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The management of patients with neovascular age related macular degeneration (nAMD) forms a large and increasing proportion of hospital eye service activity worldwide, particularly since the introduction of intravitreal anti-VEGF therapy. The delivery of anti-VEGF therapy has created substantial service pressures on ophthalmology departments. Delays in access to timely initial treatment and follow up assessment are widespread in the UK National Health Services. The aim of the presentation is to describe our model for treating patients with nAMD with antiVEGF treatment in a UK geographical location with a population of more than 600,000 people. In our centre, AMD patients are managed in dedicated clinics with tightly defined standard operating procedures. An electronic medical records (EMR) (medisoft, Leeds, UK) system enables paperless data entry at each step of the care pathway. A time-line graphical chart displays all re-treatment criteria, visual acuity and OCT measurements allowing rapid, standardized decision-making at each assessment visit. In addition, the EMR system facilitates a one-stop service design where follow up examinations and interpretation of OCT findings after the loading phase of injections are performed by trained optometrists and nurse practitioners working to protocols. The majority of ‘observe’ and ‘re-treat’ decisions are made entirely by non-medical staff and the specialist ophthalmologist is invol ved where there is uncertainty. Recently, following competency based training and supervision; nurses have been able to deliver intravitreal injections. In addition to being an efficient model that enables us to assess and treat more than 50 patients in a half day session, using this treatment model, we are able to review our patients within the indicated time period (4-6 weeks) during the initial (active) phase of the disease and also to plan future workload and capacity demands. Moreover, this model allowed the design of an efficient clinic process, which delivers comprehensive, prospective audits of clinical outcomes on a population basis and is applicable to other services as diabetic macular oedema and retinal vein occlusion treatment services. We believe that anti-VEGF service delivery is like an industrial production line where then quality of the process is the major determinant of the clinical outcome. This is very different from the traditional surgical or medical view that it is all about the doctor/patient interaction!