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Swindon DRS programme - the first year

Gill Saunders, public health manager at Swindon PCT, outlines the progress made in the first year of the trust's retinal screening programme, along with some key lessons learnt.

Swindon PCT launched the Diabetic Retinopathy Screening (DRS) programme for Swindon GP practice patients and nine Kennet and North Wiltshire PCT practice patients (now Wiltshire PCT) working with 1st Retinal Screen in February 2005.

1st Retinal Screen was the first non-NHS organisation commissioned by the PCT to deliver clinical services to Swindon patients.

The end of the first year in March 2006 saw the achievement of the national targets for patients to be offered screening and those attending screening, alongside the delivery of a service that strives to meet the quality standards as set by the National Screening Committee for DRS programmes.

Previously, because of differences in the way optometrists provided the service, there were variations in the level and quality of screening. The introduction of the programme has, for the first time, allowed patients in Swindon access to an organised, structured and regulated programme. Feedback from patients, for example, through the local Diabetes UK group, has been extremely positive such that, in the early days, some patients were lobbying their GPs where their practice was reluctant to sign up to the programme.

Thirty-nine GP practices are signed up to the programme, and screening is delivered from four sites: three in and around Swindon, including one at Specsavers, and a fourth at Savernake Hospital in Marlborough to provide easier access to screening for North Wiltshire patients. Swindon PCT administers the scheme and books patients for screening, and staff at 1st Retinal Screen grade and communicate the screening outcomes to GPs and practices. Patients with retinopathy are referred where appropriate to the Great Western Hospital in Swindon for treatment.

Effective working relationships and clear communication

Working with non-NHS organisations presents PCTs with a number of practical and management issues, especially in the current financial climate. The interface between the partners involved in the delivery of care to people with diabetes – primary care, secondary care, the PCT and the screening provider (1st Retinal Screen) – requires careful management. Maintaining effective working relationships and clear communication with clinical partners are the paramount factors in the success of the programme.

To ensure that key elements of the programme are delivered and developed, the programme is project managed and is supported by clinical and patient working groups. These working groups have ensured the successful and rapid implementation of the screening progamme, and will facilitate ongoing delivery.

As the end of the second year of the programme looms, the production of the annual report provides a salutary reminder of how much has been achieved and of the immense benefit to patients which includes the identification of previously undiagnosed diabetics.

Inevitably, there is more work to do to improve the service. However, the strong partnership working with both 1st Retinal Screen and the key stakeholders sets the scene for a third successful year ahead.