Table 4 Practical steps or actions for service improvement in the management of nAMD

From: Action on neovascular age-related macular degeneration (nAMD): recommendations for management and service provision in the UK hospital eye service

Options and practical steps for service improvements in the management of nAMD include, but are not limited to:
▪ Direct electronic referral for suspected nAMD can facilitate rapid access to clinical assessment and imaging and needs to be managed as direct appointment bookings to ensure allocation to the correct clinic.
▪ Trained non-medical AHPs may help triage new patient referrals to fast-track prompt treatment or discharge decision making.
▪ Virtual (without actual consultation) clinic models may be provided in the HES or at peripheral sites, with decisions about treatment made by the consultant at a virtual reporting session or by non-medical AHPs directly. Training, audit and governance must be appropriate.
▪ Decentralised image acquisition for nAMD virtual clinics where community OCT and cameras are already available and IT data transfer systems are available.
▪ Eye departments have successfully implemented AHP-led anti-VEGF injection clinics.
▪ Risk stratification of patients who are no longer receiving active treatment may allow graded discharge options.
  1. AHPs allied healthcare professionals, anti-VEGF anti-vascular endothelial growth factor, HES hospital eye service, nAMD neovascular age-related macular degeneration, OCT optical coherence tomography