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Opchat Magazine LOC News pagesLOC & Commissioning News, April to July 2021




GOS contract management functions to move to integrated care boards from April 2022
Health Bill must give primary care a seat at the table on commissioning
Another LOC Director of the CIC and respected member of Croydon LOC supports the story as reported
Investigation into Primary Eyecare Services loss for Croydon reveals damage to practitioners and worries for other independent LOCs.
Practices report payment problems from PES,
Workshops Provide ‘Great Discussion and Feedback’
News from January to March on LOC and Commissioning


GOS contract management functions to move to integrated care boards from April 2022

July 2021

NHS England has confirmed to the OFNC that General Ophthalmic Services (GOS) will remain a national contract with terms, fees and grants continuing to be negotiated nationally.

The Health and Care Bill, currently before Parliament, will change NHS commissioning structures in England, including the establishment of new Integrated Care Boards (ICBs).

NHS England has announced plans to transfer all primary care contract management functions from NHS England to ICBs from April 2022.

This means ICBs will hold the contracts instead of NHS England regional teams. It will not affect how the GOS service is delivered; providers will continue to provide a GOS sight testing service as now, and patients will access GOS in the same way.

Commenting on the announcement, OFNC chair Gordon Ilett said: “There is no appetite anywhere in the system for 42 variations of the same GOS sight-testing and case-finding contract. This announcement builds on a constructive meeting OFNC held with NHS England earlier this month which confirmed that, when as anticipated, GOS contract management functions transfer to ICBs, the national GOS contract terms, fees and grants will still be negotiated nationally. This is the most efficient model for both the NHS and contractors and means there will be no material changes for GOS contractors or practitioners.”

He added: “We hope that ICBs will add value by commissioning extended primary eye care services at scale. This will help tackle the unwarranted variation caused by the small footprints of Clinical Commissioning Groups.

We will continue to work closely with NHS England and DHSC to ensure the new arrangements work well for contractors, practitioners and above all patients.”

Health Bill must give primary care a seat at the table on commissioning

July 2021

The Association of Optometrists (AOP), Association of British Dispensing Opticians (ABDO) and FODO The Association for Eye Care Providers have joined with partners across primary care to call on government to ensure wider primary care has a voice at all levels of the new NHS system starting with Integrated Care Boards (ICBs) set to be handed responsibility for commissioning hospital and community care and the primary care contract management functions.

The Health and Care Bill currently before Parliament would shift the responsibility for managing the contracts for primary NHS services, including general practice, general dental practice, community pharmacy and primary optometry services from NHS England to ICBs. Partners warn the current draft legislation risks leaving around 190,000 non-medical primary care professionals working in the NHS in England shut out of representation on the boards.

Together with the Pharmaceutical Services Negotiating Committee, The British Dental Association (BDA), and the National Community Hearing Association (NCHA), the optical bodies are pressing for change as the Bill heads for Second Reading in Parliament.

As it stands the Bill only requires that each ICB includes a member nominated by General Practice, with no insight from any of the other primary care professions. This is despite GPs accounting for only about a third of the primary care workforce in England.

To remedy this, during the passage of the Bill through Parliament partners are seeking the list of ‘Ordinary members’ of ICBs in Schedule 2 (p. 127) amended to include an extra member nominated by clinicians providing non-medical NHS primary care services within the ICB’s area.

The representative bodies for primary eye care and audiology – ABDO, the AOP, FODO and the NCHA said: “Optical practices and other primary care providers are vital to population health and care, and need a voice at all levels of the NHS in England. That’s why we are working together and calling on MPs to include provisions in the Bill to make sure this happens starting with the new Integrated Care Boards.”

BDA Chair, Eddie Crouch said: “Voices that make up three quarters of NHS primary care risks being lost in commissioning decisions that affect their services and the millions of patients they treat and serve every day. General practice simply cannot be expected to effectively represent the views, perspectives and distinct challenges facing colleagues in the wider NHS.

