Clinical Pathways and Guidance

This pack is intended to act as reference points for optometrists, dispensing opticians, and practice teams, supporting safe, consistent, and high-quality delivery of commissioned community eye care services. It includes updated guidance on:

• Clinical pathways and referral criteria, including glaucoma, narrow angles (AS-OCT), cataract referral refinement, macular pathways, learning disability services, and emergency escalation
• Clear referral and discharge definitions, with escalation thresholds and expected timeframes
• Emergency and out-of-hours pathways, to support timely and appropriate onward care
• Data capture, consent, and ethnicity recording requirements, which are mandatory across COTS services and essential for governance, audit, equity monitoring, and payment
• Claims guidance, including when and how to submit accurate COTS, OCT, and topography claims

We strongly encourage all practices to share this pack with both clinical and administrative staff, as many elements rely on coordinated team working (for example, consent processes, accurate Outcomes data entry, and correct pathway selection).

The guidance reflects current commissioning arrangements across South East London and has been developed to reduce variation, improve referral quality, and support closer integration between community and hospital eye care services.

If you have any queries after reviewing the pack, or require clarification on pathway eligibility, data requirements, or claims, please use the contact details provided within the documents.