Bury Referrals

Opera Electronic Referral 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 Bury 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.

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.

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

Learn More Electronic GOS18 template
Emergency referrals

If you feel a patient requires to be seen urgently you can phone the Rochdale Eye Unit from 9.00 till 5.00pm on 01706 517 838 and ask for advice. You should then send the referral on Opera but also contact the Eye Unit where they will issue an appointment time. Out of hours ask for the on-call ophthalmologist via the switchboard on 01706 377 777

Rochdale Eye Unit 9-5pm
Tel : 01706 517 838
NHSMail : urgentreferrals@nca.nhs.uk
Out of hours ask for on-call ophthalmologist
via switchboard 01706 377 777

Where a patient attends with acute onset eye problems and your practice does not deliver CUES, a referral to CUES may be the most appropriate outcome for the patient. Please see the Primary Eyecare Services website CUES page for more information.
Wet AMD
All referrals for WetAMD should be made using Opera. You can refer to one of the providers listed below. You may phone for confirmation of receipt of the referral.

Practice Plus Group BandQ Carpark, Industrial Park,
Bridgehall, Bridge Hall Lane
Bury
BL9 7PJ Follow-up telephone : 0333 200 4058 (Mon-Fri 08.30-17.00)
NHSMail : practiceplusgrp.macular@nhs.net

Or

Pennine Acute Hospitals NHS Trust
Tel : 01706 901 800
NHSMail : urgentreferrals@nca.nhs.uk

Or

Bolton NHS Foundation Trust
Tel : 01204 390390 (ext. 390112)
NHSMail : Boh-tr.BoltonAcuteOphthalmicReferrals@nhs.net

Out of area practices may use the WET AMD Rapid Access form below. Please ring the lead nurse prior to sending the WET AMD Rapid Access referral.

Download WetAmd Referral Form

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.

EMAC If your patient meets the criteria for potencial wet AMD treatment then you can refer to the MREH Emergency Macula Service (EMAC). Please refer via Opera and include a phone number for the patient so the administration team at MREH can contact them with an appointment. Please print off a copy of the patient information form and give this to the patient.

If you don’t have Opera access. Please refer by completing the form below and send via your “nhs.net” email account.

Download Form EMAC Referral Form.pdf

Download Form EMAC Patient Information Form.pdf

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

*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.

Wrightington, Wigan and Leigh NHS Foundation Trust
Tel : 01942 244 000
NHSMail : wwl-tr.UrgentEyes@nhs.net

Refer using Opera.

For any queries, please contact Kirstin Lee on 0161 762 3073, or e-mail Kirstin.lee@nhs.net

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 vision should be better than 6/96 in the affected eye. If the vision is better than the accepted treatment threshold of 6/12 you should refer them anyway so they can be diagnosed and monitored.

This information is for patients registered with a GP in Bury. You can find details of other Greater Manchester wet AMD pathways by looking at the relevant area's LOC pages. For areas outside GM look for the relevant area's LOC website for information.

The referral form (a Word doc) can be downloaded here:

Download WetAmd Referral Form

This 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.
Cataract

Cataract referral is via the extended service provided by Primary Eyecare Services. Any patient with cataract who you feel will require surgery should be managed using the Opera online IT system. The referral will be directed automatically by the system to the chosen treatment centre.
If you do not participate in the service, or are out of the area, a practice for pre cat can be found by using OPERA GOS18 – primary care services – pre cat. You should call the practice to check they will see the patient before referring it on OPERA.

Post-operative cataract assessment and reporting is also via the Primary Eyecare service and Opera

If you do not participate in the service or are out of the area, you must send the patient to one of the accredited optometrists with a copy of the referral letter.
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
Referrals for Retinal Vein Occlusions

Any CRVO or BRVO should be referred by Opera. An urgent referral should also be 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.

Practice Plus Group BandQ Carpark, Industrial Park,
Bridgehall, Bridge Hall Lane
Bury
BL9 7PJ Follow-up telephone : 0333 200 4058 (Mon-Fri 08.30-17.00)
NHSMail : practiceplusgrp.macular@nhs.net

Or

Rochdale Eye Unit Tel : 01706 517 838 (09.00-17.00)
(If out of hours ask for on-call ophthalmologist via switchboard 01706 377 777)
NHSMail : urgentreferrals@nca.nhs.uk

Any CRVO or BRVO should be referred by Opera for assessment and an urgent referral also made to the patient’s GP practice for assessment for any underlying cause of RVO. The HES referral is not normally urgent. 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.

An electronic referral form is available here for use by out of area practices:

Download Form Electronic Referral Form
Suspect Glaucoma / OHT

Glaucoma repeat readings (GRR) In cases of raised IOP and/or suspicious visual fields in the absence of any other signs of glaucoma the pressures or visual fields should be repeated on one or two occasions using Goldmann or Perkins tonometry or full threshold visual field testing as per the extended service provided by Primary Eyecare Services. The results are reported, and fees claimed, via the Opera online IT system.

If the pressure is still raised after the 2nd repeat, or the visual field shows repeatable glaucoma suspicion, then the patient will be referred to the HES glaucoma clinic.

If you have a patient with raised pressure or suspect visual fields, and you do not take part in the extended service, you must refer them to a GERS optometrist for further assessment. Follow the referral information for GERS detailed below.

