Sheffield Local Optometric Committee

Sheffield Loc meeting 24th January 2012

Sheffield Loc meeting 24th January 2012
Sheffield Local Optical Committee
SLOC Minutes of the meeting
Held: Tuesday 24th January 2012
Present: James Allen (JA), Helen Bailey (HB) Shirley Blundell (SB), Gerry Cowley (GC), Mike Daybell (MD), Rob Hughes (RH), Deb Mullens (DM), Alastair Mew (AM) Richard Oliver (RO) Sue Wilford (SW), Helen Wilkinson (HW),
Apologies: Tan Hussain (TH), Azad Nawaz (AN), Habib Shah (HS)
Guest: Dee Singh (DS),
The minutes of the last meeting held on Monday 12th December were unavailable prior to the meeting. They are to be circulated for approval.
Meeting with Richard Sheard (RS)
RH reported on the meeting that he, AM, RO and MD had with RS and David Throssell (DT) (RS is cataract service lead at RHH, DT is clinical director), along with representation from LOCSU.
Issues arising
• Cataract scoring – RS is not in favour of cataract scoring, and would prefer if the scheme were dropped altogether and all those with lens opacity were referred to HES. The question was raised as to what other areas have implemented cataract scoring, and what criteria are used- SW offered to look at other schemes around the country. AM reported that there had not been a large change in numbers of cataract referral since the scoring criteria had changed to10. RO asked the members if we felt that scoring worked well, and all reported that it does. He said that the PCT supports scoring at present and it will aim to continue with it for now.
• Secondary pathology in cataract referrals –RS was concerned about this being missed, and reported several possible missed pathologies that were not mentioned on the cataract form, these included Wet AMD, BRVO, macular hole and others.RO and RH said that RS did not want the scoring sheet to include any other pathology as they should be sent via GOS18 instead. There arose a discussion about what constituted a co pathology that would be acceptable to send in on the cataract pathway, RO agreed to communicate with RS to clarify this. RH agreed to remove the section for co pathology, and include a sentence on the top of the cataract referral sheet indicating that cases of cataract with secondary pathology should sent via GOS 18, or direct to the appropriate secondary care department.DM to update website as appropriate. The PCT will reprint forms and send them out this time, but in future would wish optoms to print their own forms, or to pay the PCT for carbon copy pads if they wished to continue to use them when the forms had run out.
• Requirement to dilate –There was a discussion on the requirement to dilate all cataract assessments. In Derbyshire, the assessment includes dilation; we were not aware what fee is paid. All agreed that clarification was needed on this issue. Any extra time spent seeing a cataract assessment for dilation must be appropriately reimbursed it was agreed.
• Feedback from HES –there was a discussion on the lack of feedback from the hospital regarding referrals, RH reported that having analyzed his own practice, he had received a letter back in only 3o% of cases. The issue of consent was raised, but it was pointed out that it should not be a problem because there is implied consent when the patient agrees to the referral.
PEARS training – RS queried the level of training for PEARS. It was stated that PEARS is there to use optometrist’s core skills, funding appropriate further examinations not possible under GOS levels of renumeration.
• Applanation tonometry – RS asked why, if it is the more accurate method, applanation tonometry is not used as routine by optometrists? RH and others responded that there are cost implications for practices and a degree of lack of confidence in using the method. RH pointed out that the CATS scheme is a step in the right direction and is the way to encourage the use of applanation tonometers.
• Tonometers – RO said that there may be room within the PCT budget to provide more goldmann tonometers, alongside training in the use of them. HB pointed out that some practices may be disappointed that they have already had to pay for them. Therefore it was also suggested that as some practices have already invested in equipment to participate in CATS, that they might receive disposable tonometer heads FOC from the PCT budget – RO to investigate.
• HB stated it seems to have taken a long time to get the 2 new CATS optoms up and running, and the requirements seem to be confused. All that should be needed is for an optom to agree to the protocols, as the method is a core competency. Refresher training can be done by an LOC member if required, providing the optom visits the LOC member’s practice.
• Training- RO said there may be funding for more PEARS optometrists to be trained. There was a discussion about how this might be provided, whether via Reply learning, or the LOSCU course, which involves distance learning and other modules with practical assessment. The group felt that reaccreditation of current PEARS optometrists was important, and that might be achieved through the LOCSU program.
• Triaging- There was some discussion in the group about the validity of some triaging. RH told the group he had been contacted by Jon Stokes at STH who had asked that when a GOS 18 is triaged and is put into PEARS , that the referring optom is informed about it and told why. The group feeling was that this was something that would not be possible to implement.
SVC – AM said that Jon Stokes request to the PCT about SVC at STH joining the CATS scheme / GRR others was a complicated issue.
• School Vision- SB raised concerns that an optometrist in Sheffield is looking to introduce a program called “School Vision” by marketing it to Schools and GP practices. It was generally agreed that there was a genuine possibility this maybe mistaken by the public, notably parents of young children, for the school vision screening pathway, of with PRR is a part. SW pointed out that this is not a program accredited by the College of Optometrists. The group agreed it was important to keep a close watch on how this progressed.
• Discharge from SCH and RHH – DS raised an issue that a patient who had been discharged from SCH, with no discharge letter, attended his practice and he found a reduced VA, and wondered if this was acceptable for this child. The group felt it was the correct course of action to contact the department concerned at either SCH or RHH and ask about that patient if there were any concerns of this nature. SB and DM agreed to enquire at SCH and RHH respectively about who to contact for this and if an email address could be supplied for it.
Meeting ended 9.20pm
Next meeting Monday March 5th 2012 7.30 pm

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