View from FODO: Better care for AMD patients
The new NICE guideline on age-related macular degeneration – diagnosis and management is extremely welcome.
First and foremost it should ensure better and more consistent care for patients. The guideline is also an important step in the development of new integrated models of delivery across primary, community and hospital services in line with modern clinical practice.
The definitions, referral criteria and management advice are extremely helpful and patients will be reassured about the focus on active engagement in their own care and the recognition that they often have to cope with other long-term illnesses at the same time.
Also pleasing is the recognition that AMD patients are at high risk of depression and the recommendation for early certification.
Eye care professionals will find the guideline particularly helpful in clarifying the risks of progression, the urgency of referral and when community management and self-monitoring are more appropriate.
There are also very clear enhanced roles for the optical sector - one example being the explicit recognition that optometrists and other eye care professionals can give intraocular injections. This is further validation from NICE of the arguments we have long made that community eye service should play a greater role in treating and supporting patients who do not need hospital care.
Our only concern is about sustainability. There is a lack of guidance in the implementation documents about funding, yet meeting growing need, quality standards and training requirements within existing NHS resources and capacity just is not feasible or credible.