Minor Eye Conditions Service (MECS)

MECS stands for Minor Eye Conditions Service, it is an NHS funded service for those registered with a GP within Walsall.

WHO IS THE SERVICE FOR?

The service is for people registered with a Walsall GP, of all ages. Children under 16 years must be accompanied at their appointment by an adult.

The Minor Eye Conditions Service provides assessment and treatment for people with recently occurring minor eye conditions.

The service is provided by MECS accredited optometrists (also known as opticians) across Walsall. Some of the following conditions can be treated by the service:

– Red eye or eyelid problems
– Dry, gritty and uncomfortable eyes
– Irritation and inflammation of the eye
– Significant recent sticky discharge from the eye or watery eye
– Recently occurring flashes and/or floaters
– Painful eye
– Ingrowing eyelashes
– Recent and sudden loss of vision
– Foreign body in the eye

If an individual is unsure whether their symptoms can be assessed and treated by the service, they can contact one of the participating optometry practices who will advise them accordingly.

Eye conditions regularly being monitored by an optometrist or hospital eye service, will not be covered by MECS; for example Cataracts, Diabetic Retinopathy or Glaucoma.

HOW YOU BOOK AN APPOINTMENT FOR THIS SERVICE?

The service is provided by a number of MECS registered optometrists across Walsall. A list of participating optometrists can be found on this leaflet.

Simply telephone an approved optometrist directly (self-refer) to make an appointment. On contacting the optometry practice, you will be asked some questions about your symptoms in order to assess how quickly you need to be seen by the service. Depending on your symptoms, you will be seen within 24 hours or 5 working days.

Appointments are available during normal working hours and some optometry practices offer appointments at the weekend.

The service gives optometrists the opportunity to make the best use of the skills and knowledge they have gained during their training and career development in helping improve the eye health of people in their area.  In doing so, optometrists can only enhance the clinical and professional profile of their practice(s) and their importance to the community.  Optometrist will receive a much fairer financial recompense for their expertise and for their time than is currently the case under GOS.

TRAINING AND ACCREDITATION

There are two parts to the training and accreditation for this service. The two parts are based on the course used to train optometrists who provide PEARS in Wales. Part 1 must be completed before Part 2 can be started.

1)      PEARS Part 1: Distance Learning Lectures

Practitioners need to complete a course of theoretical training:

• 7 Lectures and MCQs provided online

• 7 CET points in total

• An individualised certificate (in PDF format)

2)      PEARS Part 2: Practical Station Assessments

Walsall LOC will organise practical assessments consisting of five 5 minute objective structured clinical examination (OSCE) stations, held under invigilated conditions.  These are designed to assess optometrists’ skill and knowledge in the areas of referral, communication, clinical decision making and interpretation of results.

WHAT MECS IS NOT ELIGIBLE FOR

• Flashes and/or floaters that have been stable for 3 months or more.
• Flashes and/or floaters unless at least 1 month has elapsed since the first full consultation for the same issue.
• For removing in-growing eyelashes unless at least 3 months have elapsed since the first full consultation for the same issue.
• For repeat dry eye consultations unless at least 3 months have elapsed since the first full consultation for the same issue.
• And in similar situations to the previous 2 points.
• Where the patient’s reported symptoms indicate that a sight test is more appropriate than this service.
• Adult squints, longstanding diplopia.
• Removal of sutures.
• Repeat visual fields tests to aid diagnosis following an eye examination.
• Longstanding/stable age related macular degeneration.

You may repeat a MECS consultation after a short period for a different problem. The use of MECS is constantly monitored within the IT system and outliers may be asked for explanations.

It is recognised that as patients are self-referring it is possible that they may attend the service with a condition which is excluded for treatment but requires assessment and onward referral to an appropriate eye service. In these cases patient assessment by a MECS is classed as an episode of care and payment will be made.

The key here is prior knowledge. If a patient books a MECS appointment with sudden vision loss and it turns out to be wet AMD, the consultation fee will be paid. If, however, the wet AMD is identified during a sight test, then MECS may not then be used. If you already know that as a result of the sight test that you will be referring, then you cannot use MECS.

REFFERRALS OF MECS PATIENTS
All referrals are made via Optomanager automatically from the MECS system. In all consultations a report is generated to the GP.

Urgent Referrals (Urgent 24hrs and Urgent 72hrs)
A referral letter will be generated by Optomanager and practitioners should print the letter and fax it direct to Wolverhampton Eye Infirmary Acute Referral Clinic (ARC). These will be triaged by staff at ARC who will contact the patient to offer an appointment within the appropriate timescale. It is vital that the referring optometrist ensures the correct contact telephone number is recorded for the patient and that the patient is aware of the process involved and the requirement for urgency. The patient should contact the optometrist in the event that an appointment is not offered by ARC or there is a breakdown in communication.

Fax number for URGENT referrals directly to ARC: 01902 695842To talk to someone at ARC phone: 01902 695805.

If you have an urgent referral outside the normal hours of the eye casualty service (e.g. evening, Saturday afternoon or Sunday) then phone ARC for assistance. You should contact them by phoning New Cross Hospital switchboard on 01902 307999 and asking for ARC or the on-call ophthalmology doctor.

You must stress to the patient that once the ARC appointment has been booked, the patient will need to attend the allocated slot at that time. ARC has a Zero Tolerance Policy to missed appointments and won’t offer the patient another one if that appointment is missed.

If your urgent referral into ARC is faxed after 6pm, the criteria for “seen <24 hours” won’t start until the following morning.  For this reason, if a patient presents with symptoms/condition meriting urgent referral to ARC <24 hours, try to make the referral straight away, rather than wait until the end of the day’s clinic.

Routine Referrals 

Practices refer via Optomanager and for out of area GPs you should post the referral.

Suspected Wet AMD referrals (2 week fast-track)

Practitioners should follow the present referral pathway and fax to Wolverhampton Eye Infirmary.

OFFER THE MECS SERVICE

The registration form below is for local contractors who are interested in offering this service to the public.

Primary Eyecare WM Walsall OPTOMANAGER Registration Form

USEFUL RESOURCES

Walsall MECS Pathways & Protocols

College of Optometrists’ Clinical Management Guidelines advice on the management of most common ocular conditions

Optometry Medicines Support Unit Information and advice on ocular therapeutics

Patient information leaflet

MECS Powerpoint Presentation