The Referral Support Service

Evolutio offer a cost effective Referral Support Service with central administrative support and managed patient services bespoke to the eye care sector.

With an ageing population, a rising demand for eye care services and tight financial restrictions, the need for cost effective services is increasingly impacting on health policy and service delivery. It is essential that a service exists to control and manage the flow of patients from primary care to secondary care, and ensure efficient use of capacity in each service by minimising wastage such as DNA’s. With increasing use of new technologies, many administrative functions can be centralised without loss of quality, ensuring value for money and better utilisation of resources.

Through a sustainable and clinically-led model, Evolutio drive effectiveness and efficiency throughout the patient journey by reducing fragmentation of care, enhancing the integration between primary, community and secondary care and reducing the number of avoidable or missed appointments.

The Evolutio NHS e-Referral Integrated Referral Support Service supports both national and local priorities to help CCGs deliver transformation across the eye care pathway through the provision of:

Rise in outpatient demand in the last 7 years

  • Control and management of demand into secondary care
  • Innovative service model that drives efficiencies and realisation of cost savings
  • Management in the most appropriate clinical setting
  • Improved patient experience and patient health outcomes
  • Prioritising the prevention of sight lossF
  • Fully integrated electronic shared care record
  • Patient choice
  • Care closer to home
  • Integrated, evidence based and clinically managed care pathways
  • Independent regulation of thresholds and prior approval processes.

In 2011/12, ophthalmology accounted for the 8th highest level of NHS programme spend in England, with cataract surgery being the most common surgical procedure.

The aim of this service is to control and manage the increasing demand on the HES, through the integration of community and secondary care providers. The service will ensure that referrals are consistent, appropriate, of a high quality and clinically validated in order to reduce unnecessary referrals to secondary care. In turn, this will realise a number of key benefits to both the patient and local healthcare economy as outlined below.

Implementation of the referral support services will provide bill payers with complete control of referrals into secondary care and a full data picture to inform future decision making for the provision of ophthalmology care.

In the UK, the scale of partial sight loss and blindness is highlighted below:

of sight loss is believed to be preventable (UK Vision Strategy)
people over the age of 60 who live with sight loss in the UK (Fight for Sight)
Sight loss and eye health costs the UK economy per year
Out-patient consultations in 2010/11. The second highest referred specialism from GPs
people suffer with sight loss (vision below 6/12)
Spent on eye care annually in England (DoH, 2012)

Benefits of managed referrals

Our referral support service supports the wider system to plan, direct and optimise the most appropriate services for patients, whilst reducing the variability in the referral process and improving the outcome and experience for patients.

The service provides the quality framework to manage and understand the referral process ensuring that it is clinically led, proactive and maximises the use of resource across the local healthcare economy. Understanding the local health needs is a fundamental principle of our service and we work collaboratively with CCG’s and local stakeholders to implement optimal referral pathways. Through the implementation of our service, local healthcare economies will realise a number of benefits including:

  • 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)
  • 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

Many patients with eye problems do not require the expertise of a consultant ophthalmologist and instead, could be seen and treated in an alternative setting.  With an ageing population, a rising demand for eye care services and tight financial restrictions, the need to control and manage the flow of patients from primary care to secondary care and utilise alternatives to maximise capacity is essential. This enables specialist eye hospitals to focus on treating patients with more complex needs more quickly, and for bill payers to reduce costs.

Implementation and mobilisation

We bring extensive experience of mobilising a range of services. Our experience gives us an in-depth understanding of the challenges and risks that are associated with both planning and implementing a referral support 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 Referral Support Service Service please call us on

0203 780 7860 or email


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