Mr Chris Tannorella Mrs Ceri Goodman Mrs Sharon Beatty Mr Shiraz Megli Mrs Sharon Beatty

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MINUTES OF A MEETING OF THE SOUTH EAST WALES REGIONAL OPTOMETRIC COMMITTEE, HELD AT THE SCHOOL OF OPTOMETRY, CARDIFF UNIVERSITY ON MONDAY 21ST MAY 2018 PRESENT Mrs Annette Dobbs Mr Craig Mackenzie Mr James Morris Mr Gareth Ward Mrs Cath Macnamara Mr Chris Tannorella Mrs Ceri Goodman Mrs Sharon Beatty Mr Shiraz Megli Mrs Sharon Beatty 1. WELCOME AND APOLOGIES FOR ABSENCE Apologies were received from Mr Brian Borland, Mr Jason Scaife, Mrs Dawn Saville, Mr Mike George, Ms Lydia Smith, Mrs Clare Pearce, Mr Elliot Bateman, Mr James Savage, Mr Gordon King and Mr Owain Mealing. Mrs Helen Owens would not be attending the committee in the future as she had moved out of the area. In attendance: Mrs Sali Davis (Optometry Wales), Mr Tim Palmer (Cwm Taff Optometric Adviser), Mr David O Sullivan (Optometric Adviser, Welsh Government), Mrs Kirsten Hamilton Maxwell (Director of Learning and Teaching Cardiff School of Optometry). Dr Katharine Evans (Director of Clinics and Senior Lecturer), Dr Barbara Ryan (Director of Post Graduate Teaching Cardiff University). 2. MINUTES OF THE MEETING HELD ON MONDAY 19TH MARCH 2018 The minutes were accepted as a true and accurate record. 3. MATTERS FOR DISCUSSION (a) A CONTRACT FOR THE PROFESSION Sali Davis reported OW had continued to work on a draft contract for the profession. Discussion had been held often and the plan would be open discussion with WG to shape what a contract for optometry would look like. OW had collated data and analysed the workforce survey which would be published and taken to WG for discussion. It was further reported that a formula was being compiled within a spreadsheet to record projections and prices to begin discussions with WG. OW Representatives on all ROC s had been asked for their suggestions and ideas to further add to the body of work; new and innovative proposals from the whole profession could then be included and presented to WG. The work would be closely aligned to the Any Questions Roadshow which aims to involve the profession in shaping the future of Optometry in Wales. The current GOS contract was discussed; it being 70 years old; it s validity today; what was effective about it and what was not. Voucher values had not been addressed, it should be reviewed. It was agreed a precis of the current

contract would help the committee to understand the reasons behind a contract change and what a contract change could bring and the implications of the status quo. Action: would circulate an example paper that had been prepared by Pharmacy and Dentistry and the offer in England and Scotland along the same lines. (b) CARDIFF UNIVERSITY AND PLACEMENTS A presentation from Barbara Ryan from Cardiff University covered the following points: - Why do we need a curriculum review? The drivers for change were known already; there had been dramatic changes in the way the profession practiced but the courses had not changed at the same pace due to education regulations. The GOC s review, the education review what do we know so far? The review would be wide ranging covering the whole of the UK and would look at the GOC and the way it regulates. Placements would be required as part of the review and probably from Year 1. It was envisaged the requirements would be reported in Autumn 2018, hence opening the dialogue with ROC s now. The placements and the need for partnerships. Work had already begun to seek funding for placements, HEIW were onboard already and HB s would also be approached as the placement requirement would also include hospitals and other clinics. Approaching the ROC s would inform the plan and build a partnership in the delivery of placements. The placements would be at more than one practice each year for one week, in total 5-6 weeks. The students would not only observe but learn in practice therefore the placement provider would have to be teaching and be capable of signing off. The Chairman summarised; SEWROC would consider and discuss the provision of placements; to consider what the practices would prefer; and how should the University approach the profession. 4. MATTERS FOR INFORMATION (a) CHAIRMAN REPORT The Chairman wished to note the new Vice Chairman would be Sharon Beatty who would take over as Chairman after the AGM in March 2019. The Chairman updated the committee on action since the last meeting as follows: - - Action to send a Post Cataract Assessment email and write to each HB to ascertain how many patients were seen in the community: a report had been received from the Cwm Taff Optometric Adviser stating the position of Cwm Taff was to send all patients back into Community Optometry unless specified by the surgeon on completion of theatre notes following surgery. - Aneurin Bevan confirmed they had Post Operative Cataract Assessments in primary care optometry since 2006 as a local enhanced service and latterly

