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1st Retinal Screen offers a comprehensive Retinal Screening Service with Quality Controls and Quality Assurance
built in as standard. A well know quotation concerning population based screening is
"All Screening programmes are known to do harm - only some do good". This statement
recognises that within any programme anxiety will be caused to patients and that
there will be both false negative results and false positive results. It is
therefore essential to ensure that the Retinal Screening Programme is
effectively managed and due account is taken of the quality of all elements of the service.
Finding Patients and ensuring all relevant healthcare professionals have access
CDRIntell finds more patients than any other solution, it extracts data from primary care, secondary care and other stakeholder systems, (for example the blind and partially sighted register of Social Service Departments) thus CDRIntell deploys a truly unique cross sector population based approach, and provides all healthcare professions involved in the planning and delivery of service with appropriate levels of access to the data/information. 1st Retinal Screen operates it's services from a secure data centre within NHSnet/N3 allowing access to the service from the user's desktop computers within General Practice, the community and hospital settings.
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The Prior Notification List
This cross sector approach to information sharing allows 1st Retinal Screen to generate an electronic Prior Notification List (ePNL). This process is dynamic, ensuring that General Practice always remain in Control in electing which patients can be included or excluded from the DRS programme at any stage, as well as providing them with the status of their patient(s) within the programme. This ensures a patient centric and quality call and recall programme.
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Safety
The administration of Tropicamide (eye drops which dilate the pupil) is contraindicated in several
situations (the evidence on Contraindications although significant has had
to be researched with much of the material coming from the US).
Accordingly the service 1st Retinal Screen provides includes the presentation
of a Contraindications flag to the Screener. This being established through a
review of the data held about the patient - mainly drawn from General Practice clinical systems.
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Grading of Images
The Grading of images within the service offered by 1st Retinal Screen is at three levels -
- Primary Grading - grading by the screener at the time of the clinic
- Secondary Grading - grading by the Ophthalmologists engaged by ourselves
- Arbitration Grading - grading by a Senior Ophthalmologist, again engaged by ourselves
The quality of the grading process is critical, given the impact of false positive and false negative results. Accordingly,
1st Retinal Screen engages ophthalmologists to ensure high quality standards are established and maintained.
We have taken the view that finding of both DR Retinopathy and non-DR Retinopathy will be reported upon.
It would be little comfort to a patient if they had sight loss or blindness due to non-DR Retinopathy
that we had not reported on because there was no Policy offered by the NSC in this area.
Accordingly our quality service includes; reporting on both DR and Non-DR findings and the associated referral of patients.
To view DR Result Classifications click here
The Non-DR Result Classifications has been constructed using national level experts who reviewed the evidence
base for determining the management action, eg referral or urgent referral or informed practice.
A 10% check of the negative results is undertaken by a Secondary Grader. Additionally a set of known value
images are placed in the grading pool - so that all Secondary Grader's work is checked for accuracy and consistency.
Please refer to the Grading Pathway
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Extensive Reporting
Having collated data from all relevant patient episodes of care, CDRIntell provides a comprehensive set
of reports of interest to those engaged in clinical governance reviews and public health analysis.
Reports are available by PCT, Locality and General Practice and for different timeframe.
Reports include all:
- NSC Standards 1-16
- Diabetes NSF Standards
- CHD NSF Standards
- GMS Contract Quality and Outcomes Framework
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