The Royal College of Opthalmologists’ (RCOpth) publication, in February 2018, of new recommendations for screening of patients taking Hydroxychloroquine (HCQ) created significant challenges.

Around 320,000 patients currently take HCQ to manage long-term conditions such as rheumatoid arthritis. Taking HCQ for over five years causes increased risk of retinopathy, therefore it is now recommended that patients commencing long-term therapy receive baseline testing within the first year of treatment, followed by annual screening once patients have been taking HCQ for five years.

Eighteen months after the recommendations’ publication, practical and financial barriers to delivering this large-scale programme in the acute care setting have become clear.

In response, recognising the potential for primary care opticians to deliver the programme efficiently and cost-effectively, Locsu has developed our clinical pathway for Medical Retina Monitoring (HCQ). This framework establishes an integrated service delivery model with data collection in primary care and virtual review by a consultant ophthalmologist.

As well as alleviating pressure on hospital ophthalmology departments, this offers patient benefits to attend screening appointments at a convenient time, in an accessible location outside the hospital setting.

Zoe Richmond, Locsu’s interim clinical director, comments: ‘Our clinical pathway makes efficient use of the considerable resources in primary eye care to deliver the HCQ monitoring programme in a way that best support patients. With the number of patients prescribed HCQ anticipated to grow significantly in future, it’s essential that a sustainable, scalable strategy is established to support increasing workloads.’