Sheffield Local Optometric Committee

Sheffield LOC Meeting 1st November 2010

Sheffield Local Optical Committee

SLOC Minutes of the Meeting

Held: Monday 1st November 2010

Present: Phil Banton (PB), Helen Bailey (HB), Shirley Blundell (SB), Gerry Cowley (GC), Rob Hughes (RH) (Chair), David Inman (DI), Tanveer Hussain (TH), Azad Nawaz (AN), Sue Wilford (SW), Helen Wilkinson (HW),

Guest:
Steven Haigh (SH), Richard Oliver (RO), Alastair Mews (AM)- NHS Sheffield
Robert King (RK)– Secretary Rotherham LOC.

Attendees: Louise Lambert (LL) (Minutes)

Apologies: Mike Daybell (MD), Alex Gage (AG), Deborah Mullens (DM), Habib Shah (HS),

Welcome and Introductions
RH introduced and welcomed SK, secretary to the Rotherham Local Optical Committee.

Minutes of the last meeting
The minutes of the last meeting held on Monday 21st September 2010 were accepted as a correct record. Proposed by RH and Seconded by HB

Matters Arising

1. Cataract

The recent referral meeting with Alastair was in line with the SHA position to standardise rates. Rotherham rates are considered to be high whilst Sheffield was rates are low and Sheffield scoring within national average, opposing ends of the spectrums. 30% of all referrals are not followed through by patients for various reasons

The group proposed to combine the assessment and referral forms. Any referrals not rated will be returned to either the optometrist or back into PEARS, ensuring that referrals for Cataracts are scored correctly.

RK outlined a similar pilot which was run in Rotherham and the lack of LOC involvement which led to high Cataracts referrals. He briefly explained at the request of Rotheham PCT a LOC was established about 5 years ago but without involvement in services they had little for discuss and now the LOC is not active. The Rotherham referral forms were initial three questions not including scoring.

RK further went onto explain how it was proposed that Cataracts was to be processed by one practice and whilst the community optometrist were not being paid for services performed, the practice would grow. Hospital Eye Service (HES) appeared uninterested by cataracts and referrals increased.

The group discussed the scoring system in Rotherham (which still uses the three questions) in line with the national average. Sheffield LOC explained to RK how the referral systems operate within Sheffield. Went onto further discuss the standardising referral routes of patients across Yorkshire and Humber and how optometrist are being recognised within the services.

The group agreed to combine both forms and clarified how the new forms would be processed.

SW enquired if there was a way to audit referrals to identify trends, newly qualified optometrists, how the consultant’s accepted referrals. It was suspected that budgets also played a part within trends.

The group discussed individual cases. Proposed to issue Patients with information leaflets, highlighting potential problems and asking them to sign to ensure they understand and are in agreement to attend cataracts surgery, the signature form to be sent approved by a consultant. Action: RO to obtain approval

The group discussed the combined form and free texting within, particularly highlighting driving and laser treatment. The form was unable to place fixed boxes on lifestyle as it could be perceived as discriminatory. Any comments that are deemed to be relevant can be placed within the free text box. Only when the patient is referred, does the white copy need to be sent to the Referral Information Service (RIS).

SW commented that the title of the form requires amending to “Cataracts assessment and referral form”, to also include a flow chart and guidance.
Action: RH to provide Contact details to RK

RO highlighted the need for Optometrists to discuss “Choice” with the patient due to a recent change to the services offered by Referral Information Service (RIS). The form should reflect that discussion.

There are four copies of the form, the bottom two associated with payment. It needs to be made clear that payment is only for patients registered in Sheffield.
Action: AN to amend form as per discussions

It was hoped that the newly proposed assessment and referral form will be standardised across the region.

2. CATS (Contact Applanation Tonometry Scheme)

It was considered by group that the scheme was close to being implemented.

There is a requirement to make GPs aware of the scheme and the group considered the necessity to inform GPs of outcomes, it was believed only when further action was required and taken would the GPs want to be informed.
Action: AM to review forms

The scheme should reduce referrals to PEARS and Secondary Care, allowing CO’s to offer continuity of care and making the integrated service more efficient and cost effective.

It was asked how many CO’s had expressed interest in the scheme and it was thought true numbers would be gathered from the returns.

Further discussions around the proposed letter, to be sent to all qualified Optometrist in Sheffield, SH suggested a deadline for interest to be included within the letter.

The necessity to establish a buying group was discussed in detail. Some prices have been obtained, for equipment, although further quotes are required to ensure comparisons obtaining significant discount on volume and savings to the optometrists.
Action: HB to obtain further quotes once interested numbers are known

The group discussed the National Institute for Health and Clinical Excellence (NICE) clinical guidelines regarding measuring eye pressure. NICE only recognises the Goldmann applanation tonometry (GAT) and makes no mention of the Perkins tonometer. Concerns were raised regarding GAT practicability. The Perkins tonometry benefits from being portable and cheaper then GAT. The group went onto discuss preferences and how to address within CATS. It was agreed to recommend GAT but highlight Perkins as an acceptable alternative.

RK enquired about training and it was suggested Docet learning would be suitable.
Action: SW to make enquiries

Further amendment to the SLA is that each practice Is required to nominate a person act as Caldicott Guardian, to be responsible for protecting the confidentiality of patient and service-user information and enabling appropriate information-sharing.

