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Understanding the Eye: Glaucoma  |  Information for GP's & Optometrists  |  Glaucoma Service
Glaucoma Service

  Huntingdon Glaucoma Diagnostic and
      Research Centre
  The CHANGES scheme
(Community & Hospital Allied Network Glaucoma Evaluation Scheme)
  Moorfields Eye Hospital Glaucoma Service
      at Bedford Hospital
  Anglia Ruskin University


Huntingdon Glaucoma Diagnostic and Research Centre

Mr R Bourne leads the Huntingdon Glaucoma Diagnostic and Research Centre (HGDRC; begun in January 2006) which receives secondary and tertiary referrals from its traditional catchment of Huntingdonshire and East Cambs and Fenland but also from other regions. The glaucoma service involves resident ophthalmologists in training, optometrists, orthoptists and nurses who have extended roles involving glaucoma and who have ongoing training with Mr R Bourne. The department is equipped with the most advanced diagnostic and monitoring technology for glaucoma available nationally.
The HGDRC is now a thriving unit with multiple clinics that specialize in the assessment and follow-up of glaucoma suspects and glaucoma cases.
  Huntingdon Glaucoma Diagnostic and Research Centre
Successful business cases and collaborative research projects in the past year have resulted in the provision of state-of-the-art imaging technology (HRT-3, GDx, OCT), psychophysical testing and an electronic patient record (the glaucoma module of the Medisoft system). The electronic patient record was seen as a critical element in the success of the glaucoma centre for the purposes of clinical governance, audit, and research. Miss Lydia Chang works with Mr R Bourne in the glaucoma service at Huntingdon and Bedford.
The service was awarded a national award for innovation in glaucoma care in 2006/2007 (Allergan Glaucoma Achievement Award).

For further information, please contact Mr R Bourne on: rb@rupertbourne.co.uk

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The CHANGES scheme (Community & Hospital Allied Network Glaucoma Evaluation Scheme)

This scheme went 'live' in August 2006 following approval of the business case by Huntingdonshire PCT, and with support from GPs, optometrists and the public (PPI: Patients and Public Forum). The scheme is one of only a few such schemes around the country and has been constructed in such a way as to build on the positive aspects of the other schemes while being tailored to this particular community. Eight OSIs were appointed- these enthusiastic individuals work in practices which have standardized equipment which matches the basic equipment used in the hospital glaucoma service. They have been trained in glaucoma detection by the HGDRC and also by attendance on a course held at City University, London in 2006 (postgraduate certificate in glaucoma shared care).

There are two phases to the scheme: referral refinement and shared care. Referral refinement involves the redirection of low risk (probable false positive) referrals to the appointed OSIs, offering the patients a choice of OSI. This has so far successfully reduced the number of false-positive referrals and the quality of referrals has improved as a result. Agreement between OSI and consultant ophthalmologist is checked and the scheme is closely audited. The second phase of shared care will begin when the referral refinement phase is demonstrated to be effective and safe. Shared Care will involve low risk glaucoma suspects being seen by OSIs within the community. Each patient will have an individualized care plan which will involve a baseline assessment by the hospital glaucoma service and then a series of visits at a predetermined frequency to an OSI of the patient's choice. Patients will be recalled to the hospital glaucoma service at certain intervals to check for evidence of progression. Mr R Bourne works with 2 hospital-based optometrists (Mrs Wendy Newsom and Mrs Karen French) and Mrs Alison Hammond in managing the scheme.

The glaucoma community scheme was awarded a national award for innovation in glaucoma care in 2006/2007 (Allergan Glaucoma Achievement Award).


For further information, please contact Mrs Wendy Newsom: wendy.newsom@hinchingbrooke.nhs.uk

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Moorfields Eye Hospital Glaucoma Service @ Bedford Hospital

In August 2007, Moorfields Eye Hospital agreed with Bedford Hospital to supply specialist ophthalmology services to the region served by the eye department at Bedford. Mr R Bourne was appointed as a Consultant Ophthalmic Surgeon with Moorfields to provide the glaucoma specialist service. This involves glaucoma specialist clinics run by Mr R Bourne on Tuesdays at Bedford.

For further information, please contact Mr R Bourne on: rb@rupertbourne.co.uk

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Anglia Ruskin University

Anglia Ruskin University, based in Cambridge and Chelmsford, houses the school of optometry for eastern England. Mr R Bourne was appointed Professor of Ophthalmology there in July 2007 with the remit of developing the research base there with collaboration between ophthalmology and optometry as a key feature. Several collaborative research projects are underway and more planned.
Optometry students will receive clinical training at Hinchingbrooke Hospital from October 2007 onwards.
  Anglia Ruskin University Cambridge


For further information, please contact Mr R Bourne on: rb@rupertbourne.co.uk

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