2016/17Committee Report
Introduction
When I took on the chair of Hants LOC this year it was my mission to represent all of the performers and contractors in Hants and it was to a background of continuing change in the optical profession.
So what a year-first of all we didn’t get paid! Not only did the migration of the PCSE to Capita mean that practices didn’t get paid –it meant the LOC didn’t get any funds either which caused Bill some issues!
While the payments issue is slowly being resolved the backlog of performers wishing to join the performers list is still causing issues for practices especially where there are newly qualified optometrists and this has affected several practices in Hants considerably.
This has led to the LOC support Unit loaning one of their staff to Capita to try to clear the situation but the waiting list still remains at about six months at present.
The Foresight research program looking into the impact of technology on the UK optical sector up to 2030 and the Workforce strategy report from the College of Optometrists should make us stop to think and plan strategically for the future.
The results of the workforce report showed that people are not keen on staying in the profession –a profession which by 2030 will be dealing with 22%of people >65(Optical Professions Futures).
This means that the no’s of optometrists /head of population especially in Hants is lower than we would need for the expected population growth.This was one of the driving forces behind the launch of the new Optometry course at Portsmouth, which aims to recruit and retain people to work in the Hants area and which took its first cohort of students this year.
Technology drives change as we know so the finding that a younger audience would rather trust the results of an app than a professional in dealing with their own health should not be a surprise.
Against this, evidence shows that if a patient trusts the professional they are dealing with they are likely to have better outcomes.These have in turn made the GOC launch an education review to make sure that the education that the profession has both as undergraduates and as qualified professionals equips them for this new world.
So how does this impact us in Hants?To meet the changes of the new world we embarked on a program of training allocating a portion of our cash reserves into accrediting optometrists to provide primary care extended services on behalf of the CCG’s.
MECS Training
At last year’s AGM it was agreed to use some of the LOC’s contingency funds for the year 2016-2017 to cover the cost of accrediting approximately 150 optometrists on the Hampshire Performers list to perform MECS services. To date 130 training codes have been issued and it is estimated that there are 69 performers across Hampshire & Isle of Wight that still need to complete Part 2 of the accreditation process. Our Business Manager Ian Silk has made numerous requests to be kept informed when training has been completed but sadly not everyone is providing the necessary information. If you receive an email from Ian in the coming weeks asking for confirmation of your training status please do respond not only out of politeness but also because it enable the committee to identify how many more OSCE events to provide. We have provisionally booked another training event for June 2017 to hopefully complete this programme.
Historically the stumbling block when dealing with CCG’s has always been that they did not have the budgets available to provide the accreditation required for extended services and were thus unwilling to commission them.When provided with an accredited and motivated workforce this makes negotiation a lot easier and therefore Southampton City CCG have commissioned a MECS service which those of you working in the area know launched in April 2017.
A major reorganisation of ophthalmology services is taking place in Southampton City and the area of West Hants that Is served by Southampton Eye Unit as there are capacity problems within the hospital so an expansion pf planned care in Solent Medical Services which is now based at Southampton General and the introduction of the MECS will hopefully go some way to alleviating this problem.There are also plans in place for an eye casualty phone triage service so patients can be seen in the correct service by the correct specialist rather than just turning up at the emergency Eye Unit-more of a booked appointment service.
As with building any new relationship we can then take the hopeful success of the scheme back to the CCG to then talk about further developments especially in what is known as step down care where optometry is able to provide ongoing monitoring of conditions especially OHT and stable glaucoma.
Primary Eyecare Hampshire Ltd
In December 2016 it was decided at Committee to make the Hampshire LOC Primary Eyecare Company dormant and merge resources with Primary Eyecare (Sussex) Ltd along with other LOCs in the South to create a larger company which reduces overall running costs.
The reasons behind this decision were:
Hampshire LOC does not have the necessary expertise or manpower to go it alone and joint management and experience will make for a stronger company.
Hampshire LOC lacked sufficient skills in respect of clinical governance and performance management which are essential for the implementation and governance of extended services.. Sussex currently have this experience. There is an identified need to get LOC members trained in clinical governance, performance and finance.
The new head of LOCSU is an ex commissioner from NHS England and when discussing with a member of the committee confirmed that to be operable and effective the PEC will need a population base of approx. 1.5 million and boundaries need to be reduced. Sussex has a population footprint of approximately 2.5 million and Hampshire has 1.0 million which makes a joint venture much more operable.
The newly enlarged Primary Eyecare Company also deals with payments, queries and invoicing in one structure so that all practices have a local point of contact through which they can channel their queries.As in most new organisations there will be some teething troubles but these structures operate successfully countrywide so we have experience on which to draw.
Communications with GP Commissioners the CCG”s
Low Vision Services and Glaucoma IOP and referral services have been re-commissioned directly with contractors in Portsmouth, Fareham & Gosport and South East Hampshire for 2016/17 without consultation with the LOC. LOC Committee members together with the regional LOCSU representative have had a meeting with the SE Hants CCG to discuss the breakdown in communication.
North Hampshire MECS
The North Hants MECS scheme is now in itsfourthyear –with very positive feedback from the CCG.We have had one re-accreditation eventsfor the North Hants practitioners as the scheme hasnow have been in operation for three years. We are also awaiting confirmation of accessibility to WOPEC re-accreditation modules.
Like any established scheme we face the difficulties of practitioners moving on and therefore lack of workforce at times to run the service but overall it continues to provide “the best triage service we have” according to local ophthalmology
We have to recognize that the face of practice is changing and if we need to flourish as a profession we need to provide the skills for the profession in the future.
This year alone in Hants
129 performers have signed up to complete the WOPEC glaucoma module
77 have signed up to complete the cataract module
4 have signed up for the Low Vision module
2 have registered for the Learning Disabilities module.
CET Events
During 2016/17the following CET events were held and proved to be very successful.
Academic Peer Review / For North Hants MECS Practices with Mr John Greenwood MB.BS FRCOphthOphthalmology Study Evening - Winchester / Mr Luke Clifford BM FRCOphth
Consultant Ophthalmologist
Hampshire Hospitals NHS Foundation Trust
‘OCT in Practice’ / MrDebendraSahu - BSc, MBBS, FRCS Ed (Ophth), Miss NishaniAmerasinghe, BSc (Hons), MB BS, MRCOphth, FRCOphth and Topcon
EMCS OSCE events x 4 / In association with WOPEC
‘Magnification in Practice’ – LVAs / Cilla Hubbard - Associated Optical
Glaucoma –Shared and Future Care
Winchester / In association with Allergan
Alex Mc Leod
If you feel you have the skills to further the development of Optometry in Hants then please come along and join the LOC –we are always happy to support and encourage new members
Looking forward to another busy year
Roisin Carruthers
Chair
Hampshire LOC