Primary Health Net
Visit our Public Information Site
Go to my LOC site
Grafton Mainline's page personalities

Opchat Magazine LOC News pagesLOC & Commissioning News, July to September 2019

LOCs playing a key role in Vision and Falls Awareness Campaign
CCEHC and its member organisations call for the inclusion of Eye Health within the NHS LTP
NHS REFORMS for Integreated Care Providers
Clinical Council for Eye Health Commissioning reviews community ophthalmology pathway
New Children’s Pathway can reduce waiting times for young patients
Public Health England publishes new diabetic eye screening letters
Rumours of Senior staff changes at NHS England
Implementation of e-GOS and e-Performer Listing in England, the update.
Home communications survey reveals strong demand from LOCs for advice on NHS reform
Introducing the LOCSU Optical Lead team
LOCSU publishes pathway for patients on long-term hydroxychloroquine and chloroquine
Read the archived LOC and commissioning news here

LOCs playing a key role in Vision and Falls Awareness Campaign

October 2019

Across the UK every year 280,000 people end up in A&E after a fall, costing the NHS £1.5billion. Falls cause distress and can have devastating long-term impacts on physical and mental health. But when someone suffers a fall, how many consider the possibility that poor eye health and vision problems may be the cause?

Raising awareness of the links between falls and underlying health conditions, including problems with vision, is the aim of a major falls prevention campaign running in the North East and Yorkshire last week to coincide with both National Falls Prevention Week and National Eye Health Week. The campaign is the result of a multidisciplinary collaboration between NHS England and Improvement, North East Regional
LOCs, North East Ambulance Service NHS Foundation Trust and Public Health England.

Stephanie Cairns, Chair of Northumberland Tyne and Wear LOC, who has been spearheading the optical sector’s involvement, explains what the campaign hopes to achieve: “The main aim of this campaign is to encourage people to report their falls to a GP so they can explore the reason why this has happened, it might not just be due to tripping over something, there could be an underlying health issue, and this may be related to vision. “The campaign also gives advice on how to prevent falls including promoting the importance of good eye health and the need for regular eye tests.”

Read more about the campaign here

CCEHC and its member organisations call for the inclusion of Eye Health within the NHS LTP

September 2019

The Clinical Council for Eye Health Commissioning (CCEHC) and its member organisations, including LOCSU, is calling for the inclusion of eye health within the delivery of the NHS Long Term Plan (LTP). CCEHC has presented priorities for how the LTP can be delivered for eye health and care through the collaborative efforts of commissioners, service providers and clinicians.

The Council describes how system-wide transformational change can be delivered for eye health through the implementation of the Systems and Assurance Framework for Eye Health (SAFE), including consistent commissioning of extended primary care services delivered from optical practice.

The strategic objectives for CCEHC for 2019-2021 are to:

Support the restructuring of commissioning and delivery of eye health and care service systems

Promote better use of capacity and resources

Call to improve data sharing and communication for direct patient care; and secondary uses to support planning, provision and commissioning of services

As an active member of the CCEHC, LOCSU has supported recently work adding to SAFE, click here to read more about the SAFE framework and implementation tool.

NHS REFORMS for Integrated Care Providers

August 2019

NHS Integrated Care Providers in England to be able to subcontract for community-based services

Having been informed by the High Court in 2018 that CCGs could not be abolished or merged with its preferred delivery model - Integrated Care Providers (mega Trusts covering large areas) - NHS England has now published a suite of documents about how CCGs will continue in the new world of the NHS Long Term Plan. Feel free to copy the links below and save for future use, howver the news story will remain archived on the Opchat site.

