Welcome to

1. Welcome to Staffordshire Local Optical Committee 2007 AGM

2. Pam Attwell Secretary

3. Secretary’s Report • This committee met 6 times • The Officers also met 6 times • The sub-committees met 6 times • We also held 2 locality meetings • Meeting details and minutes are now published on our web site • All OO’s and DO’s are welcome to • attend (with prior notice please)

4. Spreading the word on the web • The AGM is very formal and may not be the easiest forum for you to communicate with us • Information on an array of topics and details of various meetings • You can join our forum and let us have your comments

5. Our web site www.staffsloc.co.uk Separate areas available to the committee, the profession and the public

6. Meeting the profession • 2 locality meetings were held 1 in Lichfield and 1 in Stoke – all the profession in Staffordshire were invited • Michael Poutney from Social Services gave a presentation about the Single Assessment Process • Supplies of leaflets were provided to all

7. Welcome to Staffordshire LOC Programme Introduction Stewart Townsend SAP’s Michael Pountney Achievements of the LOC Malcolm Gray Clinical Governance & Peer Review Groups David Stidwill SPECS & new contracts Malcolm Gray Children’s pamphlets Steve Kimberley Conclusion Stewart Townsend

8. Carolyn Parker Treasurer

9. Finance • Proposal to reduce statutory levy by 0.50% for the foreseeable future • To ensure that we can fully support the new national LOC support Unit we propose that there should be a new Statutory Levy of 0.50% on all NHS sight tests, the whole of which is passed on to the new unit. • This new fund will be applicable from 1st July 2007

10. Malcolm Gray Chairman

11. A new structure • Agreement that each sub-committee focuses on a selected number of projects for which sufficient time and resources are available to ensure completion • Sub-committee produces proposal to main committee and the action of the proposal is then agreed by appropriate team

12. Staffordshire Primary Eye Care Services • Company set up by LOC for all optometrists and dispensing opticians to belong to • Will require individual shares • Will require a sign up to clinical governance standards • To enable us to negotiate business arrangements with PCT’s or Practice Based Commissioners

13. Social Enterprise Pathfinder Award • Jim Barlow liaised with Dept of Health to establish whether the LOC would qualify to apply • In November 06 an application was put together based on using SPECS to provide shared care for paediatrics, referral refinement, glaucoma,etc.

14. “Delivering the Vision Conference” • Review of National Pilots • Launch of the Commissioning tool kit for community based eye care services • Workshops on future provision of Low Vision, Glaucoma & Acute care • RNIB Low vision initiative

15. Delivering the Vision • Community Eye Care Services: • Review of Local Schemes for • Low Vision, Glaucoma and Acute Care • January 2007

16. Clinical leadership & engagement Patient involvement PbR savings Use of up-skilled clinicians Robust governance providing confidence for joint working between GP’s, Consultants & optometrists

17. An eye to the future • To consider the workforce implications of the evolution of ophthalmology and eye care in the West Midlands • February 2007 • Modernising Medical Careers • European working Time Directive • An ageing and unhealthy population

18. “An eye to the future “ • In West Midlands will lose 21 junior doctor posts • Several hospitals considering closing or reducing out of hours cover for A & E • Clear need to reduce un-necessary appointments within HES • Everyone agreed need to develop rules based care and robust patient pathways • Establish Local Eye Health Groups

20. Low Vision Services • Bev Ricketts has been heavily involved with Staffordshire Low Vision Services Committee • Offered opportunity to apply for funding from a Dept of Health initiative • Meeting of all involved in April lead to agreement that Staffordshire would be awarded help • Stakeholder meeting being organised for 12th July

21. Referral Refinement • PCTs interested in developing clinical protocols and care pathways for all eye related conditions • Discussions underway for BLT and Stafford areas to operate a Clinical Assessment Centre with electronic links via N3 to primary care, hospital eye service and optometry

22. Standards for Better Health • Core standards laid down by the Healthcare Commission • Annual Health Check for PCT’s • 24 core elements • Includes reference to arrangements with independent contractors, arrangements for commissioning and governance

23. Secondary Care • Major difficulties with the new Midlands Treatment Centre (Nations) at Burton on Trent • Wolverhampton Eye Infirmary finally moved to New Cross Hospital • UHNS has 2000 overdue follow ups

24. Optometric Advice • Contract as Optometric Advisor to North Staffordshire has now ended • There is no news as to further arrangements • Chairman has provided advice to South Staffordshire as well as post payment advice on an ad hoc basis • Ian Lucas and Pete Dartnell have been involved in PPV and practice visits in the South

