Creating a new NHS England: NHS Digital and NHS England have now merged. Health Education England will join us in April 2023. Learn more.
CCGs urged to tackle backlogs at eye health summit
Commissioners must help “radically redesign” eye health services for the benefit of patients, the first-ever NHS eye health summit was told last week.
CCGs at the “Demand and Capacity” conference heard that the need for change was now “critical”. Eye health leaders warned that inaction could have far-reaching social and economic consequences.
National Head of Primary Care Commissioning at NHS England, Dr David Geddes said: “The first eye health summit has created a vital opportunity for commissioners and providers in primary and secondary care to come together to share examples of good practice. With demand for hospital eyes services growing from an ageing population, they are now busier than ever. There is a clear need for radical change across the health sectors to better integrate care so that patients can access quality services in a timely fashion.”
Sharing best practice from Gloucestershire CCG, Graham Mennie GP eye health lead said: “If changes to ophthalmology services are not at the top of the CCG agenda, they ought to be.” “More of the same will not do”, he told the commissioners in the audience.
Opening the conference in London last week, President of The Royal College of Ophthalmologists, Professor Carrie MacEwen, said: “With the continuing rise in macular degeneration, glaucoma and diabetic retinopathy, together with welcomed new treatments, change in the design of services at a national level is critical to meet the demand.”
Professor MacEwen continued: ‘It is certain that avoidable sight loss has, and will continue to have, far-reaching social and economic consequences such as loss of independence, increased risk of falls and mental health issues that will impact on a wider scale across the health services and social care.”
Chair of the Clinical Council for the Commissioning of Eye Health, David Parkins said that primary eye care services should be the first port of call to manage and monitor cases prior to referral to hospital and that community ophthalmology solutions lay in multi-disciplinary, collaborative teams.
“Community ophthalmology services need to be commissioned to manage low-risk patients and stable conditions to agreed protocols. Clear and efficient patient flows and policies which delegates heard some hospitals have developed already, need to be shared and adopted more widely. Above all, good governance supported by audit is vital.”
The Clinical Council is calling for eye health services to be commissioned at scale to make services more efficient and cost effective. Clinicians also demanded better IT connections to speed up and share patient data both within primary care and between primary and hospital care.
Over 100 delegates heard from a number of best practice case studies of working models from across England. These showcased how improvements and innovation to patient pathways, involving both primary and secondary providers, had delivered efficiencies and better patient care, by ensuring patients saw the right healthcare professional at the right time and in the most optimal location.
This first eye health summit is one step forward in planning and improving hospital eye services, working with the key stakeholders to influence change and make a difference.
All presentations and contact details for following up discussions will be available on the NHS England website shortly.
This is worrying – the suggestion that monitoring of eye conditions that involve sight loss moves from specialist centres to community practitioners.
This goes against the arguments for hubs of excellence in other services, where the expertise is ‘measured’ by the frequency that a clinician deals with a patient’s clinical needs (whether monitoring, change of medication or surgery).
I have lived with glaucoma for 15 years since diagnosis, with some sight loss that has increased over time. This is a condition that has no cure, and no symptoms. It needs regular monitoring by suitably experienced clinicians to maintain the condition as stable and to minimise further damage, leading to blindness.
I have an allergic reaction to much of the regular medication, have had microsurgery, and numerous laser surgery treatments to control my glaucoma which is in both eyes.
I have no way of knowing when my condition becomes unstable, which happens with no warning regularly as there is no cure, because there are no symptoms.
Why should my sight be put at risk by my having to rely on community opticians who do not deal with my long term condition on a day to day basis?
It seems that the reason my sight is to be put at risk is to balance some rapidly reducing budgets.
I do not find that a good enough reason. Would commissioners be liable for a flawed decision if I became blind, as a Trust and surgeon would be for a bungled operation?
I have had my to six month’s degeneration eye check switched from every six weeks to three months and now to six months on the understanding that I will report in immediately if I notice any significant further loss of vision. All patients in my excellent clinic are routinely seen every six weeks and given that many of us are in 80s or 90s (like me) transport is burdensome. How did six weeks come about? And for all Patients regardless of individual need?