Sheffield Local Optometric Committee

Paediatric Referral refinement

PRR

As promised we have introduced electronic reporting for the PRR scheme.
The purpose of the move to online reporting is to improve safe information transfer and simplify administration by reducing the need for additional invoice and also possibly referral forms to Sheffield Children’s Foundation Trust.

POINTS TO REMEMBER

Always use the unique identifier number (provided on the initial referral email from the Orthoptic screeners) in all reports.

Completion of the electronic report will automatically generate a payment invoice for NHS Sheffield.

Direct referral to The Sheffield Children’s Foundation Trust is initiated automatically by completion of the combined report/referral from the red section on the menu page.

If parents choose referral to a hospital other than the Trust as above, a report from the blue section in the menu area must be completed in addition to a GOS 18. In this instance the GOS18 must be sent directly to the chosen secondary care provider.

All reports can be printed onto one side of A4 for your records.

This section will be updated on the website as more questions are asked so please review from time to time!

Frequently Asked Questions

How will practitioners receive referrals from School screening?
Referral information will be emailed to the practice nhs.net account directly from the Trust.

How are children allocated to a PRR practice?
The school screening staff at the Trust will offer the parents the choice of PRR practice during a post screening phone call if the child fails screening. SPA are no longer involved in the PRR pathway.

What happens if the parents are unable to be contacted by phone?
An answerphone message will be left for the parent if possible and a letter sent out allocating a PRR practice. A complete list of practices will be included so that parents can choose an alternative practice by contacting the Trust if they prefer.

Will the parent contact the practice for an appointment?
Parents are advised to contact the chosen practice to make an appointment for cycloplegic refraction and asked to quote the patient identifier. This is so that the practice is aware that the child is being referred for PRR test rather than basic sight test. The appropriate time can be given and you can make sure that you have received the patient referral information by nhs email.

What if the parent has lost the paperwork?
The referral email will contain all required information.

DNA or no contact with parent?
If the parent has not contacted you or has made an appointment but not turned up, please make reasonable attempts to contact the parent. If reasonable attempts have been made to contact the parent and encourage an appointment and you are satisfied that the patient is not going to attend, you are required to complete a brief online report from the blue section. Keep a record of this report.
Where do I complete patient details?
The patient identifier must be used instead of patient details and allows the report to be associated with the patient details by the screening administration at the Trust. Keep a note in your records of these details.

The child attended for the PRR appointment. What admin is required?
An online report must be completed for each patient at each PRR visit of which there will be a maximum of three visits under the scheme. You can print a paper version of your report for your records.

The child would not cooperate. Do I still complete a report?
Payment is linked to completion of reports however there is an option on VA for “not recorded”. Please explain in the additional information section. It happens!!

Do I need to send any information to SPA? No. We have requested that SPA is no longer involved in the PRR pathway.

The information required on the form is not exactly as on the old paperwork. Do I still record this?
We have streamlined the information required for the reports. Other tests you carry out should still be recorded in your own records. We have not included VA after cycloplegic drops, as in most cases this would not be recorded at this point.

Prescribing Notes

All parents must be issued with a written copy of the prescription clearly
indicating if spectacles are required or not in line with GOS rules.

Should I prescribe the full cyl or aniso?
90% of spectacle prescriptions have some degree of cyl and 30% of these are over 1D.
It is advisable to prescibe the aniso or cyl element of a prescription if the unaided vision is reduced and you feel the reduction is inline with your findings. Spherical component can be reduced if you feel required, especially if the unaided vision is good in the other eye.
Should I recommend full time or part time wear if spectacles are required?
The aim is to eliminate amblyopia and it is difficult due to adaptation periods to establish improvement or wearing patterns if worn on a part time basis. Our scheme requires us to make decisions swiftly so full time wear should be advised initially. If VA improves to standard thie wear pattern can be reduced at future visits. Do I prescribe if I am referring to secondary care?
Yes please. Cycloplegic refraction will be repeated and the prescription may be modified but at least treatment would be underway prior to the hospital appointment.
Any further questions please contact Shirley Blundell or Rob Hughes

Next Meeting:

Holiday Inn hotel,
Blonk St
Sheffield
S1 2AB

at 7.30 pm Tues 1st Aug

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