National Framework for Action to Promote Eye Health and Prevent Avoidable Blindness and Vision Loss

Jurisdictional update – Australian Capital Territory

Key Area for Action 1: Reducing the risk

Action Area: People with Diabetes

During the reporting period specialist Medical Officers worked with the ACT Diabetes Service to provide a multidisciplinary clinic, specifically designed to manage diabetic related eye conditions.
The DiabetesLink Program is an ACT Health initiative to improve communication and collaboration between primary and tertiary health care services. In 2013, the ACT Medicare Local, in conjunction with ACT Health, commenced the localisation of Diabetes HealthPathways for the ACT community. These Pathways aim to improve referral and management systems to promote best practice care of diabetes and to reduce the risk of diabetes complications.
During the reporting period the ACT Health Diabetes Service conducted education courses in diabetes care and management for health professionals to highlight and promote diabetes detection and management, all of which will assist in reducing diabetes eye disease.

Action Area: Eye Injury Prevention

During the reporting period, the ACT Health Ophthalmology Unit provided an Emergency Eye Clinic in order to assess and treat non-critical eye injuries and provide a 24 Hour on-call emergency service to Canberra Emergency Departments.

Key Area for Action 2: Increasing early detection

Action Area: Public Awareness

During the reporting period, ACT Health provided information through its publicly accessible website on the ophthalmology services available to residents of the ACT and surrounding region. The website² also provides links to eye health initiatives and vision awareness programmes.

Action Area: Primary Health Care

During the reporting period, ACT Health worked in partnership with the ACT Medicare Local, to improve and support communication, education and referral pathways between clinicians to enhance best practice for people with diabetes. In 2013, ACT Health provided $352,095 in funding a collaborative DiabetesLink Program between the ACT Health Diabetes Service and ACT Medicare Local (due to culminate in 2015). This programme supports the primary health care sector through improved education regarding prevention, screening and management of diabetic eye conditions. It also assists General Practice to maintain the annual cycle of diabetes care for all their patients through education activities and advice on diabetes management practices.

Action Area: People with Diabetes

During the reporting period nurses, allied health staff and a medical officer specialising in diabetes worked in the ACT Health Diabetes Service to conduct multidisciplinary reviews of high risk patients and ensured that access to services was based on the clinical needs of the patient. This collaborative approach ensures that patients who require surgical intervention from ophthalmologists have appropriate access to treatment.
In 2013, the ACT Health Diabetes Service received $113,000 in funding to establish a diabetic retinopathy screening programme. The aim of the programme is to increase the number of diabetes eye screen appointments to enable the early detection of diabetic retinopathy. The programme also aims to increase consumer awareness of diabetic eye disease through consumer education. The programme has been established in collaboration with the Canberra Hospital Ophthalmology Department and supported by the primary health care sector. The funding incorporated the purchase of a fundal retinal camera costing $37,339, which is now being actively used for screening. The programme is being delivered from the Belconnen Community Health Centre to ensure accessibility for consumers.

Key Area for Action 3: Improving access to eye health care services

Action Area: Workforce Supply

In 2011, a second retinal specialist was appointed in the ACT to help meet the increasing demand in retinal services (related to new technologies, particularly pharmaceutical treatments for diabetic retinopathy, macular degeneration and retinal vein occlusions). A new full-time ophthalmologist also arrived in the private sector, as has a private clinic staffed by visiting clinicians from Sydney. Unfortunately, this has been offset by several retirements from the private sector, and as such the ophthalmology staffing ratio (to population) in the ACT remains well below the national average, and people must endure lengthy delays for non-emergency care. Staffing levels in the public department of ophthalmology have been increased over the reporting period; however paediatric ophthalmology remains an identified gap in the ACT eye-care workforce.

Action Area: Access to Cataract Surgery

ACT Health has an established waiting list policy that ensures equity of access to patients across the ACT and surrounding catchment area based on clinical urgency. Services for cataract surgery were transferred to Calvary Hospital in order to optimise access to services and reduce pressure on Canberra Hospital and Health Services. Approximately 1,000 public cataract procedures are conducted each year by ACT Health.

Action Area: Affordability

The public eye clinic at the Canberra Hospital delivers over 13,000 episodes of care annually.
In addition to cataract surgery, there is a public surgical retinal service which performs over 200 retinal surgeries annually (elective and emergency).

Action Area: Cultural Accessibility

A diabetic eye disease service (bulk billed) was established at Winnunga Nimmityjah Aboriginal Health Service in 2014.
The Department of Ophthalmology at Canberra Hospital supports patients referred from Companion House, the refugee health service. Visual acuity is a key aspect of clinical examinations undertaken as part of the screening process by the medical service at Companion house.