Glaucoma Enhanced Referral Service (GERS) The Glaucoma Enhanced Referral Service now uses a Single Point of Access (SPoA) for patients. Greater Manchester patients eligible for GERS should be be referred to the PES GERS single point of access (SPoA) and NOT directly to a GERS practice. You should use the:
"PRIMARY EYECARE SERVICES – GLAUCOMA ENHANCED REFERRAL SERVICE (GERS)"
option on Opera’s GOS18 module.

Remember that hospitals may reject referrals if they have not come through the correct pathway.

Acute Angle Closure GlaucomaAcute angle closure glaucoma and/or IOPS of >32mmHg is an emergency referral and is NOT suitable for GERS.

Patients with Narrow Angles Only: These patients are not suitable for GRR/GERS. Instead, please refer to the "PACS+" guidance for appropriate management. Detailed information about PACS+ is available on the College of Optometrists website.
Learn More

Patients already under HES care for OHT or GlaucomaThese patients are not suitable for GERS.

Out of AreaPatients from outside the area should be referred according to their own area's protocol.

Practices outside the area and without access to Opera for referrals can find a list of participating practices using the link below. Use a referral letter and provide full details as you would for a GP referral.

Learn More Find a Practice
Orthoptics

Referrals for Orthoptics can be made through Opera to the Bury Community Eye Service.

Practices without access to Opera should send referrals to:

Bury Community Eye Service
Townside Primary Care Centre
1 Knowsley Street
Bury, BL9 0SN

Tel : 0161 762 1692
NHSMail : cesburyandhmr@nca.nhs.uk (only send from an NHSMail address)
Safeguarding in the Bury Area for Children & Adults
If you are concerned about the welfare of an Adult, call or contact one of the following:
- • Adults Care Services customer contact centre: 0161 253 5151 normal office hours.
- • Emergency Social service team: 0161 253 6606 at all other times
- • Greater Manchester Police: 0161 872 5050, or in an emergency 999
- • Age UK Bury : 0161 763 9030
Safeguarding Adult Awareness Training www.adultsocialcarejobsbury.co.uk

If you are concerned about the welfare of a child, call or contact one of the following:
- • The Bury Multi-Agency Safeguarding Hub (MASH) Team on 0161 253 5678
- • Greater Manchester Police on 101 or in an emergency 999
- • Greater Manchester Police Safeguarding Vulnerable persons unit 0161 253 6168
- • NSPCC 24hr line 0808 800 5000
- • Bury Social Services out of hours 0161 253 6606
- • Bury Safeguarding Children Board 0161 253 6153
- • Multi-agency safeguarding children website www.safeguardingburychildren.org
Strokes & TIAs

Current symptoms of an acute stroke or acute TIA (i.e. FAST positive) 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, refer the patient by phone to their own GP for same day assessment. If appropriate the GP will refer them to the TIA clinic. If you are unable to contact GP then it is reasonable to refer to A&E.

Learn More Stroke: Act FAST
Low Vision & Sight Loss Services
Low Vision Service

Low Vision is a commissioned service in Bury and is currently delivered across three sites in the borough by the Community Eye Service:
- Tottington Health Centre, 16 Market Street,
- Tottington, Bury, BL8 4AD
- Radcliffe Primary Care Centre, 69 Church Street West,
- Radcliffe, M26 2SP
- Bury Society for Blind & Partially Sighted People (BBS),
- 4 Tenterden Street, Bury, BL9 0EG
Given the difficulties and vulnerability of this patient cohort, the assessment is holistic in its approach. The Community Eye Service can offer low vision aid support to these clients to promote their ability to access printed information, to aid their independent living in a variety of visual tasks – reading, writing, distance viewing, television, craft, hobbies and glare. Low vision aids will be supplied at no cost to the client and on loan. Clients will be instructed on how to use the aids and follow up support offered as required.

By conducting a joint assessment with Bury Society for Blind & Partially Sighted People they can ascertain what other support the clients require via the Local Authority and the charity.

Bury residents can make a self-referral to this service but they welcome referrals from Optometrists through the electronic referral system Opera to the following endpoint:

COMMUNITY EYE SERVICE BURY- LOW VISION-ADULT

If you have any questions kindly call the Community Eye Service on 0161 762 1692.

Sight Loss Support Service (RNIB)

With the agreement of the patient you can refer them to the RNIB Sight Loss Support Pathway through the Opera GOS18 module:
- • Priority: Routine
- • Speciality: Ophthalmology
- • Clinic type: Sight Loss Support Service
- • Provider: RNIB advice & Support
You can access the support flow diagram here

Download Sight Loss Support Flow Diagram

The RNIB support booklet is here
Download RNIB Support Booklet
Social Services

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:

Sensory Team
Textile Hall
Manchester Rd
Bury
BL9 0DG

Tel : 0161 253 5151

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

Optical practitioners
and contractors

Interested in Enhanced Services?

Bury Referrals

Opera Electronic Referral 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.

Female Genital Mutilation

Low Vision Service

Sight Loss Support Service (RNIB)

Social Services

Optical practitioners and contractors

Interested in Enhanced Services?

Bury Referrals

Opera Electronic Referral 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.

Female Genital Mutilation

Low Vision Service

Sight Loss Support Service (RNIB)

Social Services

Optical practitioners
and contractors