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I relayed the question to Dr Gordon Caldwell, Consultant Diabetologist at Worthing Hospital, where they've had an excellent DR service for some years. Here's hos response: >I think that it is fair to say that in type 2 diabetics those who have had a completely normal retinal screening in a well planned and quality controlled and assured process, have no clinical need for a further screening in a year (maybe even 2, or 3 years). However as you know clinical need is a low priority in the NHS today! The Diabetes UK charity raises patients' expectations that screening will be annual, so you have to deal with patients' fears if it is not done (I'll go blind if I do not have my screening, they told me it was important"). Somehow I also suspect that GPs get extra dosh, if there is annual screening (to line their pockets, not those doing the screening!), and all sorts of "authorities" who have never worked in a retinal department pontificate about risk etc. In addition administratively it is easier sometimes just to do everything for everyone! >So if your Derby person is willing to forge ahead based on clinical need, clinical evidence and clinical expertise, all power to his elbow - most of us have bowed our professional heads and been obedient servants, rather than robust radical professionals! >Such is the NHS today. The point about GPs' QOF points may be significant. You'll have a job getting past your GPs anything which might cost them money. Meic Goodyear Public Health Intelligence Specialist The honourable Physicians will confesse themselves beholden to the science of Arithmetike - John Dee 1570 Cantilever House, Eltham Road Lee London SE12 8RN Tel: 020 7206 3273 Fax: 020 7206 3201 >>> Bruce Laurence <[log in to unmask]> 11/15/06 5:14 pm >>> Hello colleagues We are considering using a 2 year screening interval for diabetic retinopathy screening for those who have had a normal result. This is somewhat controversial, and not in line with NSC guidance, but there isn't really much evidence that it is less effective than an annual screen, and it is obviously cost saving where funding for these programmes is being squeezed. I would be very interested to know from any of you in pcts, or otherwise involved in DR screening, if your programme has considered this option or is actually choosing it. regards Bruce Laurence Bruce Laurence Consultant in Public Health Derbyshire County PCT