Direct Referral

There is a direct referral system for local optometrists to refer patients from St Helens and Knowsley to the Eye Department of St Helens hospital, part of St Helens & Knowsley NHS trust. In Warrington and Halton, optometrists have also referred direct to the HES for many years, with all patients seen at a triage clinic at Warrington NHS Trust within 2 weeks.

Negotiations are ongoing and it is hoped that local optometrists can eventually refer direct to other hospital trusts in the Cheshire and Merseyside area.


There are Wet AMD services available locally at St Helens and Warrington eye departments. Local optometrists should refer rapidly to these services where they suspect the presence of wet AMD. This page includes versions of the AMD atlas document, where the referral form can be printed already with the required fax number. Alternatively, you could use the GOS PDF or practice software to generate a letter with the same information included.

The referral letter should be faxed or emailed via NHS email directly to one of our AMD services at St Helens or Warrington on the same day as the patient’s appointment. The service will contact the patient and arrange an initial assessment within 2 weeks. NB The LOC does not advise referring AMD patients to the GP for onward referral.


An electronic GOS18 can be downloaded below to use for referrals. It can be filled, saved, printed or sent as a PDF attachment to HES via email.


This page has the main documents required by practices participating in screening in the Central Mersey cluster.


The LOC developed guidance on optometric referrals. There is a document below with advice on making more appropriate referrals and an Excel spreadsheet, which has link to internet pages for each condition mentioned. These links allow differential diagnosis, patient information or links to support groups. The spreadsheet is an evolving document and the LOC would welcome any assistance in updating and improving it.


The documents used by local optometrists are available on this page. Most of them are generic documents and could, therefore be used by optometrists in other areas.

  • Electronic GOS 18
  • St Helens Wet AMD referral form
  • Warrington Wet AMD referral form
  • Electronic Referral form
  • NICE Referral Proforma
  • Referral Guidance
  • Referral Spreadsheet with links
  • Referral criteria for Warrington optometrists
  • Referral routes for Warrington optometrists


If you have any comments to make or want more information, please contact the LOC chair Bob Wilkes 0151 426 2214