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 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.

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 accounts

Patient 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:
- • 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
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 390 333

Post:

Cataract Co-ordinator,
Eye Unit, Royal Bolton Hospital
Minerva Road
Farnworth
Bolton
BL4 0JR

Referral pads and invoicing templates are available on request from the LOC.
- 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
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 accounts

Practices 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 GMPEC

Acute 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:
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:
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 accounts

The 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 3NY

Learn 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

Keep upto date

Optical practitioners
and contractors

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.

Bolton Referrals

Referrals in general

Emergency referrals

Keep upto date

Optical practitioners and contractors

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.

Bolton Referrals

Referrals in general

Emergency referrals

Optical practitioners
and contractors