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Your questions - GPs

Who should be referred to NCLDESP?

Patients should only be referred if:

  1. They have received a definitive diagnosis of Diabetes
  2. This diagnosis has been discussed with the patient.
  3. Patients under 12 years may be referred to the Programme but they will not be invited for a screening appointment until after their 12th birthday. In accordance with national guidelines these patients should be seen by paediatric ophthalmology consultants in a hospital eye clinic.

We cannot accept referrals for patients who:

  1. Have a result indicating IGT (Impaired Glucose Tolerance), borderline diabetes or 
    pre-diabetes.
  2. If you believe that a patient with any of the above should have a retinal examination, can you refer the patient directly to the ophthalmology team?
    Have a diagnosis of gestational diabetes as  patients with pure gestational diabetes do not seem to progress to any referable degree of diabetic retinopathy during their pregnancy. 
  3. If a patient has gestational diabetes, but has possible pre-existing diabetes then we are happy to add the patient to our screening programme and screen the patient according to the national guidelines as long as the patient’s new status has been updated with their GP. Please see the link for the NCLDESP Gestational Guidelines http://diabeticeye.screening.nhs.uk/faqs-screening#fileid11189 and further clarity.

 How do I refer my patients?

The easiest way for your patients with diabetes to be screened is for you to be certain that the details of all your patients with diabetes aged 12 and over, are put onto the practice electronic patient with the appropriate coding.

We will send an appointment to all new patients on that list.

GPs in North Central London are requested to refer all patients newly diagnosed with diabetes to NCL-DESP as soon as possible. Referrals can be made using the referral form  here and email to northmid.ncldesp@nhs.net.

NCL-DESP also endeavours to collect the diabetic GP registers on quarterly basis. 

Will I get copies of my patient’s results?

A copy of the patients result letter will be sent to you within three weeks of their screening visit.

The copy of the screening result sent to you will include information concerning any treatment required.

GP surgeries will shortly be able to access the images and results from their patients' screening encounters via a secure internet connection over the NHS 'N3' network.

What does the patient pathway look like?

 

If my patient is in need of treatment, where will they be referred and who decides where they can attend?

NCL-DESP refers patients to several locations across the boundaries of the programme;

  • North Middlesex University Hospital NHS Trust
  • Royal Free Hospital NHS Trust
  • Whittington Hospital NHS Trust
  • Edgware Community Hospital NHS Trust
  • St Pancras Hospital
We base our decision on the site closest to the patients address, but this can be changed if the patient expresses a preference for another location.

We do not refer patients to any other locations as this Programme must adhere to strict referral to treatment timelines and these hospital eye units have all signed up to ensuring that these timelines can be met.

What if my patient no longer has diabetes?

If a patient has been incorrectly coded or diagnosed with diabetes we are happy to remove them from the register upon receipt of a completed“Certificate of Unsuitability” 

However, patients who have had bariatric surgery or no longer show the symptoms of diabetes should still attend for screening.

The National screening programme states the following: “Once there is or has been a definite diagnosis of diabetes, excluding gestational diabetes, the patient should be screened for diabetic retinopathy annually for life. 

For those patients who had steroid induced diabetes whose diabetes is now ‘resolved’ the decision about screening should be made on a case by case basis. If there is any doubt, the patient should continue to be offered screening.

 

 

What are the locations for screening within North Central London?

Can we have the Mobile Screening Unit at our practice? 

NCL-DESP has procured a new mobile screening unit, allowing us to take our screening service closer to our patients and increasing the likelihood that patients will take up their appointments. We are interested in hearing from anyone who would be interested in hosting our mobile service at their practice. Initially we would be looking  to commence the service in areas where take up has been low. However we will also be looking at taking this innovative service…a first for London… to practices that have a high demand. 









 

If your practice is interested in hosting the van please click here  to contact us .