Inadequate images in the Birmingham, Solihull and Black Country Diabetic Eye Screening programme

Since the introduction of the English National Screening Programme for Diabetic Retinopathy (ENSPDR), there has been a dramatic increase in the number of referrals to HES for other lesions, especially cataracts. Patients with unassessable images cannot be assigned a grade, and this presents a problem for the screening services. ENSPDR guidelines state that all patients referred as unassessable should be referred to a dedicated slit lamp clinic for assessment. The time between the initial encounter and slit lamp assessment should meet a minimum standard 70% within 14 weeks, with an achievable standard being 90% within 14 weeks. With the percentage of ungradable images should be <5%.

The aims of the audit are to ascertain the most prominent reasons for inadequate images and to see how patients with inadequate images are managed.

By Emma Shepherd