The rationale behind the decision of a London family health services authority (Lambeth, Southwark, and Lewisham) to embark on a programme for diabetic eye screening by optometrists is outlined, discussing the way in which the scheme was set up and its possible future development. This family health services authority brought together a range of professionals across primary and secondary care to reach agreement on development of the service, and a consensus on clinical guidelines for operation of the scheme. This was particularly difficult in an area served by four hospitals which provide care to diabetics. Development of the scheme identified key questions about quality which have promoted a separate research agenda.
References
1.
BuxtonMJSculpherMJFergusonBAScreening for treatable diabetic retinopathy; a comparison of different methods. Diabel Med, 1991;8:371–7.
2.
Department of Health and Social Security. Causes of blindness and partial sight among adults in 1976/77 and 1980/81 in England., London: HMSO, 1988.
3.
KohnerEMBarryPJ. Prevention of blindness in diabetic retinopathy. Diabetologia, 1984;26:173–9.
4.
JonesRBLarizgoitiaICasadoLBarrieT.How effective is the referral chain of diabetic retinopathy?Diabet Med1989;6:262–6.
5.
RohanTEFrostCDWaldNJ. Prevention of blindness by screening for diabetic retinopathy: A quantitative assessment. BMJ, 1989;299:1198–201.
6.
South East London Health Authority and Lambeth, Southwark and Lewisham Family Health Services Authority. Diabetic health strategy., London: SELHA and Lambeth, Southwark, and Lewisham FHSA, 1993.
7.
South East London Commissioning Agency and Lambeth, Southwark, and Lewisham Family Health Services Authority. Aiming for the best of health., London: SELCA and Lambeth, Southwark, and Lewisham FHSA, 1992.
8.
South East London Health Authority and Lambeth, Southwark, and Lewisham Family Health Services Authority. Towards a health strategy., London: SELHA and Lambeth, Southwark, and Lewisham FHSA, 1993.
9.
WilliamsRNusseySHumphryRThompsonG.Assessment of non-mydriatic fundus photography in detection of diabetic retinopathy. BMJ, 1986;293:1140–2.
10.
BarrieTMacCuishAC. Assessment of non-mydriatic fundus photography in detection of diabetic retinopathy. BMJ, 1986;293:1304–5.
11.
MurphyEKinmouthAL. General practice based diabetes surveillance: The views of patients. Br J Gen Pract, 1992;42:279–83.
12.
Department of Health. Making London better., London: HMSO, 1992.
13.
WilsonCBrownVMorleyVBrowneLEvansT.Cambertvell shared care scheme in diabetes report., London: King's College of Medicine and Dentistry, 1991.
14.
HarrisonRJWildJMHolleyAJ. Referral patterns to an ophthalmic outpatient clinic by general practitioners and ophthalmic opticians and the role of these professionals in screening for ocular diseases. BMJ, 1988;297:1162–7.
15.
Burns-CoxCJHartJC. Screening of diabetics for retinopathy by ophthalmic opticians. BMJ, 1985;290:1052–4.
16.
HillRD. Community care services for diabetics in the Poole area. BMJ, 1976;1:1137–9.
17.
Lambeth, Southwark, and Lewisham Family Health Services Authority. Optometrist diabetic screening programme., London: Lambeth, Southwark, and Lewisham FHSA, 1993.
18.
HurwitzBGoodmanCYudkinJ.Prompting the clinical care of non-insulin (type II) diabetic patients in an inner city area: One model of community care. BMJ, 1993;306:624–30.
19.
World Health Organisation and the International Diabetic Federation. St Vincent declaration on diabetes., Geneva: WHO, 1989.
20.
South East London Health Authority and Lambeth, Southwark, and Lewisham Family Health Services Authority. Improving primary and community care in south east London., London: SELHA and Lambeth, Southwark, and Lewisham FHSA, 1993.
