As part of the recovery of diabetic eye screening services following a service pause during the COVID 19 pandemic, it has been agreed as part of a national risk stratification exercise, that patients that had a retinal screening grade of R0M0 (retinopathy zero, maculopathy zero; meaning no eye damage) can have their invitation delayed by a maximum of 12 months (24 months from their last attended retinal screening appointment). 

However, there may be some circumstances where it may be clinically appropriate to screen an individual earlier than the maximum allowed interval of 24 months (but not before the minimum 12-month interval). 

If a patient falls under one of the following three categories, their diabetologist or GP can choose to contact the local DESP to ensure they are seen earlier than the potential maximum delay: 

• previously had documented longstanding variable HbA1C levels and the treatment (e.g. insulin) has brought about a sudden reduction in HbA1C levels
• has had increased HbA1C levels in the previous 12 months - HbA1c of > 10%/ 86mmol/mol
• An individual raised and uncontrolled hypertension with B/P >160/100 

It is important to note that if a GP or diabetologist does not contact the DESP for patients in these groups, the patient will remain part of the broader R0M0 low risk group, and receive an appointment up to, but not longer than, 24 months  after their last confirmed visit to a DESP. The DESP does not hold the information relating to these three points on their database, so would not be aware if patients fell into any of these groups without being informed by a GP or diabetologist.  Therefore the ask of either the GP or specialist team is to refer this specific cohort of patients directly to their local DESP service. 

For further information and/or queries, please contact Matt Cruice, Team Leader, Adult Screening Programmes, NHSE at matthew.cruice@nhs.net