Sheffield Local Optometric Committee

Sheffield LOC Meeting 5th Sept 2016

Minutes of Sheffield Local Optical Committee 5 September 2016

Present: Joint Chairman – Dee Singh (DS) and James Allen (JA), East Patel (EP), Habib Shah (HS), Tanveer Hussain (TH), Rob Hughes (RH), Rob Hobson (RHO)
Attendees: Karen Williams (Minutes)
Apologies: Gerry Cowley, Helen Bailey, Deborah Mullens, Michael Daybell Meeting started- 7:30 PM
1. OHT
2. Translator Services
3. Any Other Business

DS Are other OHTs doing anything?
RH In other areas OHT is being done with shared care which Simon doesn’t want.
JA I got an email from Dawn Roberts about the certification and who has applied for it.
RH It takes a while to get the certification and it needs consultant support.
TH Dawn said you might need a few days to complete the certification.
JA What is the actual benefit of a Glaucoma Certification.
DS You can’t really use the certification at the moment.
Translator Services
Item 2 – Interpreting Services in Primary Care – FOR INFORMATION

As you have previously been made aware the Governing Body agreed in September 2015 that the CCG would work with Sheffield City Council and Sheffield Teaching Hospitals to carry out a joint procurement for primary care interpreting services in readiness for a service start date of September 2016. As a result 12 months’ notice was given to the SCAIS interpreting service (hosted by Sheffield Health and Social Care NHS FT) who provide the current service for the CCG.

The procurement was split into two Lots. The first Lot (Lot 1) was procured jointly with Sheffield City Council and Sheffield Teaching Hospitals for an on-demand cost and volume contract for face-to-face, British Sign Language and telephone interpreting service. The second Lot (Lot 2) was for the CCG only for a pre-booked block contract for a face-to-face service for 7 high using practices. The procurement stated that both Lots could be provided by the same or different providers.

The procurement was carried out in accordance with the Public Contracts Regulations 2015. Twelve providers submitted bids for Lot 1 and eleven providers submitted bids for Lot 2. The evaluation panel was made up of 2 representatives from Sheffield Teaching Hospitals, 1 representative from Sheffield City Council and 3 representatives from the CCG comprising a GP, Practice Manager and the project lead.

The outcome of the procurement was that the panel were able to recommend the appointment of two new providers, one for each Lot.

• Language Line Solutions for Lot 1 – provision of an on-demand face-to-face, British Sign Language and telephone interpreting service for all practices.
• D.A. Languages Ltd for Lot 2 – provision of a block booked face-to-face service for 7 high using practices

The CCG will work closely with the successful providers to ensure there is a smooth transition between contracts and that GP, Dental and Optometry practices fully understand how to access the new services when they are mobilised. We envisage that the new contract will provide significant benefits for patients, practices, commissioners and the whole health economy. The new service is likely to be in place on 1 November 2016.

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JA I received the email above about interpreting services from Linda.

RH I called Diane Mason into my practice to show her that doing translation via telephone was not feasible.
DS The translator services seemed to be a good system.
RHO It is funded by CCG and it worked very well, we used to have on average one interpreter per day, you telephoned and asked for the language then they arranged to send someone at the appointment time. If a patient brings their own translator the patient is responsible for paying them.
RH Diane sent a list of the top 3 practices using the service.
RHO This could affect us if we can’t use the interpreter services. The translator services work better than using a family member as they give a more accurate interpretation.
RH Send the details of the email over and put in the minutes.
Other Business
RH Gerry sent an email as a patient of his received a letter asking them to verify that they had received various services from the optician. I emailed the address on the letter and asked some questions but got no reply. The letter was a random check that you had provided the services charged for, it is done in other areas of the NHS and it is part of the GOS contract that we may be checked out randomly.
JA Spa Medica – They offer private cataract and other eye surgery services in Wakefield. It may not be convenient for patients to go from Sheffield to Wakefield for surgery.
RHO If you recommend Spa Medica to a patient for example and the surgery goes wrong what would happen?
JA It’s a bit of a grey area especially when you get a fee for recommending them.
EP If the patient is intending to go private then there is no conflict in recommending Spa Medica for example but if they are NHS patients then it is preferable to put them into the system.
RH I have some patients who have asked for referral to specific consultant.
TH One Rotherham LOC member is going on the course and as I am near the Wakefield clinic then the post op could be offered.
RH The consultant Steve Winder asked if waiting times have changed.
DS In Leicester it is a year waiting time, I would recommend the Hallamshire Hospital to patients.
RH In Nottinghamshire only one eye will be treated for cataracts on NHS.
JA How to triage discs and blurred margins?
RH I would phone the patient and tell them I am sending them to hospital.
JA If it’s not a PEARS condition you could sent the patient directly to casualty. Or if there are no symptoms you could do urgent PEARS.
JA There isn’t a criterion for keratoconus, wear hard contact lenses record what you said to patient.
EP You are talking from the point of managing the condition but what about managing the patient as we don’t want unnecessary complaints.
RHO There may be some value in referring in the diagnosis so it’s in the system even if there is no treatment.
JA Referring in is pointless if nothing could be done. We need some guidance on this.
Question and reply from Mr Edwards:
Hi Matthew.

I think I’ve asked before, but at the LOC meeting last night a discussion came up about when to refer keratoconus.

Step one would be, presumably, refer any suspect for confirmation of diagnosis.

After that, would you always monitor, or discharge if it’s early stage and no intervention is indicated?

And when would you intervene? By which I mean cross-linking or intacs, rather than contact lenses.

Thanks. Rob,

Reply – Thanks for your email.

We’d agree about referring all suspected keratoconics for confirmation of diagnosis.

Follow-up depends on numerous factors, predominantly age but also severity of the condition, refractive history, causative factors and so on. Unless they’re approaching or over 40 we’ll probably monitor all at least initially. We only cross-link those with confirmed progression: this is almost exclusively based on Pentacam imaging.

Refractive management is individualised, based on patient wishes, visual needs, contact lens tolerance etc. Current treatments include glasses, contact lenses, cross-linking and intra-corneal ring segments (we currently use ‘Kerarings’ rather than Intacs). Other less frequent options are transepithelial PRK and phakic intra-ocular lenses. There is no doubt that the proportion who end up having corneal transplant is currently and will continue to go down.

Our department is about to join a national multicentre trial of cross-linking under 17s. We’ll probably contact you all when this starts, but should be grateful if you and your colleagues could look out for young keratoconics.


RH All enhanced providers need to know about yearly modules to be completed, they are on the website – level 2 Primary Eye Care Sheffield website has the details.
EP Supplies from Captia, are you getting them through OK?
JA Before the AGM we said we would offer another round of PEARS training.
Meeting ended 8:30 PM
Next LOC meeting is Monday October 18th 7:30 PM Holiday Inn Express

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