Sheffield Local Optometric Committee

Sheffield LOC meting 23 march 2015

Minutes of Local Optical Committee Meeting 23 March 2015
Present: Rob Hughes (RH-Chairman), Deborah Mullens (DB- Secretary), Helen Bailey (HB- Treasurer), East Patel (EP), James Allen (JA), Rob Hobson (RO), Azad Nawaz (AN), Lynda Liddament (LL), Habib Shah (HS), Michael Daybell (MD), Tanveer Hussain (TH), Shirley Blundell (SB),
Attendees: Karen Williams (Minutes)
Apologies: Gerry Cowley, Dee Singh Meeting started- 7:35 PM

OHT Pathway
LOC Company Update
Other Business

OHT Pathway
RH – Following on from the last meeting on what is and isn’t possible when dealing with patients on medication for OHT. There is a problem in that NICE guidelines state that after a while we would have to take them off medication depending on age and pressure. There are no other areas that are managing this type of system for these patients so they have to be referred back to the Hospital.
LL – If these patients are discharged to Optoms care and then referred back to the hospital to be taken off their medication then the CCG will have to cover the extra costs of that.
AN – What percentage of patients are on medication?
RH – Approximately 10% of patients are on medication for OHT and we need a specific plan for their care but the other 90% of patients who are not on medication can be dealt with straight away by Optoms.
JA – Is anyone actually aware of any patients who have been taken off medication on reaching a certain age?
AN – How do you class Ocular hypertensives as some of them will have field loss but are still classed as OHTs?
RH- They may have a field defect but nothing related to the OHT, it would be a field defect from something else as that would need referring, but there will not be many of those cases.
AN- Do we know what information we will get on a patients discharge report from the hospital?
RH- I hope we can get as much information as possible; we would want disc photographs and pressures on referral and any previous records.
MD- On discharge will we get a copy of the patients field tests as well?
RH- If there is a defect yes. I received an email from Simon Longstaff on ‘How Optoms can use the Glaucoma unit for refining new referrals’. He is suggesting that an Optom initiated new referral is seen at the tech based Glaucoma unit, then the results (fields, IOPs, disc images, Gonio, anterior segment OCT) are passed back to the Optom. The Optom reviews the results and decides OHT review or OHT requiring RX’ing and then asks their GP to prescribe and arrange an IOP check at 3 months then review. If it is possible Glaucoma the Optom will ask for a hospital review. This will guarantee all new OHTs will stay in the community so the Glaucoma fee will be less than the new tariff fee.
The problem with this is that unless an Optom was fully Glaucoma certified they would not be able to make those decisions.
LL- What he is suggesting means that the CCG will have to pay twice.
DM- Aren’t the GRR doing that anyway?
RH- What he is suggesting is that we are referring them in for diagnostics not diagnosis.
MD- We will just refer back in if the readings are over a certain level on a GRR appointment.
He will have to give us a protocol to work to, with criteria for referring patients back to hospital.
SB- Using Goldman wouldn’t we be on uncertain ground with the readings?
RH- This is not at straightforward as he is suggesting.
MD- This would require specialist training. I think a lot of Optoms would be hesitant about taking the responsibility for this.
LL- This is so different from what he is doing now that our contracting team will have to look at these new suggestions.
RH- For now we will carry on doing what we are doing; setting up the OHT monitoring pathway and he can discharge patients into that.
JA- Has anyone checked with NICE if they are going to change the rules again?
RH- The rules are always being reviewed and there was due to be a NICE glaucoma review soon.
RH- Someone from the glaucoma unit has been changing patients’ medication and telling them to go to their own Optoms to get their pressures checked and a follow up. There is therefore no letter or payment, I contacted Simon and this has now been stopped.

LOC Company Update

AN- We have worked through about 14 out of the 16 sections, it says we are 57% compliant but once the Clinical Governance lead part is completed this percentage will jump ahead.
HB- I am the Clinical Governance lead but I don’t have access to the NHS reporting website.
LL- We normally go through Afife for that but if you are talking about the generic mailbox please let me know if anyone else needs to go onto the NHS email system and also let me know if someone leaves and should be taken off the system.
RH- I sent an email to the NHS about the LOC agreement and they said the contract isn’t ready yet.
HB- The LOC Bank account should go live tomorrow. I am just ploughing through the LOC Company paperwork at the moment.
RH- The PRR DBS is out of date so everyone needs to re-apply for a new certificate, it costs about £36. If any practice or Optom doesn’t fulfil the requirements that we are asking then they will be unable to be part of the LOC Company and hence the new scheme. Provided we know they are trying to comply there won’t be a strict cut off date but if any practice is allowing an Optom who is not part of the scheme to practice we will need to know.
HB – We do have a step by step guide to what the procedure will be if you are presently non compliant.

Other Business

JA- We are setting up a PEAR Review for DOs and Optoms in May (possibly May 13th) it will be BV and Dispensing. It is for a maximum of 10 people to be held in my practice. If anyone knows a DO who would like to come please let them know about it and tell them to get in touch with me.
RO- There are people from our practice who want to go.
JA- I can do the same PEAR Review again as people need it.
AN- I charged for the DO PEAR Review as people often don’t turn up having said they will come so we asked £5 for the session to encourage a commitment.

HB- There shouldn’t be an issue with LOC Company tax position, if we end up with just a small amount of money left then we won’t be liable to pay any tax for the company.
RH- LOCSU say we have to use their Optipay system and want us to use Webstar Health as the intermediary who would take a cut from each transaction.
HB- They wanted £5 per transaction originally.
RH– Darmesh said we need to do it that way to avoid VAT and Tax but this doesn’t apply as there won’t be any tax liability. So I will get back to Darmesh and let him know we don’t want to use Optipay.
LL- The CCG won’t mind who sends the invoice but they have a quarterly contract meeting and they will want some feedback via online reporting, they have to be satisfied that you are furnishing enough information for us to the keep track of trends and referral targets. LOCSU will have to do this part as my role will change when you become a provider company.
EP – How will the cash flow work after the 1st April 2015?
RH- CCG will pay the LOC Company then the LOC Company will transfer the money into the subcontractor’s accounts.
HB- It should be the same as it is now.
EP- I thought there was a cash flow issue when we discussed this before.
HB- The money might be in the LOC account earlier that we need it so we will have time to adjust any amounts before the end of the month when we pay out.

HB- Can anyone who is owed any money from LOC submit an invoice this week please.

TH- There are some Opticians who are not on the mailing list so we need to update the PEARS Optom list and online reporting.

MD- On the 23rd February I went to the first meeting of the LEHN -Local Eye-care Committee Meeting. I have to put together a list of all enhanced services in Yorkshire and we agreed to discuss potential eye problems. No one from CCG was there, and no one representing the trust. They are going to meet every 3 months from now on and Dawn Roberts is the chair.

RH- The next meeting is the AGM on 19th May at 7:30 PM at the Holiday Inn Express. The entire committee is up for re-election, I will carry on as chairman.

Meeting ended 8.45 PM

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