NHS Standard Contract: Integrated Care Provider 2019/20
Contracting Arrangements for ICPs: Equality and Health Inequalities Analysis
About the Integrated Care Provider Contract – Easy Read
ICP Contract: Questions and Answers
Whole Population Models of Provision: Establishing Integrated Budgets
CCG roles where ICPs are established
GP Participation in an Integrated Care Provider
Procurement and Assurance approach
NHS Standard Contract (Integrated Care Provider) Template ICP/Local Authority Integration Agreement
Template ICP/Local Authority Integration Agreement – FAQs
NHS Standard Contract (Integrated Care Provider) Template Integration Agreement for Partially Integrated ICPs
GP Integration Agreement FAQs
Explanatory Notes to the Integrated Care Provider Contract
Network Contract Directed Enhanced Service data templates  

The documents show that CCGs will survive (in “streamlined” form) and are being encouraged to merge. This is already happening leading to outcries from GPs via the BMA as reported in the previous Weekly Digest (2 August) [HERE]. CCGs will also still be encouraged to award large mega-contacts for the bulk of their NHS services (including GP services) to a single Integrated Care Provider (ICP) for their area or multiple CCG areas.

At the same time ICPs will still not have to account for precisely where the money goes except in broad terms. NHS England believes this “provides a deliberate and necessary flexibility”. Unfortunately this is unlikely to help hard-pressed ophthalmology or audiology departments where budgets are often cut to meet other Trust priorities, or patients or the public seeking to exercise accountability.

As FODO warned at the outset - and the latest documents make clear - it is then ICPs rather than CCGs which will have the role of sub-contracting for local services such as community ophthalmology or hearing services from community practices to the extent that they consider necessary i.e. CCGs may well stop commissioning these although it is hoped that ICPs will roll over existing contracts and pick up the pace on shifting care out of hospitals. A careful distinction is drawn between ‘commissioning’ (which is a CCG role even if is from a single mega-provider) and ‘sub-contracting’ (which is a provider role and hence not subject to the same rules and constraints).

The Government having rejected competition, NHS England is relying on other pressures in the system such as tight financing, shared objectives, common sense and goodwill to drive these reforms. Unfortunately history is not encouraging in this regard as similar models failed in the 1970s and 80s.

Whatever the final shape of the NHS in England, FODO, with its OC partners, will to continue to press in every way we can to ensure that the NHS delivers the NHS Long Term Plan ambition of transferring at least 30% of hospital care to the community.

(Information supplied by FODO)

Clinical Council for Eye Health Commissioning reviews community ophthalmology pathway

August 2019

The Clinical Council for Eye Health Commissioning has announced a review of its community ophthalmology services pathway to bring it up to date with current thinking, developments in both the ophthalmology and optical sectors and the NHS Long Term Plan which envisages a significant transfer of care from acute hospitals to the community sector.

FODO, via the Optical Confederation, is actively involved in this work.

New Children’s Pathway can reduce waiting times for young patients

August 2019

The UK National Screening committee recommends that screening of children’s vision should be offered to all 4-5 year olds. This is usually delivered in school in the child’s first year.

Traditionally, children who fail the screening were referred into the hospital eye services, however LOCSU believe primary care optical practice is best placed to deliver this clinical work within the community.

The benefits of this approach are that patients can be seen at a time and place convenient to them, removing the need to take time out of school and work. Waiting times can be significantly shorter compared with hospital clinics, and this approach also releases vital capacity within the clinics to deal with more complex cases.

The new Children’s Pathway is based on referral to a commissioned service delivered within primary care optical practices, appropriately utilising the skills of primary care practitioners (Optometrists and dispensing Opticians).

The clinical work-up includes Cycloplegic Refraction, Orthoptic Assessment and a Fundus Assessment, in line with RCOphth recommendations.

Using optical practices rather than hospital clinics allows the clinical assessment and spectacle dispensing to be delivered at the same time, adding further convenience for patients. Children are fully managed or discharged, those who require further appointments are reviewed during their adaptation period and referred to hospital clinics if their sight fails to improve in this time.

“The pathway supports the whole system – only small numbers require consultant or orthoptic intervention and even then, the first line treatment of amblyopia is spectacle correction. If the child ultimately requires hospital referral, they will attend their ophthalmology appointment wearing their spectacles and having partially adapted to them” says Zoe Richmond, LOCSU Interim Clinical Director.