through EHEW. This was the default position and 90% of patients were followed up this way. - The Chairman of the Eye Care Group in Cardiff and Vale had also been emailed. They had responded with thanks for bringing it to their attention; they would copy in the surgery and clinical board leads who would be responsible for the delivery of the pathway, they would look at the data and give their thoughts and performance to date and their plans moving forward. - The Chairman s action to circulate the accounts had been completed. No comments were raised. - The Chairman had attended a Glaucoma Study with Dr Simon Reid, to answer questions on the model care plan of patients commencing prostaglandin analog treatment within 4 weeks of diagnosis; the focus was on how to ensure the treatment was working for the patient and if they were compliant with the time frame. It was noted and raised at the meeting that this would be better provided under WECS. Action: and CM to monitor the pilot and keep in touch with Dr Reid to hear back from the evaluation of the trial. - The GDPR Workshop in Cardiff had been well attended and received by the profession with excellent feedback. (b) TREASURER REPORT In absentia, the Treasurer reported no issues. reported the networking dinners held with the various HB s had not been arranged for the past three years. The dinners had been held to improve links with Consultants and Clinicians in each HB in a more informal setting. Action: to check that resources were available to finance the dinners and make bookings for each HB. (c) OW REPORT reported OW had signed off the re-accreditation. JS asked for more volunteers, a workshop was planned for January to April offering 6 interactive points, half of the workshop would cover foreign body removal and the second half would be a peer discussion. Optometrists who could assist with foreign body removal would be paid to attend as would those who could lead the Peer Discussion. The LVSW desktop review was progressing whereby OW had endeavored to remove some of the perceived administrative bureaucracy, a meeting would be held to work through the recommendations where it was envisioned that SSP would take some of the workload. No response had yet been received from WG regarding the proposed GOS increases for EHEW and LVSW; a response was expected at the end of May. reported OW were in the process of drafting communications to the profession around the new eye care measures: risks 1, 2, 3 to address how OW communicate with patients and give expected target dates, David O Sullivan had been working tirelessly to this end.

The hydroxychloroquine pathway proposal would go to the EHEW Advisory Group in June. It was hoped the pathway would include those patients that may already be seen in practice. It would be beneficial if records of patients experiencing delays within the new guidelines could be forwarded to. reported OW had been working well with the PPV teams, with an increase in requests for buddies and a greater leniency of the PPV process in some areas of the PPV process, therefore the protocol would be signed off shortly which would add greater clarity to the process. (d) WOC REPORT noted a new WOC Representative was required as Chris Tannorella would stand down as WOC Representative but continue to work in Cardiff and Vale as the Eye Care Representative. Action: CM to circulate the request for a WOC Representative amongst the SEWROC Committee. (e) HEALTH BOARD LOCALITY UPDATES CWM TAFF The Primary Community Care Committee had been attended by Ian Jones. Craig Wilson suggested there should be representations from the community at the Committee; Ian Jones had been asked to replace as he could attend more regularly on behalf of SEWROC. enquired about the Care Navigator scheme. Tim Palmer explained it entailed training for front of house staff in GP practices on how to guide patients to the correct service. It had been suggested the scheme should be rolled out to all primary care providers. Community Glaucoma Project: It was reported there were 3-4,000 overdue Glaucoma appointments in the CT HB. A proposal had been presented to the Directorate and Consultant for the patients to be sent out to Community Optoms to be assessed under EHEW and report back. This was declined in favour of a record review by the medical staff within the hospital. Glaucoma Task and Finish Group: Tim Palmer reported it was not yet up and running. It was agreed the SEWROC Chair would be the representative on the task and finish group. CARDIFF AND THE VALE It was reported that the papers for the most recent ECG meeting were received on the previous day to the meeting, so it was felt that there had not been enough time to prepare for the meeting. DO S provided concise statistics on the EHEW performance data. The main focus of discussion was Post Operative Cataract discharge it was reported that 24% of patients had been discharged to the community; in Aneurin Bevan the figure was 98%; a considerable disparity. It was noted that as only two Consultants attended, it had been difficult to discuss the discharge figures quoted. The ECG representatives intended to write to the Chair of the Eye Care Group requesting more timely delivery of the papers in future; better attendance of Consultants; and to meet with David and Richard the week before to help with preparation for the meeting and a better understanding of the jargon.

