Sir,

We note with interest the results published by Levy and Booth1 on 'Patient satisfaction with Peninsula Optometry Community Glaucoma Scheme'. We have significant experience with our own community optometrist glaucoma scheme2 and have recently collected satisfaction data.

Questionnaires were sent to 120 patients attending the community scheme and 120 patients in the hospital glaucoma service. Patients were questioned about the clinician they saw, and their satisfaction with the service overall (Table 1). Response rate was 57%.

Table 1 Rates of patient satisfaction with the glaucoma services and their health professionals
Full size table

Patients in the community scheme were asked whether they would like to continue with the scheme, whereas patients in the hospital service were asked if they would be happy to be transferred to the community scheme. Sixty-two out of 66 patients in the community scheme were happy to remain, whereas only 33/65 of hospital patients would be happy to be transferred to the community optometrist scheme.

The difference in satisfaction between the optometrist and doctor may reflect differences in training (with a more client-oriented approach in optometry) or differences in perceived time pressures. Satisfaction rates were equivalent between the schemes overall.

Both previous publications on satisfaction in community schemes found higher satisfaction with the community service, whereas we have found them equivalent. In comparison with the Bristol scheme,3 we did not randomise our patients to each group, and therefore some of the hospital patients may have been ineligible for the community scheme. In contrast to Levy and Booth’s1 series, we asked patients to comment on satisfaction with their current scheme, rather than making a comparison.

Patients in the scheme were happy to remain there, whereas of those in the hospital only half would be happy to be transferred. This may be due to more complicated requirements (whether perceived or real) of the hospital patients’ glaucoma. Without adequate explanation, the patient may feel that they are being ‘downgraded’ or outsourced. We would like to highlight the importance of adequate information given to patients when they are transferred to a community scheme.