Hello, my name is Dr John Rodriguez and I am the Screening and Immunisation Lead for Kent and Medway. I’d like to tell you about the recently published national guidance on the management of patients not included on the screening register in the NHS Diabetic Eye Screening Programme. I hope you'll find it useful.
Diabetic eye screening helps prevent sight loss through the early detection of diabetic retinopathy, one of the most common causes of sight loss among people of working age
One of my jobs is to manage incidents in our local diabetic eye screening services. Some of these become serious incidents because of the number of people involved and/or the potential that some patients may have been harmed.
Recently, across the country, there have been serious incidents in our diabetic eye screening services. Although each incident was different, many were 'single collated list' incidents. These involved patients who should have been on the screening register of the local service, but weren’t.
Diabetic eye screening services rely on GPs to identify people with diabetes who are aged 12 and over, and therefore eligible for annual screening. Many services still use manual processes for the notification of new patient referrals to the screening service, and for database validation (checking that the information on the screening service database is correct). Some services already have automated data extraction from their GP practices, and many more are planning to implement the new national data extraction software, GP2DRS. Eventually, we hope all diabetic eye screening services will have automatic data extraction working to the national standard.
Implementing automatic data extraction (moving data from the GP practice system on to the screening service database) will help, but this alone does not prevent single collated list incidents. Screening services should still record accurately and validate patient demographic changes – such as when patients move out of the area or die – as part of their ongoing failsafe work.
The new national guidance should help anyone trying to manage a single collated list incident and should be used alongside the general guidance, Managing safety incidents in NHS screening programmes. It gives additional advice on:
- deciding if the concern should be a screening safety incident or a serious incident
- the responsibilities of the different organisations involved
- patient communication to ensure Duty of Candour regulations are followed
The guidance has a useful table of issues and practical suggestions of what to do and who to involve. This is based on lessons learned from around the country. For example, if some GP practices have not responded to a request for validation for some time, an escalation process should be agreed between the screening service and the screening and immunisation team and clinical commissioning groups. This can then be documented in a standard operating procedure.
If you need any advice on the above please contact the screening helpdesk or your regional screening quality assurance service (SQAS) team.
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