The Community Ophthalmology Service


Evolutio provide the foundation infrastructure, administration, regulation and sustainable platform to grow, rethink and revolutionise your local ophthalmology service provision.

The service is led by consultant ophthalmologists working with a team of appropriately qualified clinical practitioners to ensure a high level of clinical delivery, supervision and leadership. We offer a unique and bespoke community ophthalmology model, enabling a truly holistic approach to eye care provision for patients across primary, community and secondary care.

Shared care with consultant oversight and the latest in telemedicine technology

A proven reduction in secondary care referrals

Operating at a percentage of tariff with proven savings

CCG locality controlled pathway management

The eCare Community Ophthalmology Service provides a sustainable and scalable solution to the provision of a consultant-led community based ophthalmology service, integrating primary, community and secondary care.

We offer a multi-disciplinary service that operates between existing primary and secondary eye care services, utilising bespoke shared electronic medical records and OCT telemedicine to serve as a mechanism to ensure the safe assessment, diagnosis and treatment of defined ophthalmic conditions in a setting that is easily accessible and convenient for patients. Our service model enables the safe management of patients within the community, where appropriate, and ensuring that patients who require specialist treatment are referred to the most appropriate secondary or specialist care service.

of patients seen within an eCare clinic are kept out of secondary care

Reducing activity in secondary care

With the introduction of the eCare Community Ophthalmology Service, a reduction of first outpatient activity in secondary care by up to 22% will be realised, through the utilisation of community based pathways, delivered through our eCare network. The number of follow up out-patient appointments will reduce as the system ensures that only patients requiring specialist clinics will be referred to the hospital eye service.

Through our current services, we manage in excess of 4,500 patients per month with an onward referral rate from eCare pathways to secondary care of approximately 16%. Effective clinical triage with consultant review ensures that patients are referred to the right service first time, reducing the number of contacts and subsequent costs in the patient journey.

Through the offer of patient choice, the referral support service will also support a reduction in the number of DNA’s at provider sites, significantly reducing the number of missed appointments and allowing clinics to be booked and managed more effectively. Detailed analysis on the services that we currently deliver shows that the implementation of the referral support service has reduced referrals to secondary care by as much as 4.8% (based on routine referrals only).

would recommend an eCare clinic to a friend or family member

Through the implementation of our service, local healthcare economies will realise a number of benefits including:

  • Provision of accurate and patient-centric information
  • Implementation of an electronic shared care record
  • Cost effective access to electronic bookings and referrals
  • Interoperability between community optometrists and primary/secondary care services
  • Introduction and utilisation of innovative technologies
  • Data to support informed commissioning decisions
  • More effective use of clinical resources
  • Improved service quality
  • Reduced DNA rates
  • Increased value for money
  • Reduced longstanding variations in treatment and pathways
  • Improved appropriateness of care (right care, right place, right time)

Providing equitable access for all

Establishing a convenient and accessible service for both referrers and patients is paramount to the delivery of a successful eCare Community Ophthalmology Service. We strive to provide high quality services to each patient, ensuring that their needs are taken into account and providing equitable access for all. As part of this, we recognise that some people may experience discrimination and barriers to accessing services, including those with protected characteristics. We make it part of our duty to actively address any barriers and provide support to patients with disabilities, sensory impairments and those who are non-English speaking.

Utilising our extensive network of providers, eCare clinics can be delivered in a number of locations across a contracted region to ensure that there is equity across the geographical area and to provide patients with a choice of time and location that is convenient for them and closer to their own home. To achieve this, we work with commissioners and use the following criteria to select the most appropriate locations to deliver the service:


  • Population distribution and density
  • Travel time to each location
  • Accessibility by public transport
  • Disability access requirements
  • Provision of a suitable and safe environment
  • Patient experience/environmental factors (including parking)
  • Type and capacity of premises to deliver an effective service
  • Infrastructure in place to support service delivery
  • Capability to meet regulatory standards (e.g. CQC)

Clinical Governance

Evolutio understand that clinical governance is crucial to the delivery of sustainable, accountable, patient focused, quality assured health care.

Ensure that quality is placed at the heart of the service we provide


Ensure that we achieve the highest standards of care possible


Help prevent mistakes


Meet our responsibilities


We implement an integrated clinical leadership, governance and operational management structure to oversee the service. The eCare Community Ophthalmology Service is underpinned by robust clinical systems and processes to ensure provision of high quality and safe services. We implement clinical governance as a whole system culture crucial to the delivery of sustainable, accountable, patient focused, quality assured health care. The service model focuses on high levels of clinical support and presence which is reflected within our clinical governance structure and a dedicated team that is led by our consultant ophthalmologist, Mr. Simon Hardman-Lea.

Our clinical governance is a robust framework to optimise safe, high quality care for all patients, and by providing evidence that can demonstrate the service is safe and effective. We operate using clear organisational structures and accountability to ensure clarity on roles, whether clinical or administrative, within the organisation. Several key components and themes combine to create an effective, high quality and robust clinical governance.

Implementation and mobilisation

We bring extensive experience of mobilising a range of community services. Our experience gives us an in-depth understanding of the challenges and risks that are associated with both planning and implementing a local community service. Our plans therefore include the development of robust relationships with the local practices, optometrists and secondary care providers.

We are experienced at supporting the transition from incumbent to new service providers and ensuring that patients are transitioned seamlessly during a change in service provision.

During implementation, the following key milestones will be delivered within specific agreed timescales to ensure delivery:

  • Identify local community services and AQP
  • Agree clinical pathways and thresholds
  • Identify GP’s/optometrists that will use eRefer
  • Provide appropriate eRefer support and training
  • Deliver the communications strategy across providers
  • Service commencement

Our approach is to start early, mobilise quickly and fully utilise our knowledge of providers and existing relationships with stakeholders. We can act quickly to invest resources in the areas that need it most, ensuring timely delivery of key milestones.

If you would like to know more about our Community Ophthalmology Service please call us on

0203 780 7860 or email


We can also provide you with an individual CCG impact assessment detailing how the service can positively impact your specific locality. Phone or email and one of our team will be happy to discuss options.