Sheffield Local Optometric Committee

Sheffield LOC meeting 29th Nov 2016

Minutes of Sheffield Local Optical Committee 29 November 2016

Present: Chairman Rob Hughes (RH), Secretary Michael Daybell (MD), Treasurer Helen Bailey (HB), Dee Singh (DS), James Allen (JA), Gerry Cowley (GC) Deborah Mullens (DM), East Patel (EP), Habib Shah (HS), Tanveer Hussain (TH), Rob Hobson (RHO)
Attendees: Niss Sabir – LOCSU, Karen Williams (Minutes)
Meeting started- 7:00 PM
1. OHT
2. Other News
MD- I spoke to Simon Longstaff he thought that before we put a business plan forward we ought to check that they are still willing to discuss OHT with us. Can the OHT service be provided for a lower cost than the hospital? Simon mentioned that there is a new NHS local strategy which may be a help to us.
NS- It’s called the Community Ophthalmology Framework, it is expected that after initially being seen the average patient will require up to 40 follow up appointments. The fees are £35 to £45 as at the hospital a nurse practitioner may be doing the test but the fees are the same as if the consultant had done the test.
MD- The email from CCG said unless there is a cost saving it is a low priority to set this up.
NS- OHT monitoring is the area where LOC could step in; the figures are £50 to £55 for that.
RH- It is the capacity that is the issue as the hospital is apparently approx 9 months behind on follow up appointments.
NS- The hospital will take on the initial referrals but cannot follow through with the appointments afterwards.
DS- Cataracts are being done but glaucoma patients have to wait a long time to even be seen.
JA- Some patients end up going through triage as they have not been seen for so long.
HB- Also a lot of referrals for cataracts are being kicked out of the system.
MD- Should we be looking at providing the service for less and putting forward a business plan.
NS- CCG will argue that they wouldn’t be interested in paying any more than they do now.
JA- I would not be interested in anything less than £50; as the hospital gets busier they will be pushed into paying more.
MD- Simon Longstaff said when you are doing glaucoma monitoring you can have other staff doing different parts of the testing so could we offer a cost reduction and make it worth our while to take this on?
JA- But as the payment comes down in price less optoms will want to take it on so the others will end up very busy with it.
RH- I think we should say that we don’t want it for any less than a reasonable fee.
GC- The first time we see the patient it will have to be a long appointment but the follow up appointments can be shorter.
RH- I will send out an email to all optoms to get a feel for what they think, they want to give up some of their usual work to take this on?
JA- There is also all the paper work to do afterwards.
NS- Doncaster charge £54 and they don’t do special clinics.
DS- Essex charge £59 which is £50 to them and £9 in charges.
DS- Some LOCs don’t use the CCGs and go straight to the hospital to arrange terms.
RH- Sheffield won’t work like that; it had to be done through the CCG channel.
NS- STP (Sustainability Transformation Plan) is a regional based concept covering the whole of South Yorkshire and Bassetlaw. The chairman of the Sheffield trust – Andrew Cash is trying to look at a regional wide plan.
RH- Sheffield does PEARS not MECs so would they try to iron out those differences? PEARS can deal with more conditions than MECs so we would be downgrading our service if we went over to MECs.
NS- LOCSU wants standardization over the board and they want to talk to a larger organization than the LOC i.e. a regional organization.
JA- If it is going to be standardized there is no point in us going in now.
GC- They will want to go with the lowest price agreed in the region for the whole region
NS- Specsavers are going in with New Medica and they would like to get in on community ophthalmology. They are sending out a letter to all practices asking you to join them in enhanced community services, Specsavers did their own accreditation.
MD- Would the CCG have to put out to tender any scheme e.g. OHT to all optoms
NS- Sometimes they will do a direct contact with one supplier
EP- I thought it had to be transparent
NS- As long as it covers a wide area and they can make a deal with one company.
MD- So all these services could end up being supplied by the one company.
RH – The CCG will not commission to separate service providers.
DM- They want to deal with as few organizations as possible hence the STPs
EP- Well we have to decide what we want to do that is the only thing that we have control over so should we wait for the STPs to come on line before we try to make an agreement. LOC Sheffield needs to have all the optoms accredited and ready.
NS- Even if Specsavers do the community ophthalmology services we can still do the other work, we as a LOC need to be prepared for these services being brought into commission, there is a lot of pressure on the trust to put out this work.
I just want to establish the fee that you are willing to accept- £55 at the moment? I would like to meet Simon Longstaff with 2 representatives of the LOC then meet with the trust and then the CCG, then lastly I want to meet with the STP; I would like to bring all the LOCs in this area to that meeting depending what you think. They may agree to a difference in fees across the area as costs can be different. The best thing would be to have as many people on board as possible. Who is initiating contact?
MD- I think you should as LOCSU and as you are representing a national body.
RH- We just want to negotiate OHT for now.
Other News
RH- When I went to the last Quarterly Review of the CCG they asked me to find out from the hospital what didn’t need to be there. I spoke to three consultants who all said there is too much macularopathy and, dry macular degeneration. So should we put more of these cases through PEARS.
MD- Unless they say it is a rapid loss of vision then I put it though PEARS, if it is definitely wet and the vision is down over the last few weeks then refer.
RH- I will speak to Chris and try to find out where these referrals are coming from and what proportion are direct or from GPs.
DM- Is it an education problem.
RH- Also at the quarterly meeting the CCG were asking what else can optoms do. They mentioned falls for example.
HB- The falls team would like a list of optoms to send patients to for an eye test.
RH- It was about 12 or 13 years ago that we were talking about falls pathways before; can anyone remember why it came to nothing before?
GC- I think it was low vision side of things.
DM- I have looked into it and eye sight is not a big factor but they shouldn’t be wearing verifocals.
MD- There is no harm in recommending an eye test for people who are having falls.
NS- I would like to see some focus on people with learning difficulties and special needs, its more about educating optoms for different ways to test people which may work better for them.
RH- I don’t think that needs to be a special case but we need to have the list of optoms who are happy to see people with learning difficulties easier to find on the web site.
DM- I have seen patients like this at the hospital transition clinic who would like to be seen locally but don’t know where to go, they trust the hospital and are wary of seeing a new optom.
EP- Asking patients to go to a website to find optoms that are willing to see them looks as though most optoms don’t want to see people like that. I think people should be encouraged to go to their local optom and just explain their difficulties; the parent is being given the idea that there is some kind of problem. Under the NHS contract you have to not discriminate against anyone.
RH- The list would still be useful so if any optom is not happy testing a certain type of person then it would be good for them to be able to refer them to a practice that is more familiar and happy to take on that type of case.
RH- Keratoconus who should we be referring in? More patients should be referred in as it is not something which should be seen under PEARS.
Next meeting Tuesday at 7:30 PM at the Holiday Inn
Meeting Finished 8:50 pm

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