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Opchat Magazine LOC News pagesLOC & Commissioning News, January to March 2020





AOP follows PHN in creating a Covid-19 Page on its Partner AOP website
PCSE Ophthalmic Bulletin publsihed shows tips on how to get the most from our online Ophthalmic services.
College responds to proposed National Tariff Payment Scheme and recommends that ending of the current front-loaded tariffs
Approval for a further 74 CCGs to merge
ICSs told by NHS England to streamline commissioning arangements by September this year
Two services face axe from embattled PCNs contract
STP’s. Now seven CCGs to become three in Sussex
Read archived news from October to December 2019


AOP follows PHN in creating a Covid-19 Page on its Partner AOP website.

March 2020

At LOCSU we are aware that there has been a range of information in circulation relating to Coronavirus and potential risks and processes for dealing with patients who may have been exposed to the virus.

It is important that all LOCs work within consistent and verified advice as such LOCSU would direct all LOCs to:

• General Coronavirus advice for clinicians: https://www.england.nhs.uk/coronavirus/ also on the PHN Covid-19 Page created last week and daily updated.

• The AOP have also constructed a page drawing together advice and support for dealing with Coronavirus: https://www.aop.org.uk/advice-and-support/clinical/clinical-governance/novel-coronavirus-covid-19-advice

PCSE Ophthalmic Bulletin published shows tips on how to get the most from our online Ophthalmic services.

March 2020

• How to register for the Performers List and Ophthalmic Payments

• What to do if you haven’t received our original registration letter

• Get help with PCSE User Guides

• What to do if you use a Practice Management System

Click here to read the full bulletin

College responds to proposed National Tariff Payment Scheme and recommends that ending of the current front-loaded tariffs.

February 2020

The College of Optometrists welcomes the priority given to ophthalmology to improve patient care and efficiency from changing the way ophthalmology services are delivered and paid for across primary and secondary care.

They strongly support the move towards a blended payment system centred around the journey of patients through the system. It will better reflect demands and costs and has the potential to support the objective of the NHS Long-Term Plan. But it will also require a constructive dialogue between all health and care professionals involved throughout relevant pathways rather than just a volume and cost discussion.

This dialogue would require a careful and realistic assessment of clinical needs and risks. It should also ensure that optometrists working in primary and community care are funded for the follow up and enhanced services we know will contribute to improving capacity and reducing avoidable referrals in secondary eye care.

The College welcomes the suggestion to remove the current outpatient front loading policy from published prices.

NHS Ophthalmology services are predominantly out-patient-based for patients with long-term eye conditions that require ongoing activity review and management. The College have long asked for the front-loading policy to be abandoned. They would welcome such a move as an indicator of a fair payment structure and one that truly reflects clinical need and risk.

The proposed blended payment approach (placing more emphasis on system planning and working and less emphasis on individual units of activity delivered by consultations in a face-to-face setting) effectively encourages and supports innovation, efficiency and quality of patient care. It rightly supports the development of new models of eye care based on clinical risk stratification and clinical competencies and the appropriate application of technological advances to deliver services.

The College actively supports the drive for more efficient models of delivery of outpatient follow-up activity, including transfer of care to primary and community providers. As part of the Clinical Council for Eye Health Commissioning (CCEHC), the College has already developed a System and Assurance Framework for Eye Health to reduce avoidable referrals to the hospital eye service and to encourage more step-down care in the community.

They support the discharge of appropriate patients to local community ophthalmology and primary eye care services, but a sea-change in commissioning thinking is needed at ICS level, combined with workforce development and an IT connectivity solution, to do this safely at the scale required within the timescale of this tariff.

In the interests of patient safety, these proposed changes to ophthalmology tariffs should be accompanied by the necessary support for service redesign to rightly address the current capacity pressures in the hospital eye service and reduce the risk of sight loss due to delayed follow-ups in patients with long-term and high-risk eye disease.

These patients may have no prospect of a cure and many will have serious sight-threatening conditions which mean that ongoing management is essential.

Approval for a further 74 CCGs to merge

February 2020

NHS England (NHSE) has approved the merger of 74 existing CCGs to establish 18 new ones, reports the HSJ.

This will take the total number of CCGs to 135.

The mergers are subject to conditions set by NHSE which include approval of the new CCG’s constitution by NHSE and filling legally required leadership roles within the new CCG. Other conditions vary based on the specific merger but typically include having a chief officer in place (approved by the NHSE) and having robust financial and operational plans.

(source HSJ)

ICSs told by NHS England to streamline commissioning arangements by September this year

February 2020

NHS England guidance has reiterated that all developing Integrated Care Systems (ICSs) should be actively “streamlining commissioning arrangements, including typically one CCG per system” with applications made no later than 30 September 2020 for a merger proposed for 1 April 2021.

The guidance also Includes reference to transforming outpatient model of ophthalmology stating: “A national programme of clinically led pathway redesign has begun and will provide practical help to support systems to adopt optimal pathways with lower in-person outpatient activity. A national trajectory for delivery of outpatient transformation will be published in the National Implementation Plan [starting] with ophthalmology …”. The plan is to “roll out best practice models as they emerge”.

It goes on to say that there is an expectation the system will “ensure that all hospital eye services can report compliance with the Portfolio of Indicators for Eye Health and Care follow-up performance standard.”.

Two services face axe from embattled PCNs contract

January 2020

The Health Service Journal reports that following criticism by GPs and others, the Primary Care Networks (PCNs) contract specifications are overly prescriptive and not properly resourced. The NHSE is likely to drop the ‘anticipatory care’ and ‘personalised care’ services from the 2020-21 Primary Care Network (PCNs) contract specifications, possibly to be introduced in future years.

NHSE plans to weaken the requirement that PCNs visit care homes on their patch each week. It also says that every two weeks the visits should be led by a GP or geriatrician, as part of the “enhanced care in care homes” service specification – this is a particularly contentious component.

Work was due to start on anticipatory care and personalised care in 2020-21, with full implementation staged over the next four years. The anticipatory care service is intended to enable doctors to provide proactive, preventive care to patients with high needs or at risk of significant problems by analysing a population and dividing patients into different levels of risk using tools such as frailty indices.

STP’s. Now seven CCGs to become three in Sussex

January 2020

NHS England has approved the merger of seven clinical commissioning groups in Sussex, that are currently in a sustainability and transformation partnership (STP), into three. This is despite having previously indicated it preferred merged CCGs to cover whole STP areas; this follows push back from local GPs.

The new CCGs in the Sussex STP will align with local government boundaries, creating organisations covering East Sussex, West Sussex, and Brighton and Hove.

 

 
 
 
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