMD Refrrral Form.docx
Cataract

Cataract referral is via the extended services commissioned by the CCGs. For further information see the Extended services page of the S&T website:

The referral form can be downloaded here:
Download Form Salford Cataract Referral Form

Available providers are:

Royal Bolton Hospital Minerva Road
Farnworth
Bolton BL4 0JR

Optegra Manchester Eye Hospital One Didsbury Point
2 The Avenue (off The Boulevard)
Didsbury
Manchester, M20 2EU
Tel: 0207 509 4186
Fax: 0207 022 1651 http://www.optegra.com/our-hospital/manchester

Spa Medica Citygate Central Blantyre Street
Castlefield
Manchester M15 4SQ
Tel: 0161 838 0870
Fax: 0161 835 1704 www.spamedica.co.uk

Warrington & Halton Hospitals NHS Foundation Trust Ophthalmology Primary Care Clinic
Lovely Lane
Warrington WA5 1QG
Fax No: 01925 662209 (If faxing the referral a hard copy is also required)

Royal Albert Edward Infirmary Ophthalmology New Appointments
Wigan Lane
Wigan
Lancashire
WN1 2NN
Fax No: 01942 773308

Scanned Referrals can also be sent via email to wwl-tr.GPReferrals@nhs.net, but only from another NHS Mail account.
Referrals to the Royal Albert Edward will have the assessment and pre-op in Wigan but the actual surgery will be carried out at Leigh Infirmary.
Referrals for Retinal Vein Occlusions
CRVO and BRVO with haemorrhaging at the fovea should be sent urgently to the MREH Emergency Macula Service (EMAC).

EMAC
Emergency macula referrals can be made direct to the EMAC service, so the patients can have scans and images taken quickly to make a diagnosis and initiate a treatment plan.

Call the EMAC team while the patient is still with you to organise an urgent appointment for that patient.

Telephone number - 0161 701 3419

Then send clinical details to the EMAC team using one of the following methods:
- • MREH EMAC referrals via Opera - for those with access to Opera you should always send EMAC referrals this way, following a phone call to arrange an appointment.
  
  • For Optometrists without access to Opera, you should refer patients by completing the below form and send via your nhs.net email account.
Download Form EMAC Referral Fillable Form.pdf

Email: mft.macular@nhs.net - only secure if sent from an nhs.net account

The NHS has been told to remove all fax machines. MREH will not receive supporting clinical details to the EMAC fax (0161 701 0262) from 1st April 2021.

*retinal vein occlusions with macular oedema may also be sent via this pathway. All retinal vein occlusions regardless of referral pathway require a referral to GP for systemic work up.

MREH Macular
Optometrists with access to the necessary imaging equipment, who are confident of a diagnosis and that there is treatable pathology can refer via the MREH Macular pathway on Opera.

This type of referral enables patients to be booked directly into a clinic for a first treatment, rather than attending initially for diagnostic imaging. In order to refer to this service optometrists must:
- • Provide full OCT image files (not just slices) and colour fundus images for both eyes via the opera system
  
  • Have identified wet AMD, Myopic CNV or * retinal vein occlusion with macular oedema and you are confident the pathology is treatable
If the 2 points above are not met, then send the patient to the EMAC pathway. You can still attach images to assist triage.

The clinical team can then assess the referral and images and book the patient in for treatment if criteria is met.

If the referral does not meet the criteria above, the referral will be rejected with instructions on what to do next; this may be to refer to the EMAC service with a telephone call and sharing the clinical information as above.

Please note it is sometimes decided that patients will need images repeated in EMAC if an OCT A is required or the images need repeating.

* All retinal vein occlusions regardless of referral pathway require a referral to GP for systemic work up.
Community Orthoptic Services

Orthoptic referrals can be made to the Salford community orthoptic service. Complete the referral in Healthi and then print and post to:

Orthoptic DepartmentSalford Royal NHS Foundation Trust
Salford Care Organisation
3rd Floor Sandringham House
Windsor Street
Salford
M5 4DG
NHSMail: orthoptics.salford@nhs.net(only send from an NHSMail address)
Suspect Glaucoma / Repeat Measures

OHT In cases of raised IOP in the absence of any other signs of glaucoma the pressures should be repeated on one or two occasions, as required, using Goldmann or Perkins tonometry as per the extended service commissioned by the CCGs.

For further information see the Extended services page of the S&T website:

Learn More Electronic GOS18 template

Glaucoma Where there are other 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.
Safeguarding Children & Adults in Salford

Safeguarding in the Salford Area for Children (0-18 years)

If you have concerns that a child or young person is at risk of or being abused or neglected you can contact the Salford Safeguarding Children's Board to report your concern:

Tel: 0161 603 4500(Bridge Partnership - Monday to Friday 8.30am to 4.30pm)

Tel: 0161 794 8888 (Outside office hours and weekends and public holidays- Emergency Duty Team)

http://www.partnersinsalford.org/sscb/contactus.htm

Safeguarding in the Salford Area for Adults If you have concerns that an adult is at risk of or is being abused/neglected you can report your concern on the telephone numbers below.

Salford Adult Social Care Contact Team
Tel: 0161 631 4777 Email: worriedaboutanadult@salford.gov.uk

Adult Social Care Emergency Duty Team (out of hours)
Tel: 0161 794 8888 4.30pm to 8.00am weekdays and 24 hours over weekends and bank holidays

CCG Lead Nurse Adult Safeguarding
Tel: 0161 212 5657 http://www.partnersinsalford.org/as-contacts.htm

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 at
Learn 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.
Learn More See Stokes
Low Vision

The Low Vision Leaflet (LVL) for putting visually impaired people in touch with Salford social services can be downloaded here.
Download Form Low Vision Leaflet

It should be sent to:
Adult Health & Social Care Team
1st Floor Unity House
Chorley Road
Swinton
M27 5AW

Information is available from:
Visual Impairment Sensory Team
Salford Health & Social Care Division
Salford Royal NHS Foundation Trust
Burrows House
10 Priestley Road
Yardley Business park
Salford
M28 2LY

Tel: 0161 631 4777

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