Zoe continues “We shouldn’t underestimate the added value of introducing a young family to primary care optical practice. NHS Sight tests are provided for all children but many parents aren’t aware that if a child fails their vision screening there may be implications for other family members. Primary care can support the whole family by inviting siblings for a sight test ahead of screening, delivering targeted earlier intervention”

See more by checking the Diagnostic Clinical Pathway

Public Health England publishes new diabetic eye screening letters

July 2019

Public Health England have issued a new set of diabetic screening letters which all diabetic screening services must use.

These are now the standard.

Proposed new right for Workplace Adjustments on Health Grounds/Assistance for SMEs

The Departments of Work & Pensions and Health & Social Care have launched a new consultation on reducing health related job loss. View.

The government is seeking views on:

• a new right for all employees (not just those with disabilities) to request work and workplace place modifications on health grounds
• statutory guidance to support employers to take early, sustained and proportionate steps to support sick employees to return to work. [FODO comment: this could become mandatory for NHS contractors under NHS HR rules]
• whether a targeted rebate of SSP for small and medium enterprises (SMEs) would help employers help employees return to work
• how the current rate and length of SSP affects behaviour
• reducing costs for SMEs of buying-occupational health (OH) (for example through a direct subsidy or voucher scheme).

The consultation closes on 7 October.

Rumours of Senior staff changes at NHS England

July 2019

PHN has been informed that Dr David Geddes, Director of Primary Care at NHS England, well known by all as being the leading light in optics is standing down at the end of September, this year after 7 years in the role.

It is believed he will be replaced by Matt Neligan, a career NHS manager, who moves sideways from NHS improvement where he has been Director of Data since 2016.

At the same time, career civil servant David Roberts, who has been in charge of the GOS budget (and the NHS Finance ‘hard-man’ in negotiations according to our fees committee) also since 2012, retires at the end of this month (July). His post is being merged with the Head of Dental and Optical Services Commissioning currently filled by Carol Reece.

Implementation of e-GOS and e-Performer Listing in England, the update.

July 2019

Following a presentation to Optical Confederation, BMA and BDA leaders on 25 June, Primary Care Support England (PCSE) – part of the Capita Group working under contract to NHS England - has announced the long-awaited implementation of e-GOS and e-Performer Listing in England.

Claims and Payments - Their claims system has three submission routes:

• e-GOS direct from the practice PMS
• PCSE on-line which involves uploading the data onto the PSC system (although a mid-point is also being explored whereby patient identity details can be ‘injected’ into the portal direct from some PMS systems)
• paper submission

Implementation Timetable - The plan for roll-out is:

• mid-August for early adopters for claims and payments
• September for performer listing
• November (starts 28 October) for full national roll-out of claims and payments system

You can access the detailed plan [See Here]

The managing director of PCSE will be attending the FODO October Board meeting which will provide a final reassurance check form the early adoptors before national roll-out.

FODO’s David Hewlett said: “This new system looks very impressive and a lot of work has clearly gone into ironing out the early bugs. PSCE have wisely replicated exactly the content of GOS forms so there should be nothing new for practices to get to grips with there. Clearly the best model for using the system is direct from the practice’s PMS. One of the key tasks for the OC Information and IT Committee this autumn will be to track progress and review how practices are experiencing the system.”

About performer listing, David added: “We are still pushing back against the proposal to have only four locations where optometrists changing location can turn up for identity checks. The good new however is that all new joiners will have to be DBS checked (on in the process for becoming so) and signed up for the update service so employers can check their DBS status.”

Commenting, FODO MD, Harjit Sandhu said: “This is good news but, in FODO’s view, it is a pity the new e-GOS system could not have been put in place before the new PPV system, as this would have made the workload much easier for both the sector and NHS Business Services Authority.”

Home communications survey reveals strong demand from LOCs for advice on NHS reform

July 2019

LOCSU recently invited LOCs to provide feedback on LOCSU communications via an online survey.

