Referral Pathways – Reminder

This reminder has arisen out of Clinical Commissioning Group (CCG) and GP concerns that some optometrists are by-passing services commissioned within Hampshire and Isle of Wight (HIOW) and are instead referring patients directly to independent providers, reportedly due to their ‘shorter waits’.

Hampshire LOC has been informed that direct referral for NHS cataract surgery via non-commissioned pathways is not endorsed by any of the CCGs within HIOW.

Although most patients have a right to ‘Patient Choice’  the CCGs within HIOW request that this right is exercised via a patient’s GP as they can assess where the shortest waiting time is, so that ‘shared decision making’ is correctly applied and the patient’s full medical history, including allergies, can be forwarded with the referral to the preferred provider using e-RS in order to aid the safe and effective delivery of care.


Hampshire LOC is aware that Covid-19 related delays in cataract surgery has resulted in patients facing the prospect of an extended wait for their NHS treatment and we, like the whole healthcare community, are keen for this to improve.  However, we would like to remind optometrists to continue to refer patients via recommended locally commissioned pathways which for cataracts are:

Southampton                          Solent Medical Services
West Hampshire                     Via GP
Portsmouth                             Practice Plus  (Previously Care UK)
South East Hampshire            Practice Plus               ”
Fareham and Gosport             Practice Plus               ”
Mid Hampshire                       Via GP
North Hampshire                    Via GP
Isle of Wight                            Direct to St Mary’s IOW HES
College of Optometrists Guidance regarding referrals as follows:

You must refer patients with appropriate urgency. If there are local protocols in place for referrals, including emergency or urgent referrals, you should
follow these…….

Although Hampshire LOC, along with primary care optometrists, are frustrated with the current waiting times for many secondary care services, it is the CCGs who are responsible for commissioning health care for their local population

We have been assured that Hospital Trusts and CCGs are looking to commission additional capacity for cataract surgery but first need to fulfil their ‘duty of care’ by looking at factors such as the safety of the healthcare services they commission and fair and equitable access.

Current referral pathways as known are described on the following Hampshire LOC web pages.