Community based digital eye screening programme set to expand

A £4.5m community based digital eye screening programme designed to detect and treat diabetic retinopathy, the leading cause of blindness in the developed world, is being rolled out to other locations, following its huge success since launching seven months ago.

The Nottingham Diabetic Retinopathy Service is expanding from four to 10 locations, to include additional health centres and a branch of Boots in Nottingham City Centre as well as two hospitals. The Service has also been commended in the recently published Department of Health National Service Framework report as a model screening programme.

The Nottingham Diabetic Retinopathy Service was launched ahead of schedule last September and is using OptoMize iP, an innovative digital imaging software and electronic patient records system developed by Digital Healthcare, a Cambridge company that is the UK’s leading supplier of specialist diabetic retinopathy screening software.

Diabetes patients in Nottinghamshire are invited to attend a screening clinic at a location near to their homes, where a digital photograph is taken of the back of their eyes that can detect diabetic retinopathy, a complication of diabetes that can lead to blindness if left untreated.

To date, the Service has offered nearly 11,000 screening appointments, with a current rate of 1,900 per month, to the 23,000 registered diabetes patients in Nottingham, including children from the age of 12 years. It is therefore well on track to meet Department of Health targets which require 100% of the diabetic population to have had access to a digital scan of their eyes by the end of 2007.

The Service began by screening diabetes patients at the Queen’s Medical Centre, the City Hospital, Stapleford Care Centre and Park House, Carlton. The recent extension means that patients can now also attend screening appointments at health centres in Clifton, Gamston, Ruddington, Hucknall and Kimberley as well as at the City Centre branch of Boots.

Dr Tasso Gazis, Diabetes Consultant at the Queen’s Medical Centre and Clinical Leader of the Screening Service, said: “Diabetic retinopathy is a symptomless disease that can have devastating effects but which is treatable with laser treatment if it is caught early on. The digital imaging service that we offer using Digital Healthcare’s software is the most effective way to identify the disease at an early stage. And we can also use this software to monitor for changes in eye condition by comparing images taken at different points in time.”

“Detection of the disease also depends on reaching out to diabetes patients and making it as straightforward as possible for them to attend their screening appointments. Digital Healthcare’s software can be pre-loaded onto laptops so that our staff can travel between health centres to hold screening clinics for about a month at each centre on a revolving basis. This means that we can provide a mobile, community-based service, offering patients a greater choice of locations for their screening appointments, which is particularly useful for elderly patients and increases the overall take-up rates.”

Turnaround times on the Screening Service, which is co-ordinated by the Departments of Diabetes and Ophthalmology at Nottingham University Hospitals, are rapid with patients typically receiving notification of their results within a fortnight of the screening. However, if an abnormality is detected during the screening process, the patient is referred directly to a specialist clinic for further investigation and laser treatment, if appropriate, without the need to seek a referral from their GP.

Dr Gazis commented: “The software contains a secure electronic patient records system covering all the patients on the programme so we can pull up patient histories and images instantly. The system is also fully-automated so we can generate referrals to clinics straight after screening, as well as reports on the screening results for GPs and patients. It enables just three staff members to handle nearly 80,000 items of correspondence to GPs and patients every year, so we can focus more resources on screening and grading work.”

Jeff Gordon, Chairman and Managing Director of Digital Healthcare, said: “I would like to congratulate Dr Gazis and his team on the success of the Nottingham Diabetic Retinopathy Screening Service. It is a pleasure to work with such an efficient, committed team to provide the technology that enables the Service to be a truly community-based programme which reaches out to diabetes patients.

“Diabetes currently affects 1.8 million people in the UK and that figure is expected to increase to 3m people by 2010. So it is vital that we make it as easy as possible for diabetes patients to attend digital screening appointments that could quite literally save their sight.”

David Cartwright, Director of Professional Services, Boots Opticians commented: "Boots is committed to providing access to healthcare services that make good health easier for patients. Offering this service in a high street setting means that patients can access the screening at times convenient to them."

In addition to the main Nottingham Diabetic Retinopathy Screening Service, there is a unique ‘ad hoc’ screening service at the Queen’s Medical Centre and City Hospital sites where patients from outside the region who attend a diabetes clinic are offered an eye screening appointment while they are at the hospital.

Dr Gazis concluded by commenting on future plans for the Service: “As we build up our screening records over a longer period of time, we will be able to use the software to plan treatment on an individual patient basis. For example, while we will continue to offer digital screening appointments to all diabetes patients on a regular basis, we could plan to offer even more frequent screening appointments for ‘high risk’ patients.

“The fact that Digital Healthcare’s software enables us to provide a mobile service also means that we could bring screening clinics to more locations.”

The Nottingham Diabetic Retinopathy Service is part of a national screening programme set up by the Department of Health which requires 100% of the diabetic population to have had access to a digital scan of their eyes by the end of 2007.

The Nottingham Service publishes a summary of the total number of digital screening appointments it offers at www.nottinghamretinopathy.co.uk