25. PCT/LOC • Re-organisation in Staffordshire from 8 PCTs to 3 • Newcastle & Moorlands now North Staffs PCT • North & South Stoke now Stoke on Trent PCT • BLT, East Staffs, Cannock Chase and South Western Staffs now South Staffordshire PCT • Lots of established relationships lost and lots of work building new relationships • Working to develop relationships with Practice Based Commissioning Groups

26. Health Improvement Bill • LOC aware of new contract due late this year • SPECS ready if necessary • Introduction of Locality Commissioning may shift emphasis to local contracting • New National body to assist with inevitable workload • LOC will respond as necessary

27. A year in the life of the LOC Carolyn Parker

28. Clinical Governance • Clinical Governance guidelines book produced in 2003 by the LOC was the only hand book published by the profession in the country • Further work with all the PCTs to develop this work • On the table is a copy of the Clinical Governance toolkit provided by the AOP

29. Clinical Governance • PCTs are now being pressured to look at Clinical Governance and are asking us what we can do • Consensus is that we have done enough and anything further would have to be funded by the PCTs

30. Peer Review • Following our locality meetings the Clinical Governance committee arranged a peer review meeting • These meetings are designed to help colleagues share their thoughts, not to criticise in any way • Those who have attended agree it is a really useful format, an opportunity to discuss issues common to all practices which organically produces helpful information and solutions • And you get CET points!

31. Peer Review • For those who would be interested in participating in peer review there is a feed back slip amongst your papers, please fill it in and hand it back tonight or send it to the LOC office

32. Continuing Education & Training • The LOC is now registered as a CET provider • It will concentrate on specific issues that affect the Staffordshire locality such as Diabetic Retinopathy and Cataracts, etc. • No conflict with our 2 local societies who do an excellent job

33. Special Activities • The Children’s leaflet which was distributed last year to all schools in Staffordshire has been redesigned and is about to go to print • PeePs certificates and badges were distributed to all optometrists practices and a second distribution was carried out last month

34. Special Activities • Contributions to the Optometrist’s Atlas which was distributed last year and is now being updated • Zeiss representatives attended an LOC meeting to present their range of low vision aids and discuss ways of making them available to appropriate patients • Initial discussions have followed about how they may be able to promote the quality of low vision services in Staffordshire

35. Communications • Proposal that Voluntary Levy money should be spent wisely to enhance: • local and national events such as National Eye Week • Distributing information on good eye examinations and good eye health • Consultation with PR companies to ensure money is spent in the most effective way

36. Communications • 2 editions of the STARE newsletter have been produced and distributed • Improving distribution of information to optometrists’ practices • Set up and expansion of web site

37. Training • Requests for support staff training such as: • Detailed explanation of eye health and basic spectacle lens technology • First aid courses • How NHS claims and form procedures work

38. Development of clinical care Stephen Saum

39. Acute Eye Conditions • In September last year negotiations began with Moorlands PCT and UHNS to establish a pathway • Pathway agreed using UHNS to triage referrals • Pilot began with 12 clinicians in Moorlands in January this year • 18 out of 25 referrals did not require HES care

40. Paediatric monitoring • After prolonged discussions with Stoke PCTs and UHNS final agreement to go ahead in Spring 2004 • 25 optometrists signed up to be involved but initially 6 underwent training and the scheme commenced • Scheme very successful and due to expand to encompass the other 19 optometrists • Despite winning an Acorn Award for Patient Care the scheme cannot be expanded due to an impasse over funding issues

41. Glaucoma Shared care • Another year of meetings! • Survey of optometrists & equipment • Leek pilot • UHNS 2000 patients overdue • Offer of joint training with orthoptists • Possibility of outside organisation to provide service & governance • Could use SPECS

42. Cataract direct referral • South Staffs PCT raised concerns about patients being referred and then subsequently refusing surgery • Guidance awaited so that training can be implemented • Consideration is being given to a single sheet form to replace our 2 sheet sets

43. Referral Refinement • The areas covered by the old East Staffs and BLT PCTs are looking at referral refinement based on optometrists connected by N3 • Tamworth have introduced a web based electronic CAS to manage referrals

44. AnyQuestions?

45. Malcolm Gray Clinical Director Staffordshire Diabetic Retinopathy Screening Programme

46. Diabetic Retinopathy Screening • 41,500 Patients (39,500 on register) • Recall system now fully functional • Last year screened 28,191 • 57 Practices, 230 GP Practices, 6 Hospitals • Scheme involves 200 clinicians, all of whom must meet national competency by March 2008 • Series of core training sessions • NSF Team to provide induction followed by local opportunity to sit appropriate examination

47. Screening Activity 06/07

49. Association of Optometrists Our AOP representative is Ian Lucas of Webb & Lucas, Stafford You will find his report on your table

50. Federation of Ophthalmic and Dispensing Opticians Our FODO representative is Heather Bailey of Dollond & Aitchison, Hednesford and Chase Terrace