Royal Wolverhampton Hospital - MANAGEMENT OF PATIENTS WITH AGE

Introduction

Age-related macular degeneration (AMD) is the leading cause of irreversible blindness in people over 50 years of age and in the UK, AMD accounts for more than half of all registered blindness.  Wet (neovascular) AMD is the most rapidly progressing form which requires an accurate and early diagnosis followed by rapid referral and treatment to achieve the best outcomes for the patient.   

What it is?

A pioneering, fast-track AMD clinic which recognises the increasing the role of general and specialist Ophthalmic nurses in counselling and treating AMD patients at multiple stages of the care pathway.

Key Milestones

The potential impact of the NICE/SMC guidance on the efficient running of an AMD clinic, and timely treatment of patients, is clear. Higher patient numbers and number of clinic visits present significant challenges in terms of resource and logistics. But the introduction of the anti-VEGF treatments provide better clinical prognoses as well as exciting opportunities for nurses (in conjunction with the medical consultants) to expand their role across all stages of the pathway (including screening, diagnosis, treatment, follow-up and support) and help provide an efficient service. In conjunction with thre med

What it is achieving?

The AMD clinic is a clinical service that has been set up to respond to the rapid progression of is able to respond to the rapid progression of a 

• Rapid referral from gp’s, optometrist, self monitoring patients to the macular clinic
• A responsive seamless and joined-up service at all stages of the pathway
• Co-ordination and best use of manpower, skills and facilities.
• Halting progressive vision and in cases improvement to visual function
• Improved patient experience
• Service adoption and training to other NHS Trusts
• Training and Educational packages
• Publications 

The Key Message

At Wolverhampton it is recognised and evidenced that experienced ophthalmic nurses play a key role in recognising the signs and symptoms of AMD in elderly patients and ensuring that these patients are directed appropriately for rapid referral to a macular clinic. The fast track service empowers all to review their role, knowledge and competency to meet the rapid and essential requirements of the patient in the progression of irreversible blindness.  A specialist AMD clinical with nurse leadership has assisted in optimising the management and operational delivery of the care pathway, training/education and continued service development.