Sheffield Local Optometric Committee

Sheffield Loc meeting 2nd October 2012

Sheffield Local Optical Committee

SLOC Minutes of the meeting

Held: Tuesday 2nd October 2012

Present: James Allen (JA), Helen Bailey (HB), Shirley Blundell (SB), Rob Hughes (RH – Chair), Tan Hussain (TH), Azad Nawaz (AN), Deb Mullens (DM), Habib Shah (HS), Helen Wilkinson (HW), Sue Wilford (SW)

Guest: Richard Oliver (RO), Alastair Mew (AM)

Attendees: Louise Lambert (LL) (Minutes)

Minutes of the last meeting
After some minor amendments the minutes of the last meeting were accepted as a correct record. Proposed by HB and seconded by SB

Prior to the meeting starting there was a discussion regarding RO attending and speaking at the National Optical Conference (NOC) 2012 in October 2012. The group gave a brief overview of the event.

Meeting started at 7.40pm

Matters Arising

1. Cataracts

The group was informed that the scoring system was due to be withdrawn nationally. It was considered that there should be a concise measure when referring. RO commented that he had emailed Richard Sheard and was waiting a response. It was hoped that the CATS scheme would reduce operations. The referrals from the community optometrist had significantly reduced, however the overall operation figures had remained unchanged. It was thought to be due to internal-departmental referrals.

The group discussed in detail that if the threshold was removed, the overall surgical cases would increase. The group felt there would be an advantage knowing the thresholds that Richard Sheard was using. RO informed the group that it was difficult to separate and identify cataract scheme referrals out from of the overall figures.

Terminology used with patients was raised as a concern by JA, it was considered that a sheet informing them of the details of cataract surgery should be handed to the patient. Various scenarios with diabetes patients were discussed. SB suggested that community optometrist follow good practice guidelines, as opposed to protocol this would retain a level of consistency / universal scoring.

It was mutually agreed that SLOC would rather retain a scoring system which could then be universally applied. It would be difficult to maintain consistency without it. Secondary Health Care would still need to adhere to the 18 week timeframe for patients.

2. Community monitoring

SW enquired if anybody had been approached by the hospital regarding Hydroxochloroquine. The hospital where trying to identify patients that had been sent for monitoring – OSCE. It was thought that the GOS was neither there to diagnose or monitor.
Action: SW to inform RO, who will make enquires.

3. Ocular hypertension (OHT)

RH enquired with RO whether OHT monitoring had progressed at all. The group discussed various national OHT schemes, with particular reference to Wales and Cambridge. It was thought that those schemes were “shared care”, which was not favoured by Simon Longstaff consultant Glaucoma and Cataract with Sheffield Teaching Hospital (STH). SW thought the community based scheme, previously discussed was in Devon
Action SW to clarify and report back

Richard was planning to attend the National Optical Conference on the 18th October 2012 where he hoped to raise the query/issue. The mention of the National Optical Conference, prompted RH to enquire if any members of the group wanted to attend as a free placement was being offered by LOCSU, unfortunately no committee member was able to accept the offer.
Action: RO to report back to group

4. Gonioscopy

RH questioned whether there were any benefits to community optometrists doing Gonioscopy for the hospital. Some felt that the extra test was not particularly necessary, as it would not effect community optometrist decision to refer into secondary care, and also that the hospital should complete it. RO said that there was no additional money, within the budget, to pay community optometrist for an additional test.

Some felt that Gonioscopy would not offer any additional value and the logistics would be quite difficult to implement, requiring equipment and training. It was felt that STH did not have the staff to facilitate the test and RO would consider opening up conversation with STH to ascertain if there was a clinical benefit. The community scheme would not alter the management of the patient.
Action: RO to approach Simon Longstaff

5. PEARS training and new PEARS optometrist.

The committee agreed that the training was good and beneficial for optometrist to complete. The practical assessments and scenarios would aid clinical consistency.

Evolving into a larger discussion about non or accredited training. Concerns were raised regarding the informal assessment of individuals, and how this could lead to the assessor being exposed. The group agreed that accredited training would be recognised particularly within commissioning.

The group went onto discuss the levels of interest/numbers, where offering the training to PEARS and non-PEARS optometrists. SW suggested potential newly qualified optometrist may hold an interest in attending, alongside a buddy system.
Action: Debs to look at how other areas are doing training

Training would ensure best practice and would bring consistency in working practices by community optometrist.
Action: Arrange a meeting of triaging PEARS.

RO confirmed that there was £1500 funding available for training. The group discussed the idea of Sponsorship and opening the training for reps to attend and promote products, companies like Graphton. There were no objections noted for the introduction of Sponsorship.
Action: Investigate sponsorship

RH confirmed for RO that WOPEC would contact SLOC should an individual fail the online training. It was considered that the individual would be given the opportunity to resit, and if they did not pass again the result would need to be adhered to and they would no longer be accredited and therefore would be unable to practice.

The group returned to the logistical conversation of training ten optometrists annually, on a rolling 3 year training programme. Allowing individuals to pick up missed training over the 3 years, if needs be. It was suggested that the contents of the training should be both, OHT, college and WOPEC training material. PEARS optometrists would also need to complete the Glaucoma training.
Action: RH to prepare a business case, including funding requirement and criteria.

6. Peer Review

RH enquired if any of the committee were aware of the recent Peer review. AN offered his viewpoint, that he felt it would be beneficial operating peer review alongside the SLOC groups. It gave optometrist the opportunity to summarise issues or ask specific advice of other community optometrist, and to bounce ideas and thoughts of each other. He informed the group that it was suggested peer review groups should be no bigger than 8 individuals.
Action: AN to circulate link

SW spoke about the college OHP resources and with the possibility of providing “What do you do” scenarios (potentially not real patients) to make open discussion easier. The peer review group would also be an opportunity to analyse records and bring them in for critical review.

The group spoke wider about logistics, including frequency and finical cost. It was suggested to hold the Peer review groups prior to the SLOC meeting, two committee members to be in attendance from 5pm. The peer review group would include all optometrist (not just PEARS) with the possibility of sending out specific invites.

AN clarified for the group that it was suggested that no specific topics be identified, and for the Peer review group individuals to bring their own queries.

The chair asked for volunteers to investigate requirements and set something up in the New Year. Both JA and AN nominated themselves.
Action: JA and AN to follow up

7. Any other Business

SW wanted to collate GOS 18 with a view to testing the system, highlighting data and quality issues, if any, and ensuring the forms are fit for purpose. The collection of forms would be analysed, allowing collective learning.
Action: Triaging optometrist to send good/bad examples to SW

SW also bought to the committees attention that there was a lecture, organised by the college taking place at the town Hall next Thursday, 11th October 2012.

Action: Helen to pay LOCSU Levi at 1.5%

Date of next meeting;

Monday 12th November 2012

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Bramall Lane
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