Threat to referral fees via 'choose and book'

The AOP has contacted LOCs in England warning them about the actions of some PCTs in the new 'choose and book' referral process.
Following a straw poll of local optical committee secretaries, the Association has discovered that some PCTs are trying to force LOCs into keeping cataract referrals within GOS by using the GOS18 form to refer patients to central booking agencies.
This potentially bypasses the possibility of a range of fees which might be paid to optometrists for work outside their GOS duties, as part of new arrangements, which was hinted at in Department of Health guidance on the matter produced at the end of last year. This guidance, which emerged in November, was produced for PCTs and the strategic health authorities (SHAs) which oversee them.
The AOP believes that making optometrists use GOS18 forms to refer cataract patients is 'not appropriate' and, in the February 1 letter from head of professional services Patricia O'Sullivan commented that patients referred in this way 'will not benefit from the advantages of the new cataract care pathway, where expert advice and counselling can be provided by optometrists in a primary care setting'.
The letter stated that 'optometrists who feel forced into this position by their PCT, will end up providing extra services to cataract patients for no additional fees'.
To avoid this 'exploitative situation', she wrote, the optometrist can continue to refer patients, on a GOS18, to their GP, until such a time they are paid for counselling work - though, she admitted this did not offer the patients advice and choice at the point of referral that the 'choose and book' scheme advocated.
The AOP has offered a draft letter to LOCs who find themselves 'in this unfortunate situation', with the aim of alerting their primary care trust lead of the problem, and failing that, a letter to the SHA that manages the PCTs.
david.challinor@rbi.co.uk