“We believe that for the benefit of patients and the NHS the crucial contribution non-medical primary care professionals make to the local health and care systems must be recognised and reflected at every level of the NHS, including within Integrated Care Boards.

“The only way this can happen effectively is if colleagues are guaranteed a seat at the table. That means a board presence drawn from non-medical primary care professions such as dentists, community pharmacists or optical professionals.”

Another LOC Director of the CIC and respected member of Croydon LOC supports the story as reported

May 2021

He says, " Overall I agree with what has been written. One of the main elements that have been lost is the goodwill of the local practices.

He continued, "Previously the directors of the CIC company were all local practitioners and we had built up a great working relationship with all the other local optom practices. We would pre COVID visit all the practices and if there were any issues we were available to help answer questions and resolve issues.

Now we all feel we are part of a multi national scheme with no local input or say if how the service goes forward. Where previously we were proud of running a local service for the good of local patients this has been lost.

During the lockdown when Moorfields effectively were not seeing any patients locally F2F several COS practices were seeing a lot of their patients on their behalf and it is difficult to see how they would have managed locally without our help and apart from some individual feedback from a couple of consultants there has been no feedback or thanks and effectively a few months after this they took the service away from the people who have been running it for he last 7 years without giving any reason why.

We have still received no explanation or viewpoint from Primary Eyecare Services Ltd. Perhaps this is an opportunity for LOCSU to make a comment on what has happened and their response to the resignation and fund levy withdrawal by Croydon LOC last week?

Others who continue to fund them will be seeking answers

Investigation into Primary Eyecare Services loss for Croydon reveals damage to practitioners and worries for other independent LOCs.

May 2021

Following on from last week’s story about the loss to Croydon locality and to its LOC of the long term community ophthalmology services inaugurated and run successfully for 11 years by them we have interviewed others affected by the unwelcome changes.

The loss of the Community Eyecare Services that have been run for 11 years by Croydon LOC has caused considerable dismay amongst the practitioners who have spend many years building a truly localised and successful service to its public. The loss at procurement level to PES is more than just a loss to those practitioners own incomes but also to the professional status as a whole.

Locally the highly successful community service company (CIC) in the recent past working with Moorfields and with its original agreed protocol was acting as a gate keeper of eye care with referral and triage firmly in the hands of optometrists.

It has now in the opinion of the Croydon Chairman been transformed into a dumbed down version where Moorfields has taken back control on referrals, and accreditation with no longer a single point of access via Optometrist alone and it is believed that further access to secondary care is now available in A & E without referral/triage.

Until these changes all referrals from GPs and Optometrists were passed through the Community Eyecare service for triage and onward referral either to Optometrists or secondary ophthalmology.

Thus putting Optometry in its rightful place in control of patient flow to Moorfields.

Thus, the changes made are affecting the level of regard optometrists were held at and changing the balance once more to ophthalmology control.

Worse still they (PES) are affecting the way the service was provided to the public by virtue of diverting the cash flow away from a truly local practitioner service to Primary Eyecare Services. PES have committed to retain all surplus monies to continue to build PES development. This can only mean one thing, a gradual erosion quality of localised primary care provided for many years and reacting to local requirements in Croydon, a spokesman for Croydon LOC explained..

This is because, the loss of money has directly affected local practitioners as when they were all fully invested in the CIC scheme they shared any surplus monies in the way of grants for equipment, costs for School Screening and training.

The previous agreements also allowed payments for the use of OCTs at the optometrists discretion, now governed by a restricted set of specefic parameters; giving practitioners the option of "OCT for free" or not doing OCT at all and just referring. Another backwards step and in the words of a director of the service and an LOC member “more dumbing down of the service.”

Referring to the process of procurement in which the placeholder Complete Ophthalmic Services was removed by PES winning the contract a Croydon LOC spokesman said,” At no point did we receive any contact from PES or LOCSU to offer to work with us which put us in an invidious position of not being able to ask our Optical Lead for advice given that the same person is also a PES director. How is it that LOCSU can after receiving members fees on a regular basis as we provide in Croydon then allow a company (PES) of which many are in shared directorship bid against one of its members?

