Diabetic eye screening is an integral component of diabetes care, which helps prevent or reduce sight loss among people with diabetes. But diabetic eye screening services rely on GPs to identify people with diabetes over 12, the age at which they become eligible for screening.
My name is Jim McMorran. I’m a GP in Coventry and the GP representative on the National Advisory Group for the NHS Diabetic Eye Screening Programme.
In many services, manual processes are still used for the notification of new patient referrals to the screening service, and for database validation by the screening service. This can be time-consuming for practice staff and staff in the screening service.
Recently updated NICE guidance for diabetes makes it clear that people with diabetes should be screened within 3 months of diagnosis.
Unless they have explicit patient consent, local screening services can only extract demographic data from a GP practice. This means they have to use a proxy (an alternative date) to represent the date of diagnosis. This is either the date the patient was referred for screening, or the date the patient was first coded as having diabetes on the practice database.
All screening services aim to screen within 3 months of that date, but any delay in referral or coding may result in patients not being screened on time.
Some screening services already have an automatic data extraction system from their GP practices. Many more are planning to implement the new national data extraction software, GP2DRS.
Over the next few years, we hope all diabetic eye screening services will have automatic extraction working to the national standard. When your local screening service is ready to switch on GP2DRS, you will be asked to sign up for the service.
Screening services that have participated in testing GP2DRS have found patients who weren’t previously identified as having diabetes. In Gloucestershire, automatic extraction of data from general practice identified 709 patients coded as having diabetes not previously known to the local screening service. These included 23 diagnosed more than 5 years previously and 29 found to have referable disease.
There are a number of reasons why this can happen. In some cases these have to be managed as a screening incident. However, careful planning before implementation can avoid this, and local screening services will now receive comprehensive guidance on what they need to do. This will include a list of codes that will be used by GP2DRS that may be different to any existing automatic extraction.
I would urge my fellow GPs to sign up for the service. The process of implementing GP2DRS may require some groundwork by the practice ahead of and during implementation. Once implemented, GP2DRS should ensure effective retinal screening communication for patients at your practice and also save practice administrative time.
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Comment by Chris Frith posted on
Patients need to give consent for their data to be shared so I recommend this explained and consented at the time of the referral. A list of which data is extracted would be useful to show the patient along with an information leaflet.
Comment by Mike Harris posted on
Please see guidance on the use and transfer of personal information: https://www.gov.uk/government/publications/diabetic-eye-screening-use-and-transfer-of-patient-information/diabetic-eye-screening-use-of-personal-information
Transfer of demographic information doesn’t require explicit patient consent as it is a routine part of diabetic care: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/528604/Consent_and_cohort_management_in_the_NHS_Diabetic_Eye_Screening_Programme.pdf