The Accuracy of GP Referrals into Manchester Royal Eye Hospital Orthoptic Department

BACKGROUND: There is little research that examines the accuracy of paediatric referrals into secondary and tertiary care, particularly those from general practicioners (GPs) to ophthalmology and orthoptic departments. Inaccurate referrals could have a detrimental effect on service delivery and NHS funding as well as patient experience. Available evidence shows GP referral accuracy to range between 39% and 90% across different areas of medicine with accuracy of GP referral to ophthalmology between 56% and 66%. METHODS: A retrospective case note analysis was carried out on 99 case notes to examine the accuracy of paediatric GP referrals (including those via the community optometrist) into the Orthoptic Department at Manchester Royal Eye Hospital (MREH). RESULTS: GP referral accuracy was found to be 63% for strabismus cases, 50% for reduced vision/amblyopia cases, 45% for NAD cases, 100% of nystagmus cases and 92% of “other” cases. GPs were significantly less accurate than community optometrists (p = 0.01). Referrals from GPs alone had an accuracy rate of 65% compared to 87% of GP referral via community optometrist. Accuracy of referral appeared to improve with age, however this was not found to be statistically significant (p = 0.06). CONCLUSION: This study found orthoptic referral accuracy for GPs in Manchester to be similar to other areas of medicine. While acceptable compared to other areas of medicine, improving referral accuracy is essential to improve NHS spending, service delivery, and patient experience. To aid with this the aim is to design and implement a virtual training package that focuses on detection of strabismus to improve referral accuracy.