How the right A&G support can help, not hinder, elective recovery
March 27, 2024
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May 26, 2026
The Leicester, Leicestershire and Rutland (LLR) Integrated Care Board serves a population of more than 1.2 million people. Like many NHS systems across the UK, LLR has faced growing demand for ophthalmology services, alongside increasing pressure on secondary care capacity.
To help manage this demand more effectively, LLR introduced the Cinapsis platform in 2024 to support ophthalmology referral triage across the region.
Since implementation, the service has helped clinicians ensure patients are seen in the right place, at the right time, while reducing unnecessary secondary care appointments and improving support for primary care teams.
Demand for secondary eye care services in LLR had continued to rise, with multiple independent treatment centres operating across the region.
This created several operational challenges:
LLR needed a more efficient and clinically robust way to manage referrals, prioritise urgent cases and support integrated working across primary and secondary care.
LLR introduced Cinapsis-led ophthalmology triage in 2024.
All primary optometry referrals are triaged daily by trained hospital optometrists with expertise in treatment protocols, referral guidelines and the capabilities of primary eye care services.
GP referrals are triaged by trained GPs working within ophthalmology clinics, while overall clinical governance is provided by consultant ophthalmologists with experience across both primary and secondary care settings.
Alongside referral triage, the service also includes Advice and Guidance, enabling primary care clinicians to seek specialist input and manage more patients safely within community settings.
Clinical triage identified that 25% of incoming referrals did not require a secondary or tertiary care appointment. By reducing unnecessary referrals and duplication of care, LLR estimates the service has saved the ICB and taxpayers approximately £1.2 million over the last 12 months.
Images and full clinical information could be attached at source, ensuring patients were directed onto the correct pathway first time. It is estimated that around 3,700 patients were appropriately streamed without experiencing rejection or redirection due to mis-triaged referrals.This also reduced the need for secondary re-triaging of misdirected cases, removing a significant layer of administrative duplication.
Triage has enabled clinicians to prioritise more sight-threatening conditions and ensure patients requiring active secondary care treatment are seen more quickly. This supports earlier intervention and helps reduce avoidable visual impairment across the local population.
The Advice and Guidance service has helped primary eye care professionals manage more patients within primary care settings. This has been particularly valuable for newly qualified clinicians, providing reassurance, education and access to specialist support when managing patients independently.
Avoiding unnecessary hospital appointments has also reduced indirect costs and inconvenience for patients, including:
In many cases, patients were able to receive reassurance and clinical advice without needing to attend hospital services, helping reduce anxiety and improve patient experience.
Reducing unnecessary hospital visits has also contributed to a lower carbon footprint by decreasing avoidable patient travel across the region.
The LLR experience demonstrates how clinically led digital triage can help NHS systems manage rising ophthalmology demand more effectively.
By combining specialist clinical oversight with streamlined referral management and Advice and Guidance, Cinapsis has helped LLR improve patient flow, reduce unnecessary appointments and focus secondary care capacity where it is needed most.
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