We asked what was to stop PES continuing its nationwide capture of similar independent or individual PEC services to which the reply was only to advise other LOCs in the same position never to agree to sub-contract to a hospital service.

In a quote received from a director of the Croydon service, “much has been lost in public service, including the recognisable value of optometrists in the community as well as financial subsidiarity, for no obvious gain bar control by PES.

They added , " Although it is said that the procurement process is transparent Croydon have been told that legal processes would be required to look at the whole decision making procurement process which could cost a considerable sum which of course would be to an even greater detriment to Croydon practitioners and the public at large.
Game Over! "

May be the Government White Paper which is beginning to see the reformation of CCGs through to ICS holds a small hope in its advice that tender and procurement processes need no longer be required where good and acceptable processes are already working or available. Too late for Croydon.

And from Daniel Waller Chairman East London, City and Islington LOC

Daniel Waller made the comment that he was very disappointed that PES with their historical links to PECs decided to bid against a successful and locally agreed and approved company providing great benefits to the local optical contractors in Croydon.

"It will be a worry for other successful and active primary care companies providing services for their local optical committees. Having been through the process of deciding on the best web-based solution for ECLOC and choosing Pharmaoutcomes, I know that we have made considerable savings on administration fees that we as a local primary eyecare company can pass on to our local members. This was not apparent in the choice that PES has made, and whose surplus funds are not to be passed back to local contractors.”

Opchat News has reached out to Primary Eyecare Services Ltd for comments on its original story published last week but has so far received no comment in return.

Stop Press: 19th May :We have just been informed that Croydon LOC have withdrawn membership from LOCSU in light of the current situation They will be notifying the Primary Care Support Services of this and asking them to arrange to cease their levy payments with immediate effect.

Practices report payment problems from PES,

May 2021

The news is not looking good for many practices who have entrusted their payment provisions for extended community eyecare concerns to Primary Eyecare Services (PES) and associated company of LOCSU holdings Ltd.

The lack of payment over a considerable period of time, some might say at a most precarious financial period for independent practices has caused many to withdraw services like MECS and CUES. Following a report from practices that have reported delays in payments dating as far back to 2020 some waiting three to four months to receive monies owed.

PES have admitted that some payment delays were the fault of PES, but others, such as CCG mergers and the Covid-19 pandemic, were beyond the organisation’s control.
In consideration of the expansionist strategy of the PES shown and detailed in our story re: Croydon LOC one has to ask; is the organisation lacking in backroom capacity which should have been in place before taking on one of the largest serving areas in London and how this bodes for its future growth and reputation in future procurement tendering?

Workshops Provide ‘Great Discussion and Feedback’

April 2021

Recently LOCSU held two packed virtual workshops were held as LOCSU looked at the future of Optometry first urgent eyecare services.

The ‘discovery sessions’ were held over two nights with one hearing from MECS practitioners and the other from those working with CUES.

From the MECS providers we were keen to hear which elements of CUES could work and which would be more challenging. In terms of CUES, it was a chance to listen and learn from those who had been working with the pathway.

Although CUES was promoted as a COVID response at a time of crisis LOCSU always intended it for the long term.

Speaking after the sessions LOCSU CEO Richard Whittington said:

“Great discussion and feedback across both sessions. Provides fantastic practical insight into service development and the future”.

Interim Clinical Director Zoe Richmond spoke after the MECS session:

“The session had great participation, MECS practitioners joined with a wide range of experience offering different perspectives but we also had broad consensus on some points.”

So, what happens now? These discovery exercises will help inform a future model of urgent eye care, delivered in primary care. We didn’t expect the sessions to provide all the answers, but we are confident they have given us areas for development.

If you weren’t able to be at either of the workshops and want to give some feedback, or you attended and would like to add some comments we would really like to hear from you.

 

 
 
 
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