The Retinal Outreach, Integration and Research Health Integration Team (RENOIR HIT) which started in December 2012, has achieved the objectives it set out at its inception. Building on Bristol Eye Hospital’s (BEH) regional, national and international strengths, particularly in retinal disorders, RENOIR was part of a strategic ambition to embed translational and clinical research into service delivery, born out of learning from the Retinal Treatment and Research Centre, where this culture and behaviour was developing. The culmination of RENOIR’s work means this strategic ambition has now become a reality, and is now business as usual for the team at the Bristol Eye Hospital.
Expanding their services through a modernised system using outreach clinics has allowed the NHS to deliver evidence based services to more people closer to home, improving patient choice and delivering research that brings new drugs and treatments to people who might not otherwise have access to them.
They have responded to the increased prevalence of retinal conditions by designing and delivering optimal and cost efficient care. They have enhanced their services through the use of modern imaging developments and IT, and extending their team’s skills. They have already recruited, trained and extended the role of optometrists, technical staff and nurses, leading to a more cost-effective delivery of services, a reduction in tariffs for this pathway of care, and enhanced research delivery.
Their outreach programme now provides high quality, modern services, treating patients closer to home to the same standards as BEH. They opened a new site at South Bristol Community Hospital in July 2013, followed by a site at a GP practice in Worle, close to Weston-Super-Mare, in October 2014. In January 2016 a mobile macular unit opened, currently based in Morrisons car park at Cribbs Causeway. They have received excellent feedback from patients: 98 per cent rated the service as very good or excellent, with the remaining 2 per cent rating it as good.
They have developed four research and NICE guideline-informed care pathways. Initial consultation and diagnosis happens at BEH, before patients are moved into appropriate care pathways for follow-up at one of the outreach locations. Patients are given opportunities to participate in research, whether they’re seen in the outreach locations or at BEH. There has been a doubling of recruitment during the duration of this HIT as well as new collaboration with the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care West (NIHR CLAHRC West) to undertake qualitative service evaluation.
Professor Andrew Dick, Director of RENOIR, said:
“The original strategic aims of RENOIR are now embedded in Bristol Eye Hospital’s day to day operational activities, and we are pleased to report that the team has achieved all that it set out to do. The culmination of all this hard work is our three outreach sites, offering excellent care, access to services and research opportunities, closer to people’s homes. I would like to take this opportunity to thank the team that has worked so hard to make this service transformation possible.”
David Relph, Director of Bristol Health Partners, said:
“Health Integration Teams – or HITs - are about making positive changes to improve care and quality of life for the people who rely on Bristol’s health and care services. I am delighted that RENOIR has achieved its goals, and is getting such excellent feedback for the services they’ve put in place. This demonstrates that the pioneering work of our HITs can, and should, become business as usual. Well done to Andrew and his team.”