Moneo writes

Shaky foundations

I listened with interest the other week to the announcement by the Department of Health that it would now extend choice for patients to include all Foundation Trust Hospitals.

At first this may not seem to have a lot to do with optometry but in fact it could impact radically on our profession. It was not very long before a patient I saw asked if they could go to Moorfields for their surgery when their cataract was ‘ready to do’. Because we have a direct referral system working in our area I was forced to say that of course she could.

However I have no idea what Moorfields requires of optometrists referring patients to them for cataract surgery. I do know that several hospitals locally all require different levels of work up from the optometrist, and also pay differing amounts for this work. Does that payment form part of the tariff paid to the hospital? Or will my PCT be expected to pay for the higher tariff if I refer people to Foundation Trust Hospitals who will pay me more? If it is the latter I cannot see it ever happening.

Once again the Bright Ideas Squad in the Department of Health have steamrollered through a change in policy that leaves clinicians at the front end completely bamboozled. When oh when will this department realise that it is not only GPs who refer patients for surgery? How many times ust they be told before they understand this basic point?

Given the total lack of information or advice from the government I am considering referring patients who want to go to foundation trust hospitals for their cataract surgery to their MP and let him sort out the debacle that now exists. Without IT connectivity we cannot possibly hope to know anything about these foundation trusts, let alone refer to them.

It has been said people will not want to travel far for their surgery, but this is not the case with cataract. Cataract operations are not disabling any more and many elderly who live alone may well choose to have an operation as simple as a cataract operation performed at a hospital close to relatives where they can recover easily with family around them. I accept that prior to this current mess the government contrived the ludicrous mess that is Connecting for Health. It is clear that the chronic failure of that project currently means that the chances of optometry getting any meaningful linkage to the NHS system are practically non-existent.

Where does that leave us and more importantly where does it leave the patient attempting to express choice? Practitioners on the high street need to have answers now. If we cannot operate these new requirements effectively we should make this known. It is neither fair to us nor the patient.

It may be that we shall have to pass this workload back to GPs. I doubt they will be happy to have their workload increased but at least they have access to the vital information the patient needs. Until we also have that information we cannot serve our patients effectively.