SW enquired about “NHS terminology services”. Action: AM to enquire within the PCT

A training CD to be dispatched with the letter
Action: PB to amend letter as per discussions

It was proposed the SLOC would start to buy equipment by the end of the year. Those optometrist who already have either GAT or Perkins tonometer will be able to commence once relevant documentation is completed and returned to the PCT
Action: RH to issue AM a list of optometrist who already have the equipment, this week
Action: AM to inform those optometrist of CATS, next week

3. DESP (Diabetes Eye Screening Program)

The LOC involvement in DESP is finishing in February 2011. It was proposed that the LOC should still attend DESP committee meetings once optometric involvement in the scheme ceases RK shared with the group Rotherham LOC’s negative experience. When the scheme was run through practices it worked well, however ran externally it did not work effectively. Practice Based Commissioning (PBC) has concerns regarding moving the DESP to secondary care as this could be seen as a move away from primary care

SW suggested those not involved with DESP should be informed, and that the College of Optometrists’ advice is that patients are not required to be seen yearly and only bi-annually if they are being screened but to inform patients that screening is due if this appears to be the case
Action: PB to inform all optometrists and update website accordingly

One practice wanted SLOC to call in lawyers to stop the PCT from removing the diabetic cameras once the scheme ends in February 2011. After consideration the committee concluded that the PCT was not in breach of the contract as the camera is still considered to be a PCT asset. The practice could pursue the course of action individually should they want to.

4. PEARS

LOC were invited to attend a meeting on Tuesday 19th October 2010, to discuss the proposed link between PEARS and the pharmacy, Minor Aliment Scheme (MAS) to establish products requiring inclusion of the medications list. AG and DI attended the meeting and drew up a list of potential medications.

The medication list was thought to contain some minor omissions. The group went onto further discuss MD concerns and Hypertonic Saline as well as alternatives medication. The group also discussed when expensive medication would be used for treatment and if that treatment would be done in practices.
Action: Specific medication list, with two choices – to be sent to RO

The group concluded that the medication list encompassed the majority of medications prescribe to patient, for the small percentage currently not on the list could be requested to the GP to prescribe. The medication list will be reassessed in 6 months time, unless a specific medication becomes apparent in the meantime.

LOC thought the proposed pilot scheme of triaging GPs referrals into secondary ophthalmology was positive. Six GP practices are now sending their ophthalmology referrals to the RIS for optometric triage. The majority of ophthalmology referrals are currently coming through the nine triaging optometrists.

Action: Arrange a PEARS question and answer session
.
Once CATS commences a meeting to be arrange with the PCT to discuss how the new scheme has impacted on PEARS referralsfeedback.
Action: SH to provide feedback

5. PRR

Once Criminal Records Bureau (CRB) checked Optometrists are able to pick up or arrange delivery of logMAR charts.

A small group of optometrists have started the scheme which will then be cascaded out. The referral pathway should be similar to PEARS, the group expressed an interest in obtaining feedback from the first referrals, potentially if there are any issues these should be raised.

6. Stable Glaucoma Management

The LOC discussed whether there would be an interest in looking at a developing a community optometry stable glaucoma monitoring scheme. The group considered the proposal and suggested that it would have to be a significant service and redesigned, there is a need to obtain possible numbers to gage optometrist’s interest. STH are being forced to reduce high volume follow ups which potentially could assist with their engagement.
Action: AH and SH to review numbers and cost
Action: PB to review nationally how others are processing patients

7. Expenses claim forms

Claim forms and bank details to be with HB by 3rd December 2010 for payment prior to Christmas. HB clarified rates that can be claimed by the group and if more than one member attends the same meeting the claimed amounts need to tally.

Correspondence

An email was received today, Monday 1st November 2010 from Lisa Faulkner (Sheffield PCT) regarding self assessment form that requires completion by the end of the year.

PB enquired about the LOC position, as Practitioners will not receive payment for completion of self assessment. Differing viewpoints were discussed; voluntary completion, no contractual requirement to complete assessment was considered however the alternative viewpoint was, as part of Care Quality Commission (CQC) standards it was an obligation part of being CQC compliant. The group felt further clarification was required regarding completion of the self assessment forms.
Action: SW and PB to make enquires
Acton: RH to investigate

Any other business

PB reminded the group of the open evening with The Royal Society for the Blind Tuesday 16th November at 6pm at Mappin Street in Sheffield.

GC mentioned Trevor Warbutons recent OT article regarding IT transfer of clinical data to PCT’s for audit and payment.
Action: PB will speak to Trevor Warbuton at the NOC

Date of next meeting

Tuesday 7th December 2010 at 7.30, Beauchief Hotel, Abbeydale Road

Future meeting dates for diaries;

Monday 17th January 2011
Tuesday 1st March 2011
Monday 11th April 2011
Tuesday 24th May 2011
Monday 4th July 2011
Tuesday 16th August 2011
Monday 26th September 2011
Tuesday 1st November 2011
Monday 12th December 2011

RH informed the group that Jan Sobieraj still wants to attend a future meeting.

« Back to the archives

Next Meeting:

Copthorne Hotel
Bramall Lane
Sheffield
S2 4SU

at 7.00pm Monday 4th December

Mailing List

Join our mailing list