EVALUATION OF ORTHOPTIC STROKE SERVICE AT SOUTHPORT AND ORMSKIRK NHS TRUST (MWL).

Published Date: 01st June 2025

Publication Authors: Garrick. A, Walsh. N, Knowles. K

Conference Abstract

Introduction: Research suggests that the prevalence of visual problems post-stroke is approximately 70%.1 Therefore, it is recommended that patients have either visual screening or formal Orthoptic assessment so that "Crucial information can thus be provided on visual status and its functional significance to the stroke team, patients and carers, enabling early intervention." The Royal College of Physicians and NICE updated their guidance in 2023 to state patients should either be "screened using a standardised approach" or offered "a specialist orthoptist assessment as soon as possible". This evaluation specifically compares the new service with the previous ad-hoc service to establish whether it is more effective.
Method(s): Since 2021, all stroke patients referred to the Orthoptic team have been documented in an Excel database. This outlines the date of referral, stroke date, reason for referral, referrer, date seen, etc., which is inputted at the time of the referral and then onwards. This audit briefly outlines the data from 2021 onwards, focusing specifically on 2022 (the old service) and 2023 (from May onwards -the new service). The stroke team and Sentinel Stroke National Audit Programme (SSNAP) have provided data regarding the total number of stroke patients coming through the trust during these time periods. Inhouse Electronic patient records were also reviewed as needed.
Result(s): Comparing the old and the new services showed that the new service was in line with the BIOS standards on 10 out of 12 points as opposed to the old standards, which only met 3 of the standards. While the new service significantly improves meeting the standards, there is still a discrepancy between recommended ward time and what is currently allocated. Despite the increase in the time allocated for seeing patients and the creation of dedicated clinic sessions, waiting times have unfortunately increased overall. However, when comparing the number of referrals from 2022 to 2023, there has been a 154% increase.
Conclusion(s): * The current Orthoptic stroke service meets 10 of the 12 factors BIOS recommends for a "high-quality service". * The factors not being met are one element of the staffing and a rota of Orthoptic staff. * Two out of three staffing recommendations are being met, with the remaining one due to falling short of the recommended WTE specifically for the ward. * The quantity of referrals to Orthoptics has increased significantly, starting around Sept 2022 when the HASU opened. * Although patients are now waiting longer, they are triaged to dedicated clinics. They have a pathway explicitly catering to the most frequently seen clinical conditions, with options for appointments that may be more suited to those with a poorer recovery post-stroke.

Garrick, A.; Walsh, N.; Knowles, K. (2025). EVALUATION OF ORTHOPTIC STROKE SERVICE AT SOUTHPORT AND ORMSKIRK NHS TRUST (MWL). Eye. 39, p.278. [Online]. Available at: https://dx.doi.org/10.1038/s41433-025-03831-0 [Accessed 26 February 2026].