Heart of West Midlands Regional OpticalCommittee18-01-2018

Present

Peter Bainbridge (PB)Sandwell/Chair

Charles Barlow (CB)Dudley/Solihull

Prab Boparai (PKB)Wolverhampton

Jill Cheney (JC)Wolverhampton

Debbie Graham (DG)Optometric Advisor

Ian Hadfield (IH)Birmingham

Peter Hampson (PH)Sandwell

Aisha Jeewa (AJ)Walsall

Simone Mason (SM)Solihull

Spencer Parkes (SP)Solihull

Richard Rawlinson (RR)LOCSU

Peter Rockett (PR)Wolverhampton

Dan Sanders (DPS)Solihull

Louise Sarjeant (LS)Sandwell/Minutes

Paul Sidhu (PS)Dudley

Dave Stevens (DKS)Walsall

Divya Sudera (DS)Clinical Governance & Performance Lead

Sonia Tyrell (ST) Clinical Governance & Performance Lead

Apologies

Claire Roberts (CR),Vince Roberts (VR)

Minutes of previous meeting

Proposed as correct by AJ, seconded by PKB

Matters arising - nil

Birmingham Audit

IH looked at electronic records of a practice in Tipton, over 1000 showed early issue of GOS 4, early GOS 1 and GOS 3s with no rx change. Audited actual records over three days, all evidenced bar 12. NHS due to review. Didn’t actually look at codes on GOS forms until the audit and didn’t differentiate between children and adults, eg for 12 month recalls. DG external auditing agency not taking into account the demographics of the area.

LEHN update (CR via email)

(CR) We were pleased to win the NOC Poster competition for our work on sight loss and dementia in November and are looking at some further work in Dudley with the CCG and LOC to look at local dementia pathways. Upcoming events include some training on sight loss and Learning Disability in Coventry. The LEHN is putting on an evening educational event for Optometrists and a ‘Look Here’ day event for people with LD and their carers/families to learn more about having a sight test and the importance of good eye health. These will be delivered by SeeAbility in March. Details will be shared when confirmed. LEHN/WMQRS workshop on eye care patient pathway standards in November was well-attended and gave rise to lively table discussion on how the standards were being used in different settings.

Work continues through the LEHN sub-group on an Eye Health Needs Assessment for Birmingham and Solihiull.The LEHN core group went ahead on Tuesday where EHNA progress was discussed, along with a draft assurance framework for eye health, at the request of the Clinical Council for Eye Health Commissioning (CCEHC), and a piece of work being undertaken in Wales on an outcomes framework to mitigate risk of harm for patients waiting for ophthalmic appointments. CCEHC is calling for the implementation of Eye Health Improvement Quality Improvement Boards (EQIB) (or similar) to be set up at STP level. I am recommending that we explore the potential for doing this across the West Midlands, as our main aim for next year.

SM mapping and gapping services for people with sight loss. CB are you looking at previous EHNA? SM yes. The England vision strategy manager will make sure it’s used, it will be a live document. RR it’s very evidence based and will help health and social care come together in future. Useful for business plans and lobbying. CB the Walsall one was instrumental in services being commissioned.

PH are the LOC being involved? RR not really, as it’s visually impaired patients. CB should be run past LOCs, check they’re not doing something relevant. DG feedback to LEHN, that stakeholders need to be consulted. Also, important to meet needs of patients before they become sight/severelysight impaired. PB may need to look at prevention.

FP10

CBSolihull LOC were asked if prescription pads were available? DS depends on CCG, have to apply on a case by case basis. PH very few issued, no budget for it.DG could LOCSU help? RR its an OC/DoH issue. PH no evidence base and in Scotland it’s mainly lubricants. DoH wants GPs to stop prescribing lubricants. DG need to look at it for glaucoma monitoring. PH Manchester are training lots of IP, see what Darmesh is doing.

CB currently unaware of IPs with FP10s in BBC. Should we have someone to support IPs in future? PB lets see what Manchester do.

Regional Company

CB DKS is stepping down as director and we’d like to welcome AJ as director.

MECS activity has seen an upward trend. We’re looking at repaying the loans. There are issues with the formulary that are going to be fixed. Dudley is due to have MECS commissioned and more OSCEs are due, but not yet organised.

Glaucoma Clinic Audit

PR have good contacts at HES, so able to do audit. Hope to influence glaucoma referrals going forwards by looking at quality of optom referrals and outcome.

BMEC

LS a staff member’s relative was sent to BMEC with sudden onset floaters, and apparently they refused to see him based on his postcode, advising him that the QE was his local hospital. DG that shouldn’t be the case, email me so I can raise a query. Raised the issue of changing fax numbers (not recently), but not heard anything from the CEO.

AOB

AJ CCG want ophthalmic formulary revisited. Helpful if fomulary is universal. PR Wolverhampton have expanded their formulary. DG please could it be shared.

PH there is an NHS consultation on self-care in March. It may need to be reviewed after as they may stop supplying lubricants.

SP concern Optomanager using faxes – CB, being dealt with, changing over to NHS email. DPS struggling to get email addresses for GPs. CB responsibility of CCG and Acute Trust to supply email addresses.

SP if patients are under the care of an ophthalmologist and have cataracts, we can’t refer via Optomanager. Do a direct referral or give the patient a letter to take to next appointment.

SP Pre-regoptoms not getting competencies, as patients being seen by MECS optoms. PB invite pre-regs into room to co-examine. Pre-reg can examine patient, but has to be under direct supervision, so supervisor also has to examine.

DPS have had patients seen at the hospital for one condition, and been told to go back to optom for referral as they might have glaucoma. PH increases revenue, DG verbal comment, so non-attributable.

SM SDIP for CCG, collating emails, awaiting response from PH.

PKB invitation from All Party Parliamentary Group, about reducing burden on NHS, told them about MECS. Due out in Feb.

PKB GOS4 audit on learning disabilities. PH there may be a pre-approved list coming. ST had a lady with broken specs due to being beaten. PH has to be health related.

PB proposed mergers of ROCs, should be amalgamating to form bigger companies. PS why? RR more relevant to areas with no services, to help support. So East Mids and Notts. PS so benefits others, not us? PB for LOCs to decide. CB there may be economies of scale with Webstar. DPS would a bigger company be more protected from downward pressure? DG it may actually cost more, would need a secretary. RR need to create a business case.

Date of Next Meeting

6.30pm for 7pm start - Thursday19th April 2018to be hosted by Solihull

Future meetings

19th July 2018 (Walsall)

25th October 2018 (Wolverhampton)