DIABETIC RETINOPATHY SCREENING SERVICE FOR WALES

.Diabetes is affecting increasing numbers of people in the UK and the burden of serious complications and their sequelae can be considerable both for the individual concerned and the health service in general.  Many aspects of these complications can be limited, even prevented in some instances, with good early management of the condition.

Diabetes healthcare services are delivered by a wide range of professionals, spanning all sectors of the Health Service in diverse locations.  Because the outcomes of diabetes care depend on the integrated involvement of so many distributed components of the health services, effective clinical quality performance monitoring poses particular challenges.

The priority is to see services from the patient's perspective and to making changes designed to improve patient experience.

The duty is to provide high quality care in a friendly and supportive environment that recognises respects and protects their rights and dignity and meets their needs in the best ways possible.

Diabetic Retinopathy is the most common form cause of blindness amongst the working age adults in the UK..

Many people will be asymptomatic until the disease is very advanced.  After 20 years from onset of diabetes, more than 60% of people with type 2 diabetes will have diabetic retinopathy.  In people with type 2 diabetes, Maculopathy is the major cause of vision loss.

The risk of visual impairment and blindness is substantially reduced by a care programme that combines methods for early detection with effective treatment of diabetic retinopathy.  The key issue in screening for diabetic retinopathy is to identify those people with sight-threatening retinopathy who may require preventative treatment. Early detection of sight threatening retinopathy and treatment with laser therapy can help prevent sight loss. Currently all eligible people with diabetes aged 12 and over are offered routine, annual screening invitations, based on UK NSC guidance.

Diabetic Retinopathy Screening Service for Wales (DRSSW)was designed as a community based service to give reasonable and equitable access to all eligible persons with diabetes in Wales. The screening methodology used is specific and sensitive for detecting and grading retinopathy, including maculopathy. The service was commissioned in July 2002 by Welsh Government as part of the Welsh Eye Care Initiative (WECI) risk reduction programme and a vital element of The Diabetes National Service Framework (NSF).Other lesions can be detected and are also referred appropriately. The service operates under the standards set by the UK National Screening Committee (NSC). 

Furthermore, diabetes has a predilection for vulnerable and disadvantaged sections of society so it is essential to ensure not to inadvertently exclude those who are not accessing services satisfactorily.

Screening and treatment for diabetic retinopathy will not eliminate all cases of sight loss, but it can play an important part in minimising the numbers of patients with sight loss due to retinopathy.

Every eligible, registered person with diabetes in Wales is invited for retinal screening. The service is community based, delivering from clinics sites that are chosen to allow all patients reasonable and equitable access.

Response from Diabetic Retinopathy Screening Service for Wales