Single Point of Access

We recently wrote to you regarding the upcoming changes being implemented across Humber and North Yorkshire (HNY) when referring a patient to secondary care for Cataracts and other Ophthalmology referrals. The ICB has introduced a Single Point of Access (SPOA) which will expand the existing Patient Choice Office, currently operational in York and North Yorkshire, across HNY. Along with this, the ICB developed a new HNY clinical commissioning policy for Cataracts – this policy can be found on our website here: Cataract Policy.
 

FAQs regarding the SPOA and digital system can be found here (and below) and will be updated on an ongoing basis.


CareID process 
Gateway demo:
Gateway registration link once CareID process has been completed​

SPoA patient questionnaire
RSS cataract patient contact information
 

The SPOA will receive all referrals in a digital format and ask the patient an associated set of questions related to their Cataract which will then determine the most appropriate set of providers to care for the patient. The team will then have an informed Choice conversation with the patient to refer them to their provider of choice.​

To enable the changes, we require Optometrists and their administrators (if referring on behalf of clinicians) in York, Scarborough and Ryedale to sign up to access the digital system by the 30th of June. There is a staged process which will provide you with a unique login using two factor authentication via your phone (an alternative to using an NHS Smartcard). Once signed up, you will be able to login using just your phone like signing in to a banking app or government portal. To start the process, please can you complete this questionnaire (Link) which will ask for your details. Once received, you will be contacted via email to share ID documents with the central NHS team followed by a short call with the IT provider to complete the sign up.​

Thank you to those who have already submitted your information. For clarity and to ensure we have captured all responses, we are resending this communication.​

The implementation of the digital system (Gateway) will follow a phased approach. Each area within Humber and North Yorkshire will be onboarded from a different date which we will communicate shortly, we are starting with practices in York, Scarborough and Ryedale. We are asking all practices to have at least 2 people signed up by the 30th of June at which point the £12 fee for completing the Direct Cataract Referral form as part of the Direct Cataract Referral Scheme will cease. For any colleagues not signed up at this point or new starters, we will continue to support sign-ups after this date.​​

For any questions or queries please contact the RSS Team at hnyicb-voy.rsservice@nhs.net (Patient Choice Office)

HNY ICB Cataracts Single Point of Access – FAQ 

June 2025

  • What changes are being made to the cataract referral pathway and why?

    The treatment of cataracts faces significant challenges due to rising demand, costs, and system inefficiencies. Variability in service specifications, referral processes, treatment pathways and post-operative care has created health inequalities, and there are limitations in available audit/outcome data to enact effective pathway transformation.

     

    The Humber and North Yorkshire (HNY) Integrated Care Board (ICB) proposes implementing a Single Point of Access (SPoA) for cataract pathway management delivered through the HNY Referral Support Service (RSS – locally known as the Patient Choice Office) across NY&Y for all NHS cataract patients across the six HNY Places to deliver the benefits required for patients, clinicians and the wider system.

  • What is the Cataract SPoA?

    The SPoA is supported by the ICB’s Referral Support Service. Optoms across NY&Y have been referring to the RSS via NHS Mail since pre-2012. A digital solution allows the expansion of the service and to streamline processes and turnaround time. The RSS team will process referrals and contact patients to offer appropriate Choice of secondary care providers based on the Patient Questionnaire (see q X) outcomes.

  • How does the SPoA benefit patients?

    All patients will be provided with a consistent offer across HNY with an easy-to-use referral system for Optometrists and the same informed conversation for all patients regardless of geography. All patients will be offered a choice conversation regarding their preferred care provider, with access to both NHS Acute and Independent Sector (ISP) waiting times.
    There will also be improved patient understanding and transparency around access to secondary care providers through the information held by the SPOA team. Lastly, there will be a reduction in inappropriate referrals into secondary care related to specific care pathways e.g. comorbidities, which can lead to delays to the patient pathway

  • How does the SPoA and digital solution benefit Optoms/referrers?

    A digital solution eliminates the NHS Mail referral mechanism and via the Gateway system, allows referrers better access to referral outcomes oversight. Additionally, a reduction of inappropriate referrals leading to secondary care rejections is expected – reducing Primary Care re-work and queries from patients.

  • What are the benefits to the wider system?

    The SPoA ensures equity of access for all patients through ensuring informed patient Choice to appropriate providers. The SPoA offers opportunities for increased efficiencies through standardisation of system and clinical pathways. The programme of work will provide an overarching view of cataract activity to support future strategic commissioning decisions and enable joined up thinking around downstream care and help with post operative checks.

  • What is the first step to signing up to the new digital solution?

    Although a physical smartcard is not required, a smartcard profile is. The ICB’s IT support team (N3i) can support your request at the following link:
    Apply for CareID Request to Access Digital Cataract Referrals

  • What is Gateway, the digital solution being implemented?

    Gateway® provided by Accenda is a referral and advice & guidance platform that streamlines referral processes. Gateway connects with Primary Care clinical systems and e-RS to provide a total wraparound solution, improving the quality of referrals and advice requests. The Gateway system has been utilised for GP referrals into secondary care across York and Scarborough since 2013-14.

    Gateway registration link for referrers (once CareID process is completed)
    Gateway – Optom cataract referral demo

  • How do I refer using Gateway?

    Once your CareID and Gateway registrations are completed, the following video demonstrates how a cataract referral is generated and submitted via the Gateway system
    Gateway – Optom cataract referral demo
     

  • Is the Gateway system secure? Choice/appropriateness/preferred provider

    Accenda has been working with the NHS for 17 years and are ISO27001, CE+, DSPT (YGM93), NHS England Accredited. The Gateway® platform is also DCB0129/DCB0160 Clinical Safety Compliant. For more information regarding Accenda, please contact the Referral Support Service (Patient Choice Office) hnyicb-voy.rsservice@nhs.net.

  • What questions will cataract patients be asked when contacted by the Patient Choice Office (Referral Support Service)?

    What questions will cataract patients be asked when contacted by the Patient Choice Office (Referral Support Service)?

  • New cataract policy effective from January 2025

    The ICB’s new Cataract policy can be located here on the ICB website

  • What can Optoms view/action in Gateway?

    Optoms across Humber & North Yorkshire can generate and submit referrals via Gateway. Referral progress, including the patient’s chosen provider can be tracked, ensuring oversight of referral outcomes. The following video highlights some of the key actions within the Digital Solution.

    HNY - Accenda Gateway® - Optician Tasks

  • Is there an overview of the SPoA’s patient contact process?

    The process can be located here on the ICB website.