Sheffield Local Optometric Committee

Sheffield Loc meeting 19th march 2013

Sheffield Local Optical Committee

SLOC Minutes of the meeting

Held: Tuesday 19th March 2013

Present: James Allen (JA), Shirley Blundell (SB) , Rob Hughes (RH – Chair), Richard Oliver (RO) Deb Mullens (DM), Azad Nawaz (AN), Helen Wilkinson (HW) Tanveer Hussain

Attendees: Louise Lambert (LL) (Minutes), Shehneela Qureshi (SQ),

Apologies: Gerry Cowley (GC), Habib Shah (HS), Susan Wilford (SW)

Minutes of the last meeting

After a minor amendment the minutes of the last meeting were accepted as a correct record. Proposed by AZ and seconded by DM

Welcome and Introductions

RH welcomed SQ, who was currently working as a locum, to the meeting and the committee introduced themselves.

Matters Arising

1. OHT (Ocular hypertension)

A meeting took place 2 weeks ago that both Simon Longstaff (SL) and RH happened to be attending. The difficulties being encountered were mentioned after the meeting and SL was not surprised by adverse reaction of Ian Rennie. SL is still in favour of OHT being monitored within the community.

There is a slow trickle of discharges into community optometrists, and a pattern/trend is beginning to materialise. The conversation continued regarding the lack of guidance, fees and community optometrists not being insured to monitor OHT patients. Patients care is being compromised by this practice and optometrists are put under pressure to care for patients in a community, with the expectation of compliancy. The group concluded that there either needs to be a formal discharge put in place or patients are not discharged into the community.
Action: RO will revisit

RO requested that in the meantime optometrists who are experiencing this practice should write formally to RO with the name, patient number and the discharging consultance details. It would also be useful to know which GP the patient was registered to.
Action: Optometrist to contact RO when they receive an OHT patient are to be monitored within the community.

The group discussed a case when a patient was discharged with Glaucoma, and it transpired that the when the patient was eventually referred back into hospital they had lost half their vision.

The group spoke about City wide coverage and accreditation should the scheme come into place. Acknowledging not all practices have the relevant equipment.

2. PRR Paediatric Referral refinement

SB distributed a questionnaire prior to the meeting asking members to review and voice any concerns. The general consensus was that the form was simple and easy to use. It was questioned whether it would be beneficial to have an online version of the form. The group spoke about the best way to administrator the forms for the Hospital Audit. The group spoke about the confidentially of returning the questionnaires. The hospital were not keen to provide prepaid envelopes. It was suggested that patients could either hand the form in to the receptionist or post directly. A fixed amount should be issued to practice, thereby obtaining a brief snapshot, possibly doing the frequency as regularly as 6 monthly.

PRR has been commissioned for another year, which will end in September next year. Then Public Health will take over screening, the council are keen on services for children. Difficulties are being experience by staff.

SB did ask if anyone had any other feedback/comments to let her know.

3. Domiciliary visits

Pre-meeting note: – The group had a discussion, via email regarding domiciliary visits in light of an email that had been sent to the SLOC.

RH distributed a proposed notification for performing domiciliaries form to the group. Reiterating email correspondence, RH confirmed that some providers where not following the correct protocol when visiting nursing homes. Sue Marriott confirmed that compliancy checks where currently not being carried out due to lack of resources.

The group discussed the protocols, providers need to offer notice prior to attending a nursing home and examining a patient, more than 2 patients requires 3 weeks’ notice to be issued to the PCT. The examination visits are therefore being monopolised buy the provider not following protocol. It appeared that one provider was deliberately not asking for patient names.

This is causing issues within the system and the committee needs to decide what authority it holds or action it can take, if any. The group felt limited in what they could do and felt anything would have to be regionally wide.

Patients who need to see a Domiciliary provider are not generally asked whom they would like. It was felt that Care home mangers try to make the process as smooth as possible and it transpired that this problem has been on-going for years.

The group commented on the testing being received by residents, particularly highlighting the frequency. The group decided to send out correspondence, highlighting the protocols for domiciliary visits. Providers would need to be registered and give reasoning account of why they tested the patient within the 12 month period. On behalf of LOC remind Garry Charlesworth, at the National Commission Board (NCB) about the eligibility of domiciliary checks and the timeframes they require.

4. Social Media

HW put forwards an idea to group about using social networking. The group thought the principal was good and they spoke about what was it they wanted to achieve, potential offering a LOC community presence, highlighting schemes, offering a feedback forum.

Speaking about Twitter, the group thought they could post events and meeting they were going to and the outcome of those meetings. Some concerns were raised about Facebook and retaining professional etiquette. The group spoke about groups on Facebook and notifications that could be received by prescribers.

As a collective the group felt that Twitter would be better at local endorsement, raising profile and highlighting schemes which looked after local people. It would also be beneficial for tweeting good advice, lessons learnt from the Peer review. It was pointed out that NHS choices website obtains 11 million hits per month.
Action: HW to investigate further

5. GP Reports

RH wanted to ensure that everyone was aware that the reports for diabetic examination and Glaucoma where no longer required by GPs.

6. Cataracts scores

The Sheffield referral forms have had a minor change. Glaucoma and OHT have been put together and simple cataract and cataract with copatholgy have obtained a single tick box.

The updated GOS 18 form is the one that all optometrists should be using. The Multiple practices have their own form on their systems, RH explained that the minor changes also included SPA details on the bottom. The endorsement form has been placed on the website.

It was also mentioned that when doing triaging there was now no need to use the multiple forms and fax them as it was thought they now all end at the same destination.

RH informed the group that the cataract scoring will finish. Part of the delay in obtaining a decision was the evidence in cataract referrals had dropped from the Optometrists but had rose from the GPs perspective. If the waiting times rise again this will cause concern and potentially it will be looked at again.

7. Any other business

a. College of Optometrists

MD informed the group that Sue had stepped down from the council and he had taken over her position.

b. PEARS Training

AZ queried the PEARS training, wanting to obtain a better understanding. The group explained that PEARS training will be offered once a year, currently there are 12 optometrists doing the distant learning which at the end of April will be complete.

c. Enhanced Services with the CCG

The group spoke about local enhanced services commissioned, acknowledging that the local CCG are able to influence contracts. Sheffield health schemes were highly thought of and there was the potential to replicate them within Rotherham and Doncaster, should they so wish. Concerns were raised about an external supplier, it was acknowledged that services had to be competitive and contracts were not guaranteed. RO acknowledge the long standing relationship the LOC currently had with the CCG, he advised that the CCG will write to LOC about their proposed services, RO suggested LOC define the services they can offer in-line with AQP government specifications

The group agreed they were very fortunate to have RO attend the LOC meetings. The supportive nature has been very unique and valued.

d. 111

RO updated the group regarding the delay on implementing 111, it was now hoped to be on the 9th April.

e. Peer review

JA and Azad offered an update to the group, they have to host 3 trail meetings to become accredited. They offered feedback on the meeting which was held on the 25th February 2013.

From the training on 25th February 2013, JA and Azad explained that the facilitator’s role, within Peer review is to influence the conversation. There were some “planted” participates within the scenarios, who’s role was to be difficult and disrupt the session. JA commented that the training was more detailed then initial thought and difficult to pass on. Unless anyone had any objection both Azad and himself would be the only accredited facilitators.

The group spoke about the logistics of the proposed Peer event and going forward until accredited both JA and Azad could only facilitate meeting of no more than 10 people pers session each. It was thought that the event would go ahead on the 1st may and participates could obtain 3 interactive CET points.

8. Date of next meeting;

Tuesday 30th April 2013

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