West Suffolk CCG

WHAT WE DO

Referral Management

Enhanced Optometry Services

Contract Management & Compliance

Data Analytics

Payment Management & Reconciliation

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 Ipswich and East CCG 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 (T11) Policy

Required (1st eye)

  • T11a form (Policy T11) – “Ipswich NHS Hospital – Cataract”
  • Binoc VA 6/10 or worse (6/9 Snellen) OR
  • Monoc VA 6/18 or worse AND
  • Lifestyle score 3 or more
  • Aware of risks/benefits, 7 days to consider

Second eye 


  • If 1st eye is better than 6/10 = 2nd eye must be 6/18 or worse
  • If 1st eye is 6/10 or worse = 2nd eye must be worse than 6/18 OR 6/10 or worse 
binoc

Exceptions

  • 3D anisometropia causing BV problems
  • Glaucoma affecting angle
  • Dense enough to affect investigation/ management of medical retina 
(diabetes, CRVO, AMD) or neuro (field defect)
  • If other eye requires closure for oculoplastics procedure
  • Further surgery likely to increase likelihood of needing cataract surgery
  • Corneal disease where early removal reduces chance of losing corneal clarity 
g Fuchs/post keratoplasty
  • Corneal/conj disease where delays might increase risk of complications e.g. cicatrising conj
Download T11 Form
View Policy

Restricted Procedures

Benign Skin Lesions (T28) pathway

  • If being referred by the patient’s GP the referral must be accompanied with a T28 pro-forma
  • If being referred by the patient’s optician the referral DOES NOT require a T28 pro-forma
Download T28 Form

Useful Documents

Cataract Invoice Template

Use this template to submit your cataract invoices to us

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ESP Invoice Template

Use this template to submit your cataract invoices to us

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Good invoicing guide

Use this template to submit your ESP invoices to us

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Referral Pro-forma

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

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Cataract Communication

Communication from the CCG regarding the Cataract T11 pathway

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Ophthalmology Referral Guidance

Evolutio Ophthalmology Referral Guidance Nov 17

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