Unconfirmed Minutes of the VISION 2020 UK Ophthalmic Public Health Committee Meeting
Held on Monday 9 February 2015 at The Royal College of Ophthalmologists
Attendees / Committee membersParul Desai (PD) - Chairman/RCOphth
Matt Broom (MB) - VISION 2020 (UK) Ltd
John Buchan (JB) - RCOphth
Olivier Deneve (OD) - CoO
Mark Godfrey (MG) – ADASS
David Hewlett (DH) - Optical Confederation
Mercy Jeyasingham (MJ) - VISION 2020 (UK) Ltd
Richard Knight (RK) –LOCSU Deputy
Yvonne Needham (YN) – RCN
David Parkins (DP) – CoO
Geoff Roberson (GR) – Deputising for David Hewlett Optical Confederation
Jennifer Yip (JY) - FPH
Richard Wormald (RW) – RCOphth
Author / Beth Barnes (RCOphth Professional Standards Department)
Apologies / Committee members
Lesley-Anne Baxter (L-AB) - BIOS
Catey Bunce (CB) – CVIC
Helen Lee (HL) - RNIB
Darren Shickle (DS) – FPH
Aeesha Malik (AM) - Co-opted member
Jugnoo Rahi (JR) - RCOphth
Waqaar Shah (WS) – RCGP
Mark Godfrey (MG) – ADASS
Agenda Item / Discussion
1. Welcome / PD welcomed the Committee to the meeting. She welcomed OD and JB to their first meeting of the OPHG.
2. Declarations of interest
No new conflicts of interest were declared by the members present.
3. Notification of Any Other Business
No additional items of business were identified.
Discussion / Action
4. Minutes of the meeting on 19 November 2014 / The minutes were approved subject to a change under items:
5.1 To state that Moorfields Directors of Research and Finance were considering the eCVI project following the rescoping of the project; not the future of CVI office funding. / 1. MB to correct November 2014 Minutes
5. Matters arising from the minutes
Discussion / Action
5.1 Immediate Risk to CVI data / Funding has been secure via Moorfields Eye Hospital for a further year from 1 April 2015 to 31 March 2016 to run the Certificate of Vision Impairment Office. MJ is chairing a task and finish group to resolve the longer term funding and expects to have a proposal to submit to the new government in June 2015 following the General Election. The task and finish group will be chaired by Mr David Croisdale-Appleby
5.2 Electronic CVI / MJ is writing to the Chairman of the National Information Board, Tim Kelsey, to ensure he is aware of the lack of electronic data collection for the CVI and the related Public Health Indicator. She is liaising with the RNIB and Moorfields Eye Hospital regarding the content of the letter. The letter will link to the Five Year Forward View and refer to the eCVI pilot and how the eCVI can be rolled out nationally. There are a number of challenges related to roll out of the eCVI e.g. links with social services which will need to be addresses in follow up conversations. / 2. MJ to circulate letter to OPHG
5.3 Outstanding actions from November 2014 /
- DP and MB to liaise and circulate a copy of DP’s publication to the OPHC.
- MB to circulate the relevant summary of responses to the James Lind Alliance consultation.
- RNIB map of local authorities with Joint Strategic Needs Assessment
4. MB to circulate the relevant summary of responses to the James Lind Alliance consultation.
5. MB to ask HL for RNIB map of local authorities with JSNAs
6. Feedback from the Chair
Discussion / Actions
6.1 Action plan following the NHS England’s Improving eye health and reducing sight loss – A ‘Call to Action’ consultation / PD reported that NHS England had not yet published its action plan following the consultant in 2014. / DP to inform group when response is released.
7. Feedback from Members / RK reported that LOCSU is working to improve the Ocular Public Health Network. A guide on how to login to the Network is being drafted. Members were encouraged to post on the Network or to send LOCSU information to post on their behalf. There will be greater publicity of the Network at various meetings such as the IAPB general assembly and the VISION 2020 UK conference in June 2015.
8. Portfolio of Indicators / The amended portfolio of indicators had been circulated with the agenda papers. The indicators have been out to stakeholder (VISION 2020 UK UK wide leads, committee chairs and member organisations, Moorfields Eye Hospital). , consultation and the responses had been circulated with the papers. The feedback is generally supportive and there are a few suggestions for expansion of the indicators. PD reminded the Group that the premise is for the burden of data collection of the indicators to be reasonable. The indicators will need to be appropriately communicated to different audiences. The version agreed at this meeting will be put to the Clinical Council for Eye Health Commissioning (CCHEC) on 19 February 2015. If the indicators are accepted the Group will ask the CCEHC to write formally to each health service lead across the UK to endorse the indicators and recommend they be included in 2015 work plans.
PD reminded the Committee that The purpose for developing this collection of indicators is:
- To review and monitor population eye health and well being
- Embed eye health perspective in use and interpretation of mainstream Outcome Frameworks
- Monitor/demonstrate UKVS outcomes
There will need to be good liaison with Local Eye Health Networks as implementers of many of the indicators and the Group plans to engage via the Local Professional Network meeting on 29 April 2015. DP also plans to pilot the indicators in London. The Group should also plan to liaise with Clinical Commissioning Groups in the summer to influence commissioning decisions for 2016. The Group will also consider asking for NICE endorsement in the future.
Additional information needs be added for all the indicators to show how the data is collected etc. The indicators will also need to be reviewed annually to reflect changing practice.
8.1 Eye Specific Indicators: Primary Care / 1. % of school entry children (4-5yrs) screened. This indicator was agreed. BIOS is going to collect this information anyway. The indicator will be tested with BIOS in 2015.
