Health minister Rosie Winterton gives an update on the care pathways of cataract, glaucoma, age-related macular degeneration and low vision that are now moving into testing
The development of responsive eye care is a serious issue. That is why we have provided £77m to develop innovative, practical proposals to modernise NHS eye care services.
Our focus is on creating integrated, patient-centred services, aimed at improving access, choice, waiting times and quality for all sectors of the community. In order to achieve this we established the Eye Care Services Steering Group in December 2002. The Steering Group included stakeholders from across eye care - the health professions, the voluntary sector, the NHS and those representing the patients themselves. The Group also aimed to deliver proposals consistent with, and to support, the Vision2020 programme, the global initiative to eliminate avoidable blindness by the year 2020.
Initially the Steering Group focused on developing model care pathways for the four main eye diseases; cataract, glaucoma, age-related macular degeneration and low vision.
The Steering Group concluded that with an already highly skilled workforce in primary care, further training and proper regulation can further develop primary care professionals and offer greater scope in providing extra resources for patient care; more convenient care for patients nearer to home; reduced pressure on secondary care; and improve patient choice.
However, while increasing services provided in primary care is likely to provide many benefits, not all care can be provided there. The specialised skills available in hospitals are essential and at different times, people will need different types of care in different places. We therefore need a joined-up system that will allow them to be in the right place at the right time for the right treatment.
Crucial then, is the need for partnership between primary and secondary care, social services, patients and carers.
To achieve this, Integrated Eye Care Services were developed. Model care pathways are designed to help the NHS develop integrated eye care services - making better use of the skills in primary care, with an increased amount of care for all in accessible primary care settings.
To move these changes forward £73m was made available to reduce cataract waiting times to three months so the new pathway for cataract care can be implemented once this target is achieved.
We also provided £4m to fund eight pilots to test the implementation of the new care pathways for glaucoma, low vision and age-related macular degeneration.
Local involvement
These pilot sites are now completing their preparatory work and moving into testing and development. This includes engaging all partners across the health, social care and voluntary sectors; working with local patients and patient groups to ensure their involvement with, and endorsement of, all aspects of the proposed schemes; designing protocols and training programmes; and identifying, selecting and training optometrists involved in providing new clinics within communities (with patients being seen from mid December).
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| Rosie Winterton: pathways are the best use of local skills, bringing patient care closer |
In May last year we issued the Steering Group's report as commissioning and planning guidance to PCTs and the pathways to provide a resource to draw upon to develop plans to modernise services.
While much progress can be made in delivering modernised eye care services without changes to legislation or current funding arrangements, some areas do need changes to legislation to fully implement the changes. For example, allowing direct referral by optometrists under General Ophthalmic Services arrangements; extending prescribing responsibilities to optometrists; amending the Opticians Act to give powers for the General Optical Council to create lists of optometrists with specialist interests. Work is in hand in all these areas.
I hope the NHS will see the eye care pathways as a real opportunity to change the way eye care services are provided, making the best use of local skills to bring patient care closer to people's homes.