Since my last column, two items have caught my attention. The first, which appeared towards the end of August, was, in many ways, a welcome sight as I noted the intention of the Optometric Fees Negotiating Committee (OFNC) to survey optometrists in order to better inform the committee in its next round of so-called negotiations with the Department of Health and Social Care (DHSC). This is, at first sight, a welcome development. However, reading on, I note that the purpose of the survey is ‘to help the committee accurately demonstrate the time needed to complete an NHS sight test.’ While this may seem laudable, I have serious concerns as to whether this will prove useful or not. I would be very interested to learn whether the NHS sight test referred to is the one we have all morphed to over the years, where we have relentlessly added more and more content that the DHSC has seen fit not to recognise, and therefore not pay for or whether it refers to the eye test as laid down in statute and has changed very little from its beginnings in the 1950s.
My fear, when looking at the survey questions, is that it refers to the former. With questions like: ‘On average how long does pre-test activity take?’ This includes fields pressures and imaging. I fear the OFNC is expecting the DHSC to roll over and accept a new definition of the NHS sight test. I don’t have much confidence that will ever happen. Probably a better set of questions, bearing in mind the current NHS dentistry debacle, would include: ‘Have you recently ceased to provide NHS services because the current contract is unworkable?’ and then: ‘Are you actively considering ending your NHS contract because the current contract is unworkable?’ I suspect these questions would provide far more useful ammunition.
I now turn to the story that appeared in The Times on Friday, August 26, under the headline ‘Free checks will prevent thousands of heart deaths’. The article reported that a new NHS scheme was to be launched offering free blood pressure checks at high street pharmacies. It went on to say: ‘NHS England is encouraging everyone over 40 to go to their local pharmacy for a check-up in a drive to slash rates of heart attacks and strokes.’ The scheme started nine months ago and so far 275,000 people have had checks with the pharmacist being paid up to £45 per check.
My question is a simple one. Why on earth are optometrists not included in this scheme? This is not a new idea. The over-40s health check was introduced quite a few years ago, but did not really achieve what it set out to do. Why not? Quite simply, and unsurprisingly, people who are healthy do not make time in their busy lives to get check-ups. But every day optometrists see thousands of well people over 40 who are staring to experience reading difficulties. Therefore, it is not difficult to see that the profession best positioned to reach this population is not pharmacy, but optometry. So, why are we not included in this scheme when it would appear to be the proverbial no-brainer?
Where have our negotiators been? What have they been doing and what are they waiting for? The fact that the fee for doing this work is twice the fee we get paid for a full NHS sight test should not influence our thinking, but it is certainly something that warrants consideration. The simple fact is we are perfectly able to carry out these tests and many optometrists already do this as part of their routine patient care. I simply cannot understand why our professional representatives to whom we pay an awful lot of money to each year to represent us have not made a strong enough argument for using optometry to do this work. After all, it is these same people who tell us they are making great strides with the DHSC in having the importance of the role of optometrists recognised. Given that we have been totally overlooked for this work, I wonder what these people are doing.
I would suggest that all LOCs make the strongest representations on our behalf to both Locsu and their local commissioning teams to have us recognised as the most suitable profession to reach the maximum number of over-40s to ensure this latest initiative is not to fail alongside the over-40s health check. Maybe our professional bodies would also like to explain why pharmacy always seems to be the first port of call for the DHSC when we are also suitable on so many occasions, if not better placed, to deliver this new service.
I wish the OFNC well in its deliberations and urge every one of you to participate in their survey. It is in all our interests. I would also urge the organisation to ask the two questions I have asked here, but in the absence of those questions please let the OFNC know your responses to them anyway.