A telephone study of diabetic retinopathy and the diabetes miniclinic in general practice: A regional study in Wessex

With the objective of examining the structure, staffing and policies for screening in diabetes miniclinics in general practices throughout a health region in the United Kingdom, a telephone study was conducted of 296 practices which had applied for permission from the local Family Health Servic Authority (FHSA) to conduct a diabetes clinic. All the clinics offered services to people with diabetes within the five FHSAs which comprise the region of Wessex.

Of the practices contacted, 286 (97%) provided information. Of these, 249 (84%) were conducting diabetes clinics which covered 65.4% of the Wessex population; 207 (83%) of the clinics were run in practices with a computerised record system. The most common model of care in 120 clinics (48%) was one in which each GP reviewed his or her own diabetic patients. The types of diabetic patients reviewed showed that 55% of the practices contacted saw both insulin‐dependent (IDDMs) and non‐insulin‐dependent (NIDDMs) diabetics; 28% of the clinics saw mainly NIDDMs with few IDDMs; and 12% of the clinics reviewed solely NIDDMs. In all, 23% of the clinics contacted never checked visual acuity and 23% never examined the fundus. Fundal examination through a dilated pupil occurred in fewer than half of the clinics (47%) and only 35% performed a full screening of visual acuity and dilated fundal examination.

It is concluded that the services offered to diabetic patients attending clinics in general practice are inadequate for the purpose of eye screening and will fail to detect much treatable pathology.