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: pah-tr.urgentreferrals@nhs.net
Out of hours ask for on-call ophthalmologist
via switchboard 01706 377 777
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.

Bury Care UK
BandQ Carpark, Industrial Park,
Bridgehall, Bridge Hall Lane
Bury
BL9 7PJ
Follow up telephone: 0333 321 8844
NHS Mail: cuk.northwestmacular@nhs.net

Or

Pennine Acute Hospitals NHS Trust
Tel: 01706 901 800
NHSMail: pah-tr.urgentreferrals@nhs.net

Or

Bolton NHS Foundation Trust
Tel: 01204 390390 (ext. 390112)
Fax: decommissioned
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

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 for referrals, 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.

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. For further information
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. You can search for an accredited practice using the link below.

Learn More Find a Practice
CUES- Urgent Eyecare Service
If your practice does not participate in this service, then eye problems such as:
- • 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

Learn More 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.

Bury Care UK
BandQ Carpark, Industrial Park,
Bridgehall, Bridge Hall Lane
Bury
BL9 7PJ
Fax: 01706 638594
Follow up telephone: 0333 321 8844
NHS Mail: cuk.northwestmacular@nhs.net

Or

Rochdale Eye Unit 9-5pm, 01706 517 838, out of hours ask for on-call ophthalmologist via switchboard 01706 377 777
NHSMail: pah-tr.urgentreferrals@nhs.net

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 do not participate in the service or are out of the area, you must send the patient to one of the accredited GERS optometrists with a copy of the referral letter. You can search for an accredited practice using the link below.

Learn More Find a Practice

Glaucoma Enhanced Referral Service (GERS) Where there are signs of glaucoma, with or without raised IOP and/or suspicious fields, patients should be referred directly to the GERS service via a GOS18 referral on OPERA. You can either refer to a GERS practice or to the Bury Community Eye Service

For a practice: “routine” – “primary care services” – “GERS” – “Practice select”

For BCES: “routine” – “ophthalmology” – “glaucoma” – "Bury Glaucoma Community Eye Service"

You should detail reasons for glaucoma suspicion and a copy of their visual fields where performed. You can search for a local practice providing the service using the same link above.

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 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

T: 0161 762 1692
E: pcn-tr.CESBuryandHMR@nhs.net (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

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

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Optical practitioners
and contractors

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

Keep upto date

Optical practitioners and contractors

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

Optical practitioners
and contractors