The results provide clear direction on how LOCSU communications should evolve, and they (LOCSU) are grateful to everyone who participated in the survey for their valuable insight.

The survey results show high demand for advice and support on NHS Policy and commissioning changes at national, regional and local levels, as well as interest in sharing best practice in this area through case studies and regional feedback.

Other opportunities highlighted by the survey include providing more insights into delivery of LOCSU’s key priorities of supporting LOCs and PECs.

Find out more about the survey results and the LOCSU action plan here

Introducing the LOCSU Optical Lead team

July 2019

The new LOCSU Optical Lead team is now in place and able to support LOCs across a range of issues, from LOC specific questions and queries through to the facilitation of discussions with commissioners and wider stakeholders.

The previous commissioning Lead team was focused, correctly, on the mechanics of the commissioning process and the establishment and support of Primary Eyecare Companies alongside supporting LOCs more generally.

With the emergence of Primary Eyecare Services and other Primary Eyecare Companies LOCSU now has the opportunity to focus a team more fully and specifically on LOC needs as Primary Eyecare Companies find themselves more qualified and experienced to deal with the mechanics of procurement and service delivery.

The new Optical Lead team has been recruited from within the LOCs to ensure that the support LOC receive is both local and delivered by individuals with a local viewpoint. The Optical Leads will be able to supply advice and support to LOCs around areas such as process and succession planning as well as cementing LOC links to the national LOCSU team ensuring that LOCs are able to take full advantage of the training and support that team can offer.

As the NHS moves through the current restructuring and reorganisation there is clear requirement for LOCs to engage with the new and emerging organisations, such as Primary Care Networks, at a local level. Simultaneously there will be a need to engage with the forming Integrated Care Systems at a regional and in some cases on a cross-LOC basis. During the recent induction programme, the Optical Leads and wider LOCSU team have been prepared to support LOCs and networks of LOCs in this task.

Over the next 2 to 3 weeks all LOCs will be contacted by an Optical Lead to discuss any support needs individual LOCs require. The leads will support LOCs to perform a self-evaluation to help identify gaps in knowledge and local support needed. The process is not one size fits all and support and advice will be tailored to individual LOCs and individual needs.

Meet the new team members:

Zoe Richmond

Zoe heads the team of Optical Leads. She is an Optometrist, an active member of Tees Local Optical Committee and experienced member of the LOCSU team having joined in 2011.

Max Halford

Max is a Contact Lens Optician and accredited MECS practitioner working in the South West.

Tom Mackley

Tom is an Optometrist working in both community and hospital settings in the North West, with a particular interest in glaucoma.

Richard Rawlinson

Richard joined LOCSU in April 2016 and has a wide range of professional roles.

Nizz Sabir

Nizz is an Independent Optometrist based in South Yorkshire. He has a keen passion for ophthalmic public health and is keen to develop the role of the profession in a sustainable health and care sector.

Amar Shah

Amar is an Optometrist, with his own Boots Opticians franchise on the outskirts of Bristol.

LOCSU publishes pathway for patients on long-term hydroxychloroquine and chloroquine

July 2019

The Local Optical Committee Support Unit (LOCSU) has published a new hydroxychloroquine pathway to align with Royal College of Ophthalmology (RCOphth) guidelines published in February 2018.

The guidelines recommended a baseline assessment and annual screening for retinal toxicity for patients on long-term hydroxychloroquine and chloroquine therapy.

The new LOCSU clinical service pathway framework incorporates Medical Retina Monitoring (Hydroxychloroquine), the Medical Retina Monitoring pathway diagram and Medical Retina Monitoring Clinical Management Guidelines.

These allow patients to be assessed in community optical practices as part of a consultant-led service, including a virtual review by a consultant ophthalmologist, to identify patients at risk of vision loss.

It is hoped commissioners and hospital eye departments will take up the new pathway to improve access for patients in the community and relieve pressure on acute hospital capacity.

The pathway can be accessed via your LOC or here.

Internet Inks
Primary Health Net