2. % children and young people aged 12-18 years diagnosed as Diabetic that are screened. The national diabetic screening service does collect this data by does not report on it. Liaison with software manufacturers will be required to ensure the data can be easily entered. This indicator was agreed.
3. Uptake of sight tests in people >60 yrs and 0-15 years. Again this is data that is already collected nationally and is mappable to Health and Wellbeing Boards. The GOS payments system is going to be an electronic system in future. This indicator was agreed.
4i. Number (and %) of CCGs procuring a repeat (IOP) measurement service - by defined locality (Region, England or other local health economy). This indicator was agreed.
4ii. Number (and %) of CCGs procuring a referral refinement service (IOP, discs and Fields) - by defined locality (Region, England or other local health economy). This indicator was agreed.
4iii.Number (and %) of participating practices in each of these services (repeat measurement and / or referral refinement) - by CCG. This indicator was agreed.
All of the indicators in group 4 are being collected by LOCSU. It was noted that the Hospital Eye Service can also provide these services and should be included in future data collection if possible. / 6. Liz Tomkins to ask BIOS how the data can be accessed by non-BIOS members.
7. MB to request information from BIOS on the variation of coverage across the UK.
8. DP to liaise with the diabetic screening service research committee to ensure that the data is included. This will be followed up by a letter from PD to the screening service at the end of April 2015.
9. RK and GR to liaise with NHS England to ensure that the data collection for indicator 3 is included in the procurement of the electronic GOS payments system.
10. RK to ask LOCSU to look at the data for indicator 4from 2013 onwards and see what schemes are covered in which areas and whether there are practices offering these services.
11. PD to add columns for data source in each of the four countries so they can be asked how they would populate them.
8.2 Eye Specific Indicators: Hospital Eye Service / 5. % Hospital appointments that occur within 25% of their intended follow up period, including rescheduling of hospital initiated cancellations. PD stated that this indicator had been supported by the RCOphth and Moorfields Eye Hospital. Other stakeholders had questions the 25% target. The Group agreed this should remain as it is intended to identify patients being lost to follow-up and different follow up times are required by different groups of patients. This indicator was agreed. There does need to be further explanation of the clinic types the indicator applies to.
6. Audit of certification of visual impairment (CVI) where the primary cause of vision impairment is due to AMD, Glaucoma and DED. This indicator was agreed.
7. Clinical Outcomes: VA outcomes of Anti-VEGF treated following initial “loading course of 3-4 injections” and at one year after starting treatment for wet AMD ; but also consider for DMO; CRVO and BRVO. This indicator was agreed.
8. % of R3AM0 and R3 AM1 Diabetic Eye Disease seen within 2 weeks. Again this indicator was agreed. The Group acknowledged that it may be difficult for some units to audit but that it should be encouraged. / 12. PD to amend indicator 5.
8.3 Eye Specific Indicators: Interface/ Community / 9. ECLO Service. Every Commissioning Organisation (e.g CCGs in England) to have commissioned an ECLO Service to be provided within the Hospital Eye Service, community or both. This indicator was agreed. There should be additional background information in the descriptor to include information on standards for ECLOs using the existing RNIB standards as the example. RNIB collects this information anyway and will ensure it is available in the public domain.
10. Low Vision Service (LVS). Every Commissioning Organisation (e.g. CCGs in England) has commissioned a Low Vision Service to be provided either within a Hospital Eye Service, community or both. This indicator was agreed. LOCSU will try and collect the data although it is assumed that there may not be much to collect as not many services are being commissioned. The RNIB also collects this data. / 13. PD to amend indicator 9.
8.4 Indicators for development / These will be discussed at the next meeting. / 14. MB to add to agenda for next meeting.
8.5 Broad population indicators / The Public Health Outcome Indicators for Domains 1 and 2 are already collected by Public Health England, background information on how this impacts in eye health should be added. PD stated that Public Health England is aware of the Groups indicator work and she will also liaise with the Faculty of Public Health. These indicators were agreed.
The NHS Outcomes Framework indicators were agreed.
The Adult Social Care Outcomes Framework indicators also acknowledged as difficult to collect. It was agreed that these should be further developed but for now only general information will be suggested for inclusion. / 15. JY and PD to update this indicator and liaise with the Faculty of Public Health.
9. Objectives for 2015 / The NHS Five Year Forward View and the Call to Action response from the Group had been circulated as background for this discussion. The Group agreed the following actions for 2015:
- Send the agreed portfolio of indicators to David Geddes at NHS England to encourage these to be included in the NHS England Action Plan arising from the Call to Action.
- Send the agreed portfolio of indicators to all four UK countries
- Continue to raise the profile of eye health in the UK; provide a briefing on eye health for ministers following the general election in May 2015 that can be used by all VISION 2020 UK member organisations.
- Liaise with other VISION 2020 UK groups to ensure consistent messages are present in literature and at meetings.
- Liaise with the eye research group
- Work with SIGN to ensure the agenda for sight loss is also raised in Scotland
- Work to inform and influence NICE quality standard development and push for sight loss to be recognised in other pathways e.g. dementia. VISION 2020 UK to monitor NICE website for upcoming opportunities to include issues relating to sight loss
- Ensure the Group is acting on a UK wide basis, consider the membership of the Group.
- Via the RNIB; collect JSNAs and evaluate achievements.
- Ensure that patient safety and quality of services are embedded in the work of the Group.
- Invite a lay representative onto the Group
- Continue to work on the portfolio of indicators and consider how to report on usage.
17. MJ to speak to the RNIB about review work on JSNAs.
18. MJ to consider lay representation.
10. Date and Time of next meeting:
Mon 11th May 2015:12 – 3pm RCOphth
Wed 9th Sept2015:12 – 3pmRCOphth
Tues 8th December : 12 – 3pm RCOphth
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