Thurrock CCG

WHAT WE DO

Referral Management

Enhanced Optometry Services

Data Analytics

Contract Management & Compliance

GP Inclusion List

If your patient’s GP is contained within the GP inclusion document then you need to refer via the Evolutio pathway if they meet the inclusion criteria

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Inclusion Criteria

Within the service we are able to receive all non-emergency (see College Guidelines) referrals via normal methods (fax, nhs.net, ERS and eRefer)

How to refer

Local threshold policies and prior approval pathways

CCGs are increasingly implementing threshold policies and prior approval / independent funding request (IFR) pathways for particular conditions to ensure finite resources are managed to provide the population with as wide a range of healthcare interventions and to prioritise resource allocation based on evidence of the clinical effectiveness and safety of treatments, their cost effectiveness and affordability, and on which interventions provide the best health outcomes.

Where Evolutio run a referral refinement service, we are tasked with policing these policies. If a referral is outside of threshold or is not sent with an accompanying prior approval form / IFR where required by the CCG we will have to unfortunately return the referral to you.

Cataract Policy

Referrals should not be based simply on the presence of a cataract. Referral of patients with cataracts to ophthalmologists should be based upon the two following indications:

A: Impairment of lifestyle (not exhaustive list) such as;

  • the patient is at significant risk of falls, or
  • the patient’s vision is affecting their ability to drive, or
  • the patient’s vision is substantially affecting their ability to work, or
  • the patient’s vision is substantially affecting their ability to undertake leisure activities such as reading, watching television or recognising faces or
  • management of other co-existing eye conditions

and

B: The patient understands the risks and benefits and is willing to have cataract surgery.

The referring optometrist or GP should discuss the risks and benefits using an approved information leaflet (national or locally agreed) before referring.

Second eye 


As the benefits of second eye surgery have been demonstrated patients will be offered second eye surgery provided they fulfil the referral criteria (see above).  Second eye surgery should be deemed urgent when there is resultant anisometropia (a large refractive difference between the two eyes of 2 ½ dioptas) which would result in poor binocular vision or diplopia (this should be clearly recorded in the patient’s notes).

Download T11 Form

Restricted Procedures

Chalazia (cyst on or in eye lid) / Chalazion

Chalazia are benign, granulomatous lesions caused by blockage of the Meibomian gland duct, which will normally resolve within 6 months with conservative management in primary care.

Community excision of Chalazia (where a community service is available / commissioned) will be funded for those patients with Two or more of the following:

  • Present for more than six months.
  • Present on the upper eyelid.
  • Source of regular infection (2 times within six month time frame) requiring medical treatment.
  • Interferes with vision.
  • Conservative management has been tried & failed and there is no appropriate alternative to surgical intervention.
  • The site of the lesion or lashes renders the condition as requiring specialist intervention.

Only the patients meeting the following criteria should be referred to secondary care:

  • All children should be referred on.
  • Any recurrent chalazion should be referred.
  • Any atypical features i.e lash loss, bleeding should be referred.

Any patient with previous history of Basal cell carcinoma (BCC) or Squamous cell carcinoma (SCC) or where malignancy is suspected should be referred on.

Chalazion Policy statement

Useful Documents

Ophthalmology Referral Guidance

Evolutio Ophthalmology Referral Guidance Nov 17

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Referral Pro-forma

Use this our referral pro-forms to fax your referrals to Evolutio

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