Compliance with the quality standards of National Diabetic Retinopathy Screening Committee

The National Diabetic Retinopathy Screening Committee has recommended 19 standards for quality assurance of screening programmes in the United Kingdom. Five of the standards apply to the care provided by ophthalmology departments. This study assesses the quality assurance of the eye care provided by the Wakefield and North Kirklees Screening programme.

A retrospective audit of case notes of patients for 12 consecutive months in 2007. The outcomes were compared with the five quality standards.

Out of a total number of 15,080 patients screened for diabetic retinopathy (DR), 479 (3.17%) required referral to ophthalmology department (screen-positive). Of these, 352 (2.33% of total screened) were referred for diabetic retinopathy. Forty-three patients (13%) were referred for proliferative retinopathy (R3), 279 (79%) for maculopathy (M1), 24 (7%) for non-proliferative retinopathy (R2), and 4 (1%) for a history of previous photo-coagulation (P1). Fifty-eight patients (16%) failed to attend. A timely consultation was achieved in 33% of R3 and 77% of M1 patients. Only 31% of R3 and 8% of M1 at screening were listed at their first visit to ophthalmology clinic and received laser treatment in stipulated time.

Significant progress is required for timely consultation and management of screen-positive patients. In order to achieve these targets efficiently, it may be appropriate to re-define M1 so that a significant proportion of patients with M1 may be referred to and better managed by primary care physicians or diabetologists.