Specsavers’ commitment to enhanced optical services is now well-established but independent providers of such schemes will be keen to hold their ground at a local level.
Last week it was confirmed the multiple had secured the contract to provide a MECs scheme for Surrey Downs CCG.
The idea of a private company winning community services caused a stir on optical forums, it being a departure from the well-trodden LOC pathway.
Indeed, four years on from the decision to award Specsavers with the DVLA testing contract, practitioners would be forgiven for speculating enhanced services might go the same way.
But they would not, a Specsavers spokesperson told Optician following the developments in Surrey.
‘We are a major funder of the work of LOCSU and we are committed to working with LOCSU nationally and with LOCs locally to develop and participate in optometry-led community services contracts,’ she said.
In addition, the DVLA contract was tendered nationally rather than the regional commissioning of healthcare services. Nevertheless, this was evidence that in areas where LOCs have not prepared a bid, Specsavers has the scale to step in and swoop for its own arrangements.
In the case of Surrey Downs, Specsavers only acted after finding out Surrey LOC would not be bidding for the contract in the absence of an active primary eyecare company in the area.
‘In the interest of our patients, we decided that we would therefore go ahead and submit our own tender for the contract,’ it said.
According to Specsavers, it was only after this that Surrey LOC tabled its own bid.
‘As this was an AQP rather than a sole-provider tender we decided to proceed with our own tender on the basis that if the LOC were also successful, we could cooperate in providing the service,’ Specsavers said.
Eventually, the MECs contract was awarded to Specsavers via a formal Any Qualified Provider procurement process, with the LOC bid turned down.
Two years has now passed since Specsavers co-founder Doug Perkins stood on the podium at Optrafair and announced that offering enhanced optical services represented the future for both Specsavers and the wider profession.
Since then it has worked closely with LOCSU to secure and provide community services alongside other multiples and independents, and there have been positive signs that high street optics can step up to relieve the pressure on hospital eye departments.
According to latest official LOCSU figures, 60% of CCGs have or intend to commission a MECs service. Looking forward, with what was described to Optician as a ‘helicopter view of the commissioning landscape’, LOCSU also wants to better align with the geography of a proposed 44 sustainable transformation partnerships (STPs), and was encouraging LOCs to merge operations where possible.
There was also hard evidence of extra clinical services being provided at scale.
For example, 48 LOCs now have a MECs pathway in place – representing 62% of the overall 78 LOCs. This represented total income of £6.1m, based on 102,245 MECs consultations, meaning that each appointment was worth an average of around £60 to the practice providing it.
Furthermore, increased interest in MECs has seen the College of Optometrists up its number of practical assessments, resulting in 1,526 being completed between August 2016 and July 2017.
The formation of primary eyecare companies, now in 71% of LOCs, has also helped to bolster figures across all types types of enhanced optical services.
As of last year, cataract schemes were in place across 128 CCGs, representing an 8% increase. Glaucoma referral refinement schemes were commissioned by 164 groups, climbing 15%, while MECs has been rolled out by 106 CCGs, representing a 68% increase.
Therefore, the results have been encouraging, and for just this reason the independent sector will be keen to avoid too many repeats of Surrey Downs.
Time and again, Specsavers has underlined its commitment to working together with other retailers to advance clinical services though, most recently at last week’s 100% Optical trade show in London.
Perkins again told delegates that technological, demographic and political shifts meant the profession had to cement its position in primary care.
He said: ‘If we ignore these it is at our peril. In particular, the combination of automatic refraction and internet dispensing will take huge amounts of business from the high street. And our enhanced optical services role is under threat from the large corporate providers.
‘We need to become the GP of the eyes – the only way we can retain customers is that when people think of eyes they automatically think of the optometrist and that is where they head to.
‘The message is that there must be collaboration in this industry between all the different segments to succeed. There must be leadership so that we can drive a model right to the heart of Government and demonstrate the value of optometry to the community.
‘Or it will be like a boiled frog, with the temperature racking up, you won’t realise it until it’s too late – it could threaten the very basis of our core NHS status. No doubt there are some aspects of the business such as fashion that will survive as shopkeepers but the profession that we all value so much, that will be gone.
‘There is no point in us all competing at referral level. With our model, every deal that is on tariff, the referring optometrist will get the full split. I don’t care who gets the MECs fee. That’s not why I’m standing here. I’m standing here for the sustainability of the profession.’
Therefore, Specsavers itself sees a threat to enhanced services such as MECs, from corporations outside traditional optics, perhaps explaining why it felt so compelled to tender alone in Surrey Downs.
Nevertheless, the development showed how the piecemeal nature of eye care commissioning not only affects patients but can challenge the relationship between the contractors they are treated by.