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Guildford is the kind of place you might expect to find the finer things in life.Despite its closeness to London it has a country town feel, a university, a cathedral and its outlying villages command some of the highest property prices in the country.
Its cobbled high street boasts an array of bijou shops while its opticians count among them the winner of the Optician Award for Fashion Frames Practiceof the Year.
When it comes to extended eyecare Guildford also has a new clinic, Optegra Eye Care. Thisclinic is on the city's science park a stone's throw from the county hospital and the university. Within its modern walls is housed an impressive array of consulting and operating rooms offering personal eye care in a calm and clinical setting.
In common with many clinics Optegraoffers cataract, laser refractive and cosmetic procedures but it also has ambitions to work with local optometrists to offer glaucoma, retinal and macular degeneration services within the private healthcare sector.
Justin Annett, business development manager with Optegra, says the clinic came about when a director with the investment company which owns Optegra underwent cataract surgery and saw an opportunity in the market.
Annett says he is dismayed by the commoditisation of surgical procedures such as Lasik and says it is important to offer patients an environment in which they are co-managed through eye care by a surgeon and their own optometrist.This, he says, is what Optegra is all about and so far claims the idea has been well received by local optometrists.
Optegra invited local optometrists to come to the clinic to have a look around and hear how they might work with Optegra. 'The 25 practices we have spoken to all want to work with us,' says Annett.
One practice which has sent patients to Optegra is Haig-Brown of Esher. Optometrist Nicola Haig-Brown says the practice has discussed shared care with Optegra but says: 'It's very early days. We have had chats about doing shared care. We have sent patients, at the moment it is more referrals. They have been great at handling our patients and the patients have been very impressed. It is a well equipped clinic.'
She says Optegra has been very good at communicating with the practice and she has been invited to watch operations.
However, Haig Brown'spractice has a Topcon OCT and a GDx and it has built up a very good relationship with local ophthalmologists over the years so tends to have a good relationship with local ophthalmologists already.
She says the practicewelcomes wholeheartedly the idea of working in partnership on enhanced care schemes with clinics intent on offering the best possible care.'What we wouldn't want to do is to send them our patients and never see them again.'And this is the fear Annett is trying to allay. By working with us, opticians can offer patients extended services but keep in contact with the patient throughout, he says. 'We are trying to get them to refer patients to us so we can manage patients together. Because of the way Optegra is set up the optometrists and ophthalmologists are in close contact and can discuss issues and bounce ideasback and forth.'
Referrals are quicker and the whole process is on a human scale. 'This is not a situation where a referral is made into a black hole. Optometrists often say to me that after the referral is made they hear nothing back from the ophthalmologist, even in the private sector.'
Annett insists that Optegra is a way for the optician to retain the management of the patient but with the back up of state-of-the-art ophthalmologic care, close at hand.'If you send a patient here that patient is still the optometrist's patient but we look after them together, it is a shared care process.'
He has also worked closely with the local optometric committee to make sure what the clinic offers fits in with local needs. The clinic and its consultants have close links with local hospitals and the consultants work locally within the NHS. The procedures that can be offered in the high street are, for everything else the patient comes to us.
Optometrists are increasingly looking to up their clinical credentials says Annett. They may or may not choose to spend £50,000 on an Optical Coherence Tomograph but partnering with an ophthalmology clinic allows them to continue their involvement in extended care if that is what is needed.
All of the procedures are done on a private basis so the optometrist is paid for chair time in the high street and Optegra is paid for the procedures carried out at the clinic.
The clinic is like a showcase for the latest eye care equipment housed in a feng shui world. Its optometric consulting rooms feature Topcon CV5000 refraction suites, tonometers, keratometers, autorefractors and lensmeters integrated with bespoke furniture. The diagnostic rooms for retinal, glaucoma and cataractpatients are equipped with instruments and data-capture equipment from Zeiss, Alcon, Carelton and Oculus.
The rooms are light and airy with touch controls for the blinds, lighting and aircon. The slit lamps have digital image capture and screens to enable the rooms to be used for teaching. Annett says Optegra is keen for optometrists to visit, watch procedures and learn from the consultants.
Gloria McCall, regional sales manager with Topcon, which has installed around £200,000 worth of equipment in the clinic's state of the art consulting rooms, says it is the human scale of the clinic which is its greatest asset. The time it takes for a patient to be seen can be as short as a few hours. If practices are going to position themselves as clinical they need equipment like OCTs to do that monitoring and provide an enhanced level of care.
Optegra believes that optometrists can offer a complete service to their patients by linking to its clinic and sharing the care of patients.This joined-up approach is the way everyone would like to practise eye care. It is open to everyone, but at a cost not all can afford. He says optometrists know their patients and will have a fair idea for which ones private management of AMD, glaucoma and retinal issues will be an option.
'The optometrist may have someone sat in front of them who they have dealt with for 20 or 30 years. It is quite an easy proposition for them to deliver.'
For those patients that can pay, Optegra offers care in pleasant surrounding and with a human face. For optometrists it may offer an opportunity to be more involved in extended care and to retain the patient and not refer them into the black hole described by Annett.
