Enhanced Optical Services (EOS)/ Minor Eye Conditions (MECs)
AGENDA The State of the Nation Sight Test Provision Current Pressures Community Optometry and EOS Schemes NHS Funding What Next?
The Sight Test Provision Over 19 million sight tests carried out each year in England and about 13 million of these are NHS funded (GOS contract) GOS sight tests are in place to investigate patients with visual complaints that relate to defects of sight caused by refractive error Any patient with symptoms relating to their vision, such as headaches and eye strain that require refraction should be signposted to a sight test
1
Capacity and Financial Pressures People with eye related conditions account for 5 million GP consultations & 270,000 A&E attendances Demand for hospital eye services has increased by 8% in the past two years adding to capacity pressures 1.5 2.0 % of all GP appointments are eye related 2 3 Optical practices, as an integral part of primary care need to be signposted to if the NHS is to meet the needs of an ageing population, whilst improving efficiency, outcomes and closing the funding gap
Community Optometry Who Benefits? EOS in the community setting has significant advantages for both patients and GPs alike: Convenient community based locations, with extended opening hours Patients have access to aftercare services as and when required All examinations carried out by qualified, accredited opticians using all relevant diagnostic equipment
MECs Scheme
Minor Eye Conditions (MECS) These type of symptoms should be signposted into a Minor Eye Conditions scheme, rather than a Sight Test: Red eye Sore eye Dry eye Watery eye Flashing lights Floaters Sudden loss of vision Sticky eye
Minor Eye Conditions (MECS) Collectively the 140,000 days currently spent by GPs on eye related queries could be dealt with by community Optometrists The equivalent of over 500 extra full time GPs could be freed up 6 The commissioning of MECS significantly impacts on referral rates to secondary care, reducing the 1.7 million first attendances at Ophthalmology outpatients by at least 10%; the equivalent of 170,000 HES appointments and net savings of 5.5million 7 8
NHS Funded Schemes
Specsavers view is that community optical practices in England can and should play a greater role in primary care Optometrists have the capability to do much more than sight testing If you feel NHS funded EOS schemes would be beneficial in your area, your own views as well as local groups such as the LMC may be able to influence at CCG level
Thank you for your time! If you require further information please contact us at gg.nhsservices@specsavers.com
References 1. Download the full RNIB report here: http://www.rnib.org.uk/knowledge-and-research-hub-researchreports/prevention-sight-loss/stateofthenation 2. Health and Social Care Information Centre, Hospital Outpatient Activity- 2011-12 3. Health and Social Care Information Centre, Hospital Outpatient Activity- 2013-14 4. Eye Volume: 26 Issue: 10 Pages: 1288-1294, DOI: 10.1038/eye.2012.120, Published: October 2012. The Portsmouthbased glaucoma refinement scheme: a role for virtual clinics in the future?, Trikha S, Macgregor C, Jeffery M, and Kirwan J 5. British Journal of Ophthalmology, 2015;99:313-317 doi:10.1136/bjophthalmol-2014-305588, Service innovation in glaucoma management: using a web-based electronic patient record to facilitate virtual specialist supervision of a shared care glaucoma programme, Wright Heathcote R and Diamond Jeremy P 6. National Health Service (2015), Health Education England, Medical Careers https://www.healthcareers.nhs.uk/explore-roles/general-practice-gp/working-life 7. Data from the Information Statistics Division, NHS National Services Scotland shows first attendances at ophthalmology outpatients reduced by 5% in Lothian, 9% in Glasgow, 26% in Fife and 41% in Grampian between 2006 and 2010 following introduction of the enhanced GOS contract in Scotland in 2006. 8. Data from St Thomas' Hospital, London showed a 12% reduction in ophthalmology outpatient first attendances for patients with a Lambeth GP and a 18% reduction for patients with a Lewisham GP, for 2013/14 compared to 2012/13 following the introduction of a Minor Eye Conditions Service in both areas. Ophthalmology outpatient first attendances for patients from the neighbouring area of Southwark, where there was no Minor Eye Conditions Service, fell by less than 1% over the same period.