Heywood, Middleton & Rochdale 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 Heywood, Middleton & Rochdale Referrals 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 practices outside the area without access to Opera for referral:

  Download Form 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
  Croft Shifa Health Centre
  Follow up telephone: 0333 321 8844
  NHS Mail: practiceplusgrp.macular@nhs.net or
  Rochdale Eye Unit: (telephone lead nurse first)
  Tel 01706 901 800
  NHSMail: urgentreferrals@nca.nhs.uk

  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.

  You may phone to request confirmation of receipt of a faxed referral.

  This information is for patients registered with a GP in HMR. 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.

   

•   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

  Cataract referrals in HMR go via the Opera GOS18 tab.

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

•   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
  Croft Shifa Health Centre
  Tel: 01706 764 722
  NHS Mail: practiceplusgrp.nwophthalmology@nhs.net or
  Rochdale Eye Unit: (telephone lead nurse first)
  Tel 01706 517838
  NHSMail: urgentreferrals@nca.nhs.uk

  out of hours ask for on-call ophthalmologist via switchboard Tel 01706 377 777

  An electronic referral form is available here:

  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 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 HMR Orthoptics can be made through Opera to the HMR Community Eye Service.

  Practices without access to Opera should send referrals to:

  HMR Community Eye Service
  Townside Primary Care Centre
  1 Knowsley Street
  Bury, BL9 0SN
  
  T: 0161 762 1692
  E: cesburyandhmr@nca.nhs.uk (only send from an NHSMail address)

•   Safeguarding Children & Adults

  Safeguarding in the Heywood, Middleton and Rochdale Area for Adults

  If you are concerned about the welfare of an Adult, call or contact one of the following:

  • • Adults Care Services Team : 0300 303 8886 Monday to Friday 8.30am-4.45pm or 0300 303 8875 at all other times

  • • Greater Manchester Police: 0845 226 5500, 101 or in an emergency 999

  The Adult Care Services website is here:

  Learn More Rochdale Stay Well

  Learn More Safeguarding adults at risk

  Safeguarding in the Heywood, Middleton and Rochdale Area for Children

  If you are concerned about the welfare of a child, call or contact one of the following:

  • • Children's Social Care Services : 0300 303 0440 Monday to Friday 8.30am- 4.45pm or 0300 303 8875 at all other times. e-mail: social.services@rochdale.gov.uk

  • • Rochdale Borough Safeguarding Children Board (RBSCB) website: www.rbscb.org

  • • NSPCC 24hr 0808 800 5000 e-mail: helpline@nspcc.org.uk

  • • Greater Manchester Police on 101, or in an emergency 999

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  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.

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  The NICE link for a child maltreatment quick reference guide is:

  Learn More Child Maltreatment Guidance
  

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  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

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  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.

  See: Learn More Stroke: Act FAST

  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 & Sight Loss Services

  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

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  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:

  Adult Social Care
  Number One Riverside
  Smith Street
  Rochdale
  OL16 1XU

  Tel: 0300 303 8886social.services@rochdale .gov.uk

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  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