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The Confederation website provides information to optical practitioners, GPs and patients on referral pathways, local services and a range of eye conditions.


Bolton 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.
Practices outside the GM border that see GM Patients can register for the Opera GOS18 function. Where Opera is already used for extended services this will be an easy addition.
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 Bolton 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
Bolton Referrals
Referrals in general
Routine referrals that are not part of an extended service (e.g. cataract,) go via the GOS18 tab on Opera. You should assume it will be up to 3 months before the patient is seen. "Soon/Urgent" is not generally recognised by GPs or by HES appointments, so for anything that you feel is more urgent you should still send your referral using the GOS18 tab on Opera but following the Emergency Eye Referrals protocol below.
Patients already under careIn 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.
Practices without access to Opera for referrals should send any routine referrals to the Bolton Referral Management Booking Service (RMBS).
BolCCG.gpreferrals@nhs.net Referrals should only be sent from NHS.net accounts
An electronic GOS18 template is available here for those areas without access to Healthi:
Download Bolton GOS18 Substitute.doc
Remember that with routine 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.
- Emergency referrals
Emergency referrals
You can phone the Bolton Eye Unit on 01204 487 577 (Option 1) and ask for advice. You should make these referrals via Opera to:
Bolton NHS Foundation Trust
Tel: 01204 487 577
Fax Number: de-commissioned
NHSMail: Boh-tr.BoltonAcuteOphthalmicReferrals@nhs.net
Referrals should only be sent from NHS.net accounts - Wet AMD
You should make these referrals using Opera. You may phone for confirmation.
Bolton NHS Foundation Trust
Tel: 01204 390 390 (ext 390112)
NHSMail: Boh-tr.BoltonAcuteOphthalmicReferrals@nhs.net Referrals should only be sent from NHS.net accountsPatient identifiable information should only be sent by email if both ends are accredited by the NHS as secure. Usually this mean NHS.net(i.e. xx@nhs.net), although Bolton Royal FT has been accredited for the xx@boltonft.nhs.uk email domain
Practices wothout access to Opera for referrals my use this WET AMD Rapid Access form:
Download Bolton WetAMD Refrrral Form.docx
- CUES - Urgent Eyecare Service
If your practice does not participate in this service, then eye problems such as:
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• Red or painful eye or eyelids
• Recently occurring flashes and floaters
• Recent and sudden loss of vision
• Foreign body in the eye
should be referred to one of the CUES accredited optometry practices.
Full details and a practice search are available on the Primary Eyecare Services website CUES page here
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- Cataract
For the past few years we have been operating a direct access scheme within the Bolton area. Accredited optometrists can bypass initial out-patients appointments and refer those suitable for surgery directly into pre assessment clinic.
This helps reduce the patient waiting time and allows more out-patient appointment space for the local ophthalmologists.
Accredited optometrists on deciding to refer perform dilated fundoscopy and counsel Bolton patients on the risks and benefits of surgery. There is currently a high sensitivity in referral from accredited practitioners which reduces inappropriate appointments for patients.
Those who wish to participate in this scheme should attend yearly accreditation meetings. If you wish to become accredited please contact a member of the committee who will advise appropriately.
Guidance is available on the service:
Download Clinical Guidelines for Referral to Bolton Cataract Clinic V52.doc
Copies of the completed referral form should be processed as follows:
Bolton NHS Foundation Trust
Fax: de-commissioned
Tel: 01204 390 333Post:
Cataract Co-ordinator,
Eye Unit, Royal Bolton Hospital
Minerva Road
Farnworth
Bolton
BL4 0JRReferral pads and invoicing templates are available on request from the LOC.
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Mohammed Dawood - Send eMail
Practitioners not accredited to perform cataract pre-ops should use the GOS 18 Substitute and refer as per routine referrals.
Download Bolton GOS18 Substitute.doc
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- Referrals for Retinal Vein Occlusions
Any CRVO or BRVO should be referred by Opera and an urgent referral made to the patient's GP practice for assessment for any underlying cause of RVO. The HES referral is not normally urgent unless there is oedema or hamorrhaging at the macula. If there are any unusual features (such as the patient is unwell, optic nerve head swelling is present or the patient is of a young age, then please ring the clinic to discuss the case.
You can phone the Bolton Eye Unit on 01204 390 333 and ask for advice. You should make these referrals via Opera to:
Bolton NHS Foundation Trust
Tel: 01204 390 333
NHSMail: Boh-tr.BoltonAcuteOphthalmicReferrals@nhs.net Referrals should only be sent from NHS.net accountsPractices without access to Opera for referrals may use the form below for referral. You should also advise the patient to see their GP
Download Form Electronic Referral Form
This includes the GP referral as a 2nd page which fills automatically from page 1.
- Suspect Glaucoma / OHT
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 Primary Eyecare Services. The results are reported, and fees claimed, via the Opera 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 GMPECAcute Angle Closure GlaucomaAcute angle closure glaucoma and/or IOPS of >32mmHg is an emergency referral.
Out of AreaPatients from outside the area should be referred according to their own area's protocol.
Practices outside the area should refer patients to GERS with a supporting letter and a copy of their visual fields where performed. You can search for a local practice providing the service using the same link above
- Orthoptics
Referrals to Orthoptics should be made through Opera
Practices without access to Opera for referrals should sen their referrral via the RBMS at:
BolCCG.gpreferrals@nhs.net Referrals should only be sent from NHS.net accounts - Safeguarding Children & Adults
Safeguarding in the Bolton Area for Children
If you are concerned about the welfare of a child, call or contact one of the following:
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Bolton's Referral and Assessment Team on 01204 331500 Office hours only 9.00am-5.00pm
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Outside these times you can contact Bolton Emergency Duty Team – 01204 337777
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NSPCC 24hr 0808 800 5000 e-mail: helpline@nspcc.org.uk????.
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Police on 101 or in an emergency call 999
Learn More Vist the Keeping Children Safe in Bolton website:
Safeguarding in the Bolton Area for Adults
If you are concerned about the welfare of an Adult, call or contact one of the following:
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01204 337000 to Report Abuse
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01204 332032 for Professional Advice
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Police on 101 or in an emergency call 999
Learn More Visit Bolton's Safeguarding Adults at Risk website
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.
For further information see:
Learn More Stroke
The GOS contract does not allow you to discriminate between patients by, for instance, not seeing a particular age group. If an infant presents to you for a sight test and you are uncomfortable seeing them you should ensure that you find them an alternative practice that can see them.
- Low Vision
Referrals for assessment for low vision aids should go routinely through Opera or via the RBMS at:
BolCCG.gpreferrals@nhs.net Referrals should only be sent from NHS.net accountsThe Low Vision Leaflet (LVL) for putting visually impaired people in touch with social services can be downloaded here:
Download Form Low Vision Leaflet
The address to which it should be sent is:
Independent Living Service, Adelaide Depot,
Adelaide Street,
Bolton,
BL3 3NYLearn More Visit The directory for services aimed at helping blind or partially sighted people.
The Sightline Directory allows you to search for support services for a patient by town or postcod, and by type of service if you wish.
Learn More Sightline Directory