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Impact of the Manchester Glaucoma Enhanced Referral Scheme on NHS costs

Forbes, H., Sutton, M., Edgar, D. F. ORCID: 0000-0001-9004-264X , Lawrenson, J. ORCID: 0000-0002-2031-6390, Spencer, A. F., Fenerty, C. & Harper, R. (2019). Impact of the Manchester Glaucoma Enhanced Referral Scheme on NHS costs. BMJ Open Ophthalmology, 4(1), article number e000278. doi: 10.1136/bmjophth-2019-000278


Objectives: Glaucoma filtering schemes such as the Manchester Glaucoma Enhanced Referral Scheme (GERS) aim to reduce the number of false positive cases referred to Hospital Eye Services. Such schemes can also have wider system benefits, as they may reduce waiting times for other patients. However, previous studies of the cost consequences and wider system benefits of glaucoma filtering schemes are inconclusive. We investigate the cost consequences of the Manchester GERS. Design: Observational study. Methods: A cost analysis from the perspective of the National Health Service (NHS) was conducted using audit data from the Manchester GERS. Results: 2405 patients passed through the Manchester GERS from April 2013 to November 2016. 53.3% were not referred on to Manchester Royal Eye Hospital (MREH). Assuming an average of 2.3 outpatient visits to MREH were avoided for each filtered patient, the scheme saved the NHS approximately £2.76 per patient passing through the scheme. Conclusion: Our results indicate that glaucoma filtering schemes have the potential to reduce false positive referrals and costs to the NHS.

Publication Type: Article
Additional Information: © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:
Subjects: H Social Sciences > HJ Public Finance
R Medicine > RE Ophthalmology
Departments: School of Health & Psychological Sciences > Optometry & Visual Sciences
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