CM reported had written a briefing paper on Committee Responsibilities and Protocols to enable all members to understand the roles of Committee Members. The paper would give guidelines on preparation for meetings and what is expected from representatives. Action: to circulate the Committee Responsibilities Paper for comments. CM suggested greater clarity of Risk Register ownership and recording was required, both from EHEW and ECG. Pertinent questions could then be raised on behalf of patients of the ECG. At a recent Orthoptists Training Evening, Alison Hooper had circulated the Cardiff and Vale Referral Guidelines. It was requested by the ECG that the Guidelines be circulated again with a responsibility asked of practice owners and managers to disseminate the information to the Optometrist. Action: to circulate the Cardiff and Vale Referral Guidelines. The Regional Glaucoma Plan was had commenced in the pilot practices. How the pilot practices had been chosen, how long the pilot would run for and what equipment was required would be asked of the ECG at the next meeting. Vascular pathway would be taken forward by DO S and reported at the next meeting. Cluster/ECG Representatives had been asked at the last meeting to secure funding for cluster engagement. AB HB The Eye Care Group meeting would be held on Wednesday 23 rd May 2018. (f) SWEF 5. AOB CM reported SEWROC had been approached to fund pieces of work from WOC along with the other ROC s, each contributing pro-rata on the size of the ROC. would ask Phil Jones to contact each ROC with further details. Action: CM to circulate the request for funding to all Committee members and add to the next agenda for discussion. CM noted his thanks to for arranging the SEWROC Expenses Dinner planned for 18 th June 2018 at Chapels. Cath Macnamara reported a data protection issue regarding patients being referred from other practices as an emergency. The referring practice had refused to give any information about the patient. It was suggested the problem of understanding the GDPR Guidelines and what information can be shared between practices should be clarified.

Action: CM to communicate to the profession the duty of care to the patient, sharing information in the patient s best interest. contact the person within company who is overseeing EHEW. SB to take the matter up with Nik Sheen 6. DATE OF NEXT MEETING The confirmed date of the next meeting to be held on Monday 17 th September 2018. Action Person Responsible Completed would circulate an example paper that had been prepared by Pharmacy along the same lines. and CM to monitor the pilot and keep in touch with Dr Reid to hear back from the evaluation of the trial. and CM to check that resources were available to finance the HB networking dinners. and EB CM to circulate the request for a WOC Representative amongst the SEWROC Committee CM to circulate the Committee Responsibilities Paper for comments.

to circulate the Cardiff and Vale Referral Guidelines. CM to circulate the request for funding to all Committee members and add to the next agenda for discussion. CM to ask Phil Jones To contact each ROC to give further details of the funding request from WOC. Action: CM to communicate to the profession the duty of care to the patient, sharing information in the patient s best interest. contact the person within company who is overseeing EHEW. SB to take the matter up with Nik Sheen CM SB