Community Macular Service

Descriptions

North & South Manchester and Trafford CCG commissioners wish to commission a high quality, comprehensive and efficient community-based macular service to commence in August 2016. The service will treat Wet Age-related Macular degeneration (Wet AMD), and similar conditions such as Diabetic Macular Oedema (DMO) and Retinal Vein Occlusion (RVO). Timely local access to the service will enable GPs and optometrists to refer patients quickly for expert opinion and diagnostic investigation without the need for the patient going into hospital. This will improve clinical outcomes for patients. The overarching objectives of the service are to: · Ensure patients are seen and treated in the right place at the right time and by the most appropriate person · Ensure that all patients have their initial treatment quickly and all subsequent treatments to plan · Deliver more care in the community with at least one site in each CCG area with more sites opening as demand requires · Operate under a substantially lower than existing but sustainable tariff offering Value For Money (VFM) · Offer new technology and treatments as they become available, for example Oraya Therapy, for all those who are eligible for it · Ensure pro-active shared decision making (SDM) for patients and carers · Ensure that Clinical practice/treatments are in line with the current research/evidence-based care, ensure adherence to NICE Guidelines and/or any relevant locally developed guidance and evolve as the evidence evolves. · Ensure that patients have a positive experience of care resulting in improvements in patient satisfaction. · The service will ensure that all treatments are complaint with the CCG’s Effective Use of Resources (EUR)policies http://www.northmanchesterccg.nhs.uk/funding-treatment · A fully inclusive service will be available to all communities and, where necessary, make reasonable adjustment for individuals with cognitive, emotional and physical impairments The CCGs considered including within this service specification a requirement for the provider to offer Avastin (bevacizumab) by choice, given there is a significant body of evidence which shows no material difference between this and the licensed drugs in terms of efficacy and safety and the cost differential between this and the licensed drugs. It has been decided by all 3 CCGs that offering Avastin by choice is not part of the service specification. However, the CCGs wish to include the use of Avastin in scenarios where it can be legally offered in the patients best interests. The provider will agree these scenarios with the commissioner. NICE will publish a new AMD diagnosis and management guideline in August 2017. The CCGs understand that routine use of Avastin is covered in the guideline scope and the CCGs positon will be reviewed at this point.