Ophthalmology is currently the busiest outpatient specialty in the NHS. Across England only 75% of ophthalmology referrals are met within the 18-week target, with 3.6% of patients waiting over a year for their first appointment (NHSE September 2025). 

The challenge as with many outpatient services is the number of unnecessary referrals being made to specialist eye care services. There is a need to streamline the process by widening access to specialist advice and guidance from Ophthalmologists. 

Resulting in managing waiting lists more effectively to prioritise those who need urgent treatment. Whilst reducing the amount of time spent by GPs in processing eye care referrals and enabling practice teams more time to support other patients.

Midlands EeRS

Across the Midlands region covering 11 ICBs, Cinapsis has set up the Midlands Electronic eyecare Referral System (EeRS) to support clinicians across the region to streamline referrals. In the last 12 months (Nov24-Oct25) the case volume is 235,100 on average monthly use is 19,591. 

Using the platform optometrists can request real-time advice from Ophthalmologists from local hospitals. Enabling the sharing of high-resolution clinical images, documents, complete OCT scans and videos, providing the Ophthalmologist with information to remotely advise on whether a referral to secondary care is needed. If the referral is deemed unnecessary, the patient can be triage to a more appropriate service or care pathway within primary care or the community.

Within the Dudley Group NHS Foundation Trust, Cinapsis is integrated with their EPR mediSIGHT electronic patient record which has significantly improved the Trust’s ophthalmology referral process. Previously, referrals were received through multiple channels and could take up to six weeks to process requiring manual data entry into mediSIGHT. Additionally, these improved processes enabled the review of cases to be directed to the right clinical service creating further efficiency savings. 

Now, information is shared easily between community optometrists and ophthalmology specialists across the Dudley Group. Whilst the integration enables clinicians to view the referral documentation without logging onto multiple systems. 

Key benefits identified included: 

• 1 minute saved per patient referral
• 3.5 hours of admin time saved per week
• Zero transcription errors

Through their integration with GP Connect, Cinapsis have recently launched GP Connect into Primary Care for Optometrists with this functionality being deployed over the Midlands region for Optometry practices. In the future planned new functionality will include the sharing of discharge letters, so Optometrists can then view discharge summary following treatment. With the aim to educating Optometrists and thereby improving their patients’ continuity of care.

Cambridge and Peterborough Paediatric ophthalmology referrals 

Across the region Cinapsis platform is used to streamline referrals and provide advice and guidance in real time between local optometrists and ophthalmologists at local hospitals. Over the past 12 months (Nov 24-Oct 25), the case volume was 19,026 serving a population of 1 million people.

• Evaluation showed in 25% of cases that Cinapsis enabled advice to be given to the referrer and the referral returned, compared to 5% with conventional referrals. 
• The average triage and advice turnaround was 24 hours with Cinapsis, versus previous practice which took approximately 7 days. 
• 90% of optometrists rated the advice speed as ‘fast’ or ‘very fast,’ 95% found it reassuring, and
• 90% stated that Cinapsis ‘significantly contributed to their clinical development’ in paediatric practice (Novitskaya and Farrell, 2025). 

For more see published paper. 

As a result, the use of Cinapsis has been expanded into adult ophthalmology referral management including cataract referrals. With an ageing population the demand for cataract surgery is continuously increasing. As referrals are uploaded directly to eRS, appointments with independent sector providers can be given to patients to triage them straight into hospitals. 

The benefits that Cambridge and Peterborough ICB found with using Cinapsis included: 

• Reduce referral errors and rejections with NHS Spine integration
• Route patients to the right service first time
• Provide full visibility and tracking for clinicians and patients
• Automate routine steps, saving valuable staff time by changing day-to-day practice.    

Outcomes

• Reduction in the number of false positive referrals - as the triage clinician can provide detailed feedback to the community optometrist on their decision with condition management advice. 
• A standardised set of easy-to-use electronic referral forms and the ability to easily share images. 
• Reducing delays for patients whilst reducing the admin burden on community health professionals. 
• Improved flow of information across the system.