Sheffield Local Optometric Committee

Sheffield LOC Meeting 21st September 2010

SLOC Minutes of the Meeting

Held: Tuesday 21st September 2010

Present: Phil Banton (PB), Helen Bailey (HB), Shirley Blundell (SB), Gerry Cowley (GC), Mike Daybell (MD), Rob Hughes (RH) (Chair), David Inman (DI), Tanveer Hussain (TH), Deborah Mullens (DM), Azad Nawaz (AN), Habib Shah (HS),

Guest: Steven Haigh (SH) – NHS Sheffield, Ravi Moham (RM) – Sheffield Local Pharmaceutical Committee.

Attendees: Louise Lambert (LL) (Minutes)

Apologies: Richard Oliver (RO), Sue Wilford (SW), Helen Wilkinson (HW), Ian Van Hoof (IVH)

Minutes of the last meeting
The minutes of the last meeting held on Monday 2nd August 2010 were accepted as a correct record.

Matters Arising

1. Pharmacy

A presentation was kindly given by RM, Chair of Sheffield Local Pharmaceutical Committee (SLPC), introducing SLPC and outlining the relationship between PEARS and the Minor Aliment Scheme (MAS).

RM gave a brief outline of the 117 Community Pharmacy in Sheffield and the services offered which are split into three dispensing services; 1. Essential Services – Prescribing and clinical governance. 2. Advance Services by Accredit pharmacist and 3. Enhanced Services which are commissioned locally.

There are currently 11 enhanced services – including anticoagulation, minor ailments, dyspepsia management and smoking cessation. MAS will stop unnecessary appointment with GPs and link in with PEARS. It is hoped to be developed nationally.

RM discussed the development and workings of Sheffield LPC, which is part funded by NHS Sheffield pharmacy development and contractors, this year acquiring office space with more focus on day-time bi-monthly meetings. The help and support offered by Sheffield LPC.

RM outlined the benefits of joint working and mutual support between the SLOC and SLPC committees regarding patient referral under MAS. Example; Instead of PEARS referring back to doctors for drops, if items being recommended are sale or pharmacy items then PEARS could refer directly to Pharmacists. The patient referrals process will be more streamlined of benefit to patients and freeing up GP resources.

RH enquired about Prescription Card exempt and whether charges would be applied to MAS, if it would be cheaper to buy without prescription. RN confirmed that Card holders would still be exempt.

The referral process is not yet confirmed and it was felt that the establishment of mutual working, sharing good ideas and common interests between SLOC and SLPC would be of value to the development of the process.

RH highlighted the need to organise a recognised from or signed order for referrals between PEARS and Local Pharmacists. RM clarified that Michelle Black (MB) was arranging the forms, prior to her departure in November when Peter Magrir will be covering the role.
Action: MB to discuss with PEARS sub-committee
Action: RM to feedback to PB what progress has been made on forms.

GC enquired if pharmacy would find it useful to refer to Optometrists if a patient had an obvious condition which didn’t clear up within (a certain number of days), then Pharmacy could issue the list of PEARS optometrists to the patient. The group explained the current referral process. The group was reminded of the Referral Information Services (RIS) relocation.
Action: PB to provide RM a list of PEARS optometrists and the current referral process

RH enquired about Health Checks, particularly regarding Hypertensive and Diabetic checks, currently Sheffield Pharmacy are not currently involved with Health Checks.

RH also enquired about Cost effect of products. RM explained that the pharmacists are paid a standard dispensing fee per transaction, approximately £6.50 and explained how product transaction should average out. Formulary list has already been issued to SLOC.

The group went onto further discuss medicines on and not on the formulary and costing. SB made example to the necessity to issue a day and night medication for “Dry eyes”, RM confirmed that costing were consultation fees not product. The group highlighted that the PEARS scheme formulary and items would need inclusion. GC asked about eye bottle squeezers, which are not currently included in the Pharmacy formulary although they could be available for purchase.

