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The NHS reforms are being driven by a desire to deliver the right services to the right people at the right price, and optometrists are well placed to offer primary eye care services in the high street at a vastly reduced cost to some services in hospitals. Local optical committees will be at the forefront of negotiating and setting up these enhanced schemes and now is the time for optometrists to get involved.
Katrina Venerus, an associate for the Local Optometric Support Unit (LOCSU), stresses that the reforms will only apply to England and will be organised around a new NHS Commissioning Board (NHSCB) which will take over responsibility for GOS contracts from April 2013.
The Optical Confederation will continue to negotiate eye examination fees on a national level, but local services and enhanced schemes will be handled by new, local structures. Diabetes will still be managed under the national screening committee and come under the public health area.
The NHSCB will have local outposts likely to be based around the 50 or so primary care trust (PCT) clusters that were formed from the 153 PCTs for the transition period. 'As far as where an LOC and individual contractors can have influence, then we have to look at the other bodies,' says Venerus.
'Locally we are almost assured that enhanced services will be handled by the clinical commissioning groups (CCGs), which will be responsible for looking at local eye ca re services and the primary/secondary needs.'
All of the glaucoma, PEARS, ACES-type services (see panel opposite) will sit with the CCGs, while contracts management may be delegated back to local commissioning boards. Other organisations, called health and wellbeing boards, will have the job of looking at who they have in the local population and their needs, and part of that will be eye health, says Venerus.
'The LOC will have opportunities to build relationships, influence the people doing the needs assessment to say: "Hang on, is eye care even in there, and this bit is important and that bit is important".'
Local professional networks are also beginning to take shape, but it is not yet clear exactly how they will work. 'These should have representation from the local committees so for us that should be the LOC. In a way, the LOC has a greater opportunity to have official representation. That's why we have to make sure that energetic proactive people are involved in these things as they get off the ground.'
Venerus believes there is an opportunity to push enhanced services with the changes to the NHS. 'The opportunity is much greater than it's been before because the agenda is to have as much done in primary care as you possibly can and not in hospitals.
'Obviously opticians aren't the only group that can provide eye care services in the community, but they have got the premises, they have got the equipment and, as long as they are organised, are an easy bunch to deal with because they have already got the GOS contract.'
Not all optometrists get involved in the organisation of their LOC, but a big proportion take part in LOC schemes. However, it could and should be higher, says Venerus. In most areas there are upwards of 70 per cent of local practices involved in schemes such as IOP services. For enhanced services, take-up is generally lower but it needs to grow.
'The appetite for more community practices to get into primary eye care services is definitely there.' It might not be for all practices but the goal is pushing that forward. The result may not only be an expanded role for practitioners and greater job satisfaction but also enhanced patient care. ?
Useful resources
Local Optical Committee Support Unit (LOCSU) www.locsu.co.uk
info@locsu.co.uk or 0207 549 2051
LOCSU can put you in touch with the relevant committee in your area.