On October 23 my local colleagues and I received a letter from our clinical commissioning group (CCG) telling us that, with effect from November 1, we could no longer refer our cataract patients for surgery without the approval of the CCG and the issuing of a ‘unique reference number’ for the surgery. Without this number, surgery could not proceed and if it did, it would not be paid for. We were told we had to download a two-page form from the internet, complete it, and then email it via a secure NHS mail link to the CCG for approval, before waiting for consent to proceed.
There was no discussion with the LOC on this matter and no agreement with local optometrists. The edict was imposed. I, and others, immediately contacted the CCG to see who was funding this additional workload and was told it was the responsibility of the optometrist.
When it was pointed out that no one had a secure NHS mail account and, therefore, could not email the required document, this seemed to cause confusion. It was also pointed out that the website we were asked to use did not exist! This resulted in a further letter telling us to post the required documentation. Once again with no funding.
Given that the CCG concerned is one of the worst financially performing CCGs in the country and is in special measures, it is not surprising it is looking to cut expenditure.
I am in total agreement with appropriate use of public money.
However, the sort of tactic used by the CCG is unacceptable. It is utterly unreasonable to expect clinicians to do additional work that creates a financial loss and expect those clinicians to foot the bill. The sad fact is, once again, that optometry is seen as a soft touch and it is expected that we will roll over and give in, however unreasonable the demand is.
In our case, I am glad to say that after several conversations, some with local optometrists and some with the LOC, it has been determined that until the CCG comes to us with a reasonable set of proposals all referrals will cease to go through the current fast-track route, but will be sent to the patient’s GP to obtain the unique reference number.
This will increase the length of the wait for the patient and the workload for the GPs. That is not our fault and sends a very clear message to the CCG that optometry is there to serve the public but not to be kicked around at the will of CCGs. There is no way the CCG would have adopted this bullyboy approach with the local GPs and we will not stand for it either.
I hope to be able to report a happy conclusion in a future column.