MD enquired about Hypertonic Saline which is not on the list, RM would have to look at the Drop formulation to cost, Once a bespoke product was confirmed the general wholesaler could provide the item within a couple of days.
Action: PB to provide RM with drop formulation

The group discussed repeat prescriptions and currently PEARS necessity to inform the GPs. Under MAS the Pharmacist records repeat prescription not involving the GP and the process is more efficient.

Over half of Pharmacy have, Smoking Cessation Advisors trained by NHS Sheffield. They offer 1-1 support, check levels and issue products for individuals. Patients are able to self refer to the services. Optometrist smoking patients would benefit from knowing of the Stop Smoking Shops.
Action: RM to provide SLOC a list of pharmacy that provide a Stop Smoking Shop, to be published on SLOC website
Action: PB and RM to liaise regarding links each website.

Concluding the group decided to reassess the situation in 6 months where it was hoped the generic form will have been circulated, potentially also being used by Non-PEARS Optometrists. The development of joint working will greatly simplify the process and be of benefit to patients.

RM returned the offer for SLOC members to attend Sheffield LPC meetings and express the usefulness of obtaining different perspectives.

The group thanked RM for the interesting and useful presentation and attending the meeting, also appreciating the opportunity to discuss MAS and the similarities between respective professions.

2. Glaucoma referral and monitoring

RH and PB will attend a meeting with Alastair Mew on Wednesday 22nd Sept to discuss LOC proposals to introduce a payment for optometrists to perform contact tonometry on patients presenting with raised IOP using non contact methods

The group also discussed proposals put forward by Simon Longstaff to introduce a new scheme for a cohort of elderly patients with glaucoma. He proposes that contact tonometry could be performed by optometrists in the community rather than the patient attending the HES. The group did not feel that this is an area that should be pursued at the moment and felt that a complete service redesign would better serve patients with glaucoma

3. Cataract

The group was informed that the PCT’s wish to reduce the numbers of cataract procedures in certain areas of the country. The group went onto discuss grading and score standings. It has been reported that Rotherham’s rates are high, which was consider to be due to the “best practice” tariff and package. The group went onto further discuss tariff variations instead of the “best practice” tariff. Sheffield scores are considered within national average, the standardised grading thresholds aiding scoring levels. The requirement to improve standards was expressed.

Actions: SLOC to assist Rotherham LOC and with scoring system.

4. Low vision

PB recently visited Steve Hambleton from the Royal Society for the Blind at Mappin Street in Sheffield. Few referrals are currently being made directly to the Society. It was felt that if optometrists better understood the services and facilities on offer more use of the service would be made.

Action: PB to work with the Royal Society for the Blind to arrange an optometrists open evening at Mappin Street

5. Hospital placements for pre-registration Optometrists

SW has encountered problems obtaining hospital placements for pre-registered students.
It was thought that Chris Brand? was going to assist. The group discussed that the contact within STH for pre-registration placement was unclear it was thought possibly to be Paul Rundle (PR), STH are being paid for pre-registration placements although it appears that there is difficulty in obtaining them, the group went onto further discuss the necessity for placements. Action: DM to ask PR to email RH details.
Action: SH to enquire within STH

6. Patient benefits

There have been some problems with some patients not knowing which benefit they are in receipt of when signing GOS paperwork. This can in theory culminate in the patient making a fraudulent GOS claim. HB suggested that practitioners telephone the DwP to obtain this information in some cases
Action: HB to email SW and RH phone number. PB will put this number on the website

7. Correspondence


8. Any other business

The Chair informed the group of resignation received from Will Walters and Ian Van Hoof

The group discussed CRB Checks prior to commencing PRR. Sue Witham will assist completing the checks in Individual appointments, although she is on holiday next week.

9. Date of next meeting

Monday 1st November 2010 at 7.30, Beauchief Hotel, Abbeydale Road

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Bramall Lane
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at 19:30 Tuesday 8th January

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