Sheffield Local Optometric Committee

Sheffield LOC Meeting 20th October 2009

Sheffield LOC Meeting 20th October 2009

Present: Helen Bailey, Philip Banton, Shirley Blundell, Gerry Cowley, Mike Daybell (Chair),
David Inman, Sue Stentiford, Helen Wilkinson

Guests: Steven Haigh, Richard Oliver, Jan Sobieraj

Apologies: Alex Gage, Rob Hughes, Ian Van Hoof, Will Walters

Minutes of Last Meeting

The minutes of the last meeting held on Tuesday 8 September 2009 were accepted as a correct record.
Prior to the agenda Jan Sobieraj spoke about the aims of NHS Sheffield’s Achieving Balanced Health Strategy. He explained that realising the aims requires significant changes to clinical infrastructures, clinical pathways and clinical behaviour and that the planning and implementation of these changes is a significant challenge. He stated that the challenge could only be met through clinicians and committees (supported by PBC consortia) working closely with NHS Sheffield to drive the changes needed.
He felt that NHS Sheffield is currently in a strong position after the 2009 Care Quality Commission report rated NHS Sheffield as ‘good’ and ‘good’ for its use of resources and its quality of service.
The committee was able to discuss with Mr Sobieraj the difficulties and frustrations already encountered while trying to make changes to clinical pathways and introduce new schemes in Sheffield.

I. Referral Information Service (RIS): A letter was sent to all community optometrists with details of new referral pathways using RIS. However, NHS Sheffield did not consult fully with the LOC and the letter incorrectly requested that all glaucoma referrals should be sent through the RIS. This would mean that all referrals based on raised IOP alone would go directly into secondary care and bypass PEARS. A second letter was sent recommending glaucoma referrals from non PEARS or non GRR accredited optometrists should be sent to the patients GP.
Steven Haigh commented that despite the initial difficulties, the new referral system appeared to be working well. He is to ask Lynda Liddament to produce some RIS address labels for practitioners to use.
Richard Oliver commented that the role of the RIS will be extended to include referral management. This will mean that patients may be referred to services including PEARS via the RIS. It is anticipated that a clinician will soon be required at the RIS to triage optometric referrals. To aid this, it was felt the clarity of GOS 18 referrals could be improved by using a revised GOS 18 referral from. Sue Stentiford will email the committee a copy of a revised GOS 18 form currently used in other areas.

II. PEARS and Glaucoma Referral Refinement: There was some discussion regarding whether raised IOP should be formally included as a PEARS condition. It was felt that referrals based on raised IOP alone could be seen within PEARS as all PEARS providers currently perform applanation tonometry. However, PEARS and GRR should co-exist as separate schemes for the moment. Once a clinician is established within the RIS, referrals from non PEARS / non GRR providers via the RIS for raised IOP will be encouraged so that these patients may be referred on to a PEARS or GRR accredited optometrist for applanation.
More optometrists want to become PEARS accredited. Steven Haigh said that it was unlikely that the PCT would fund more training sessions at the moment as currently the scheme is underutilised by GP’s. Richard Oliver suggested that to increase GP referrals into PEARS, optometrists should communicate with GP’s about how to use the scheme appropriately. He also suggested that utilisation of PEARS is likely to increase once a clinician is established within the RIS.
David Inman will enquire about the possibility of funding further PEARS training sessions by using money allocated by the PCT for training optometrists on Quality Assurance issues.

III. Children’s Eye Care: Shirley Blundell received a draft service level agreement for the Paediatric Referral Refinement scheme and emailed a copy to committee members. There are a number of potential changes required. An LOC sub-committee will meet 21 October 2009 to ‘red flag’ any changes thought necessary. Shirley invited email comment from the committee.

IV. Diabetic Eye Screening: Philip Banton and Rob Hughes attended the DESP meeting for further discussions with Chris Brand regarding optometrists becoming accredited slit lamp graders. Chris Brand requires accredited optometrists to slit lamp grade those patients that cannot be screened using digital photography. He estimates that two to three optometrists will be sufficient to see numbers required (approx 1000 per year). It was suggested to Chris that slit lamp examination and grading could be performed within community practice for a fee of £30 to £45 per patient. Chris Brand will bring a proposal to the next DESP meeting.

V. Low Vision Group: Not discussed at this meeting.

VI. Primary Care Trust: David Inman circulated draft copies of NHS Sheffield ‘Optometry Quality Assurance Self Assessment’ for comment at the next LOC meeting.

VII. Website: Not discussed at this meeting

Correspondence: None

Any Other Business: Participation in optometric schemes across the city remains low. It was suggested that all contractors should receive an LOC funded visit, with an information pack giving details of the schemes running in Sheffield. The visit could be used as an opportunity to introduce contractors to the LOC website and collect email addresses. It was felt that David Inman could provide this visit.
Richard Sheard has produced an updated cataract referral form which Mike emailed to the committee for comment. There will soon be a cataract review committee meeting within NHS Sheffield. Optometrists could potentially be more involved in pre-operative cataract assessments.

Date for Next Meeting: Tuesday 1 December
Beauchief Hotel – Abbeydale Road
Meeting closed at 10.10 pm

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Copthorne Hotel
Bramall Lane
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S2 4SU

at 7.00pm Monday 4th December

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