Coronavirus: diabetic eye screening programme update
In response to the coronavirus (COVID-19) outbreak, please read our advice and information before sending any referrals.
The South East London Diabetic Eye Screening Programme, which is known locally as SEL DESP, is the diabetic retinopathy screening programme for patients aged 12 and over who are registered with a GP in south east London (Lambeth, Southwark, Lewisham, Bexley, Bromley and Greenwich).
Screening programmes operate on geographical boundaries. If you are outside of the south east London area you can find your local screening programme or see a list of all screening programmes in London with contact details.
Diabetic eye screening programmes manage a register of all patients with diabetes living in their geographical catchment area to ensure that all patients are invited for annual screening (or more frequent screening during pregnancy), or suitably suspended or excluded with appropriate alternative management and evidence. The programme seeks to maximise the number of patients attending for screening and if patients do not attend they can contact the administration team at any time to rebook their appointments.
We run daily diabetic eye screening clinics at several hospital/community healthcare sites and three high street opticians. Please see the clinics page for more information. All appointments and administration is managed centrally by an administration team based at Guy’s Hospital.
Diabetic eye screening register and GP2DRS automated system for referral of patients with diabetes
The programme maintains a register of all patients aged 12 and over who have had a diagnosis of type 1, 2 or steroid induced diabetes. This includes patients whose diabetes is in remission, as current guidance states that these patients should continue to receive diabetic eye screening and other checks annually.
A national data extraction system known at GP2DRS is used by practices in south east London. Practices submit their diabetes register to the programme each month, allowing us to add new patients to our register and invite them for screening. We are also notified of changes of address, name, and GP practice which we use to keep our register up to date.
The following patients will not appear on the register and therefore will not be invited for screening,
- Patients who are coded with 'diabetes resolved' (this is now an administrative code used for a diagnosis having been made in error, any patients who have ever had a definitive diagnosis of diabetes should be coded 'diabetes in remission'.
- Patients who are registered under a temporary registration, student registration or private patient registration.
- Patients with gestational diabetes will not be on the register we receive. We will only invite these patients for screening if a hospital consultant suspects type 2 diabetes.
- Patients who have been coded with 'consent to share demographic data for retinal screening withheld' (XaNQY or 9NdC.). Please ensure that patients coded with this understand they will not be invited for eye screening and that this code will transfer with them if they move practices.
We do not need GP practices to refer patients to us manually, or for patients to self-refer, if all practice coding is completed correctly. Patients will be invited for screening between one to three months of notification to the programme. GP practices should ensure that patients are informed of their diagnosis of diabetes before they are invited for eye screening.
If you have any questions about this process, please email the programme office at firstname.lastname@example.org.
SELDESP is a screening programme. Patients who are symptomatic and require urgent assessment (for example, sudden loss of vision) should be advised to attend eye casualty at St Thomas' Hospital or their nearest Emergency Department (A&E).
Onward referral and treatment for diabetic retinopathy
Patients who are found to be screen positive are referred to a hospital eye service which is closest to the location at which they attended for screening. The hospitals we refer to are:
- St Thomas’ Hospital
- King’s College London
- Queen Mary’s Hospital, which operates a satellite clinic at Queen Elizabeth Hospital
- Lewisham Hospital
- Princess Royal University Hospital.
Patients being referred for diabetic eye disease or another urgent retina condition which is identified as an incidental finding will be monitored and tracked for the duration of the time that they are under the care of the hospital eye service. Patients will be suspended from screening for the duration of the time that they are under the care of a medical retina specialist. Patients attending the hospital eye service for another condition, for example glaucoma should continue to attend for retinal screening and are not suspended.
Patients wishing to opt out of screening
Patients may make an informed choice to opt out of screening. They are asked to sign a form confirming this, and that they have discussed this with their GP and understand the risks.
Opt out periods are one, two or three years. Patients wishing to opt out for three years or longer will automatically be invited for screening after three years and can opt out again at this point by signing the form. If a patient wishes to opt out, please contact us and we will send them a form. If we receive a signed form, we will send a copy of this to their registered GP.
We ask that in all instances the GP discusses this decision with the patient to ensure they have made an informed choice to opt out of screening. Patients need to understand the risk of not having their eyes screened for diabetic retinopathy and that diabetic retinopathy is a symptomless disease until it is in the advanced stages.
If you receive an opt out form from us signed by one of your patients who you have not previously discussed with this, please contact them to discuss this. We are happy to reverse this decision at any time. Please contact us if you would like us to send out a copy of this form. If a patient has requested a form but they have not returned it they will continue to be invited for screening.
Patients who do not attend for diabetic eye screening
Any patient who does not attend for diabetic eye screening will be sent a letter and their GP will be notified. We ask that GPs inform us of any reasons why patients may not have attended their appointment or if patients may no longer be suitable (eg they are medically unfit for screening).
We will offer patients who do not attend (DNA) a further fixed appointment automatically. If they do not show for this appointment they will be reinvited the following year. Our DNA rates for our clinics can be up to 35%. Please help us reduce this as much as possible by ensuring patients are aware of the importance of eye screening, are aware of their diagnosis of diabetes and tell us of any additional information that can help us accommodate the patient.