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MODULE 3: Providing Diabetic Retinal Screening
3.1 The Requirement
In order to deliver a DRS programme Retinal Screeners are required to undertake the screening process. Very often the Retinal Screener
not only undertakes the screening, they also undertake primary grading of the images. There are requirements to be met,
in terms of the competence; and continuous professional development of these individuals; their supervision and mentoring
arrangements; and there is a requirement to ensure Retinal Screeners undertake the national accreditation programme.
3.2 The Issues
Many DRS programmes cover a relatively small Diabetic population with just one or two retinal screeners being employed.
Should a Retinal Screener take time off, perhaps due to holiday or sickness or leave the post - we find that DRS
programmes stall and patients suffer as a result. It may be several months before posts are filled with competent
Retinal Screeners and the whole DRS programme is adversely affected. In addition, offering an out of normal business
hours screening service is often regarded as important by patients, but these arrangements are difficult to establish
within small programmes.
As part of any recruitment process, Criminal Records Bureau clearance is also required, given the age range of the patients covered by this programme.
Clear retinal screening protocols need to be established for handling the screening appointment, obtaining informed written
consent to the procedure and information sharing; administering the eye drops; and handling patients under 18 and those with special needs.
3.3 The Solution
This module can be provided independently of other modules. For example, it may be provided as part
of an existing programme to deliver extra screening capacity. There are two options:
- 1st Retinal Screen can operate one or more screening clinic locations, providing Retinal Screening personnel or
- Specsavers can deliver the Retinal Screening Service from their high street locations within professional environments and with significant flexibility
For example, retinal screening can take place at weekends when this may be more convenient to patients.
- Provide competent Retinal Screeners - who can be deployed within your existing programme or we can establish the programme.
Our Retinal Screeners have undertaken a competence based training course administered by Roehampton University;
they could operate within clinics based in NHS accommodation or mobile unit.
- Issue of Invitations to Patients - whilst keeping General Practice in control of their patients involvement in the
programme, invite patients to attend; offering a choice of available screening dates; times and locations.
Provide patient information leaflets (currently available in eight languages).
- Conducting the Retinal Screening Appointment - patients will be welcomed upon arrival; the retinal
screening procedure explained; informed written consent obtained; Visual Acuity Test undertaken;
contra-indications checked and where appropriate eye drops administered prior to at least two
quality digital images of each retina being obtained.
- Using Approved Software - we propose to use PASA approved capture software, where this is a
requirement of the Commissioners.
- Security checked personnel - we have an established relationship with Specsavers, with
software developed and infrastructure established, enabling us to deploy rapidly. These arrangements also include the
provision of a Biomicroscopy examination for those with media opacity where the images are not assessable (expected to be
approximately 3% of patients during year one, based on our experience in delivering DRS programmes).
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