Quality measures
The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.
Structure
Evidence of local arrangements and clinical protocols to ensure that adults with late AMD (wet active) start treatment within 14 days of referral to the macular service.
Data source: No routinely collected national data for this measure has been identified. Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example, referral pathways.
Process
Proportion of adults with late AMD (wet active) who start treatment within 14 days of referral to the macular service.
Numerator – the number in the denominator who start treatment within 14 days.
Denominator – the number of adults with late AMD (wet active) referred to the macular service.
Data source: No routinely collected national data for this measure has been identified. Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example, patient records, referral records and appointment systems.
Outcome
a) Loss of vision (changes to visual acuity) of people with late AMD (wet active).
Data source: Database audit – National Electronic AMD Audit feasibility report contains: mean change in visual acuity between baseline and month 12 (figure 7) and percentage of eyes losing ≥3 LogMAR lines between baseline and month 12 (figure 8). Data, collected from 40 centres dating from January 2012 to December 2013 (8 had low numbers and the data were excluded), were last collected in 2016. Available from the Royal College of Ophthalmologists' National Ophthalmology Database Audit.
b) Health-related quality of life of adults with late AMD (wet active).
Data source: No routinely collected national data for this measure has been identified. Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example, a questionnaire.
What the quality statement means for different audiences
Service providers (NHS hospital trusts) have agreed protocols to ensure that adults with late AMD (wet active) start treatment within 14 days of referral to the macular service.
Healthcare professionals (such as ophthalmologists, advanced nurse practitioners, optometrists and orthoptists working in secondary care) treating late AMD (wet active) in adults adhere to local protocols and start treatment within 14 days of referral to the macular service.
Commissioners (clinical commissioning groups) monitor providers to ensure that treatment for adults with late AMD (wet active) starts within 14 days of referral to the macular service.
Adults with late AMD (wet active) start their treatment within 14 days of being referred to the specialist service so that they have the best possible chance of keeping their sight.