ABCD position statement on diabetic retinal screening following publication of the NSF for England and Wales

Abstract

• The Association of British Clinical Diabetologists welcomes the National Service Framework (NSF) plan to develop an effective and comprehensive screening programme for diabetic retinopathy. • Responsibility for commissioning of a local retinal screening service lies with the primary care trusts (PCTs). Responsibility for ensuring that the service is provided and adequately resourced lies with the strategic health authority. The following components are essential for the provision of an effective service:. - Leadership. An individual with suitable skills and clinical experience should have overall responsibility. In many cases this will be a diabetologist or ophthalmologist. Where it is not, these clinicians should be very closely involved in planning to ensure that systems are in place for prompt treatment of sight-threatening retinopathy and integration with other aspects of diabetes care. - Revenue. Capital funding will be available for equipment but PCTs must ensure that sufficient funds are available for the running of the service. This will include equipment maintenance costs and staff salaries. Retinal screeners/graders and administrative staff will be required. The job plan of the lead clinician should include time for direction of the service. - Co-ordination. Central co-ordination will be essential to ensure that the service is comprehensive and efficient with robust quality assurance. This will require communication between the screening programme and primary care IT systems with appropriate software selection. - Existing local screening programmes. Many districts will already have a retinal screening service in place. These may require upgrading to meet the standards set by the NSF and the National Screening Committee. Optometrist-based services will need to consider how to incorporate digital photography in a way which achieves the recommended quality assurance standards. Copyright © 2004 John Wiley & Sons, Ltd.