Many practices are currently delivering essential services to patients in very challenging circumstances whilst also delivering emergency and urgent services with no commissioned framework for service delivery.
To address this patient need, a COVID-19 Urgent Eyecare Service has been developed by LOCSU, NHSE-I and the Clinical Council for Eye Health Commissioning (CCEHC), endorsed by the College of Optometrists and Royal College of Ophthalmologists.
This single specification service is to be delivered via primary care optical practice, supported by hospital ophthalmology services, commissioned locally by CCGs.
In summary, the service will allow patients to gain prompt access to a remote consultation leading to a care plan for the patient to:
- self-manage their ocular condition (with access to appropriate topical medications where appropriate); or
- be managed by an optical professional with advice, guidance and remote prescribing as necessary; or
- be appropriately referred to hospital ophthalmology services
Virtual consultations will allow patients to receive their consultation at home, in line with the public health guidance and the needs of patients who are self-isolating or in the high-risk vulnerable category.
The service will require collaboration across the system, with primary and secondary care clinicians working together to support each patient in the most appropriate way, minimising the need to travel and reducing the risk of infection.
The service broadens the scope of care optical practice can offer. Where available, optical professionals including CLOs and those with higher qualifications will be able to offer a broader range of eye conditions than is typically offered in optical practice, initiating treatment and delivering care as necessary, as well as supporting other practitioners with advice and guidance as required.
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As this is part of local pandemic planning, and key to meeting urgent and emergency eye health needs whilst reducing pressures on other parts of the local NHS system, rapid action is required to mobilise this service at pace and scale. Many practices are already delivering essential services as well some urgent and emergency care. The priority is to commission and implement a service to ensure that this can continue safely and consistently in areas where no extended services are currently commissioned. To achieve this, the commissioning is best done at scale, ideally with a single contract across each of the 7 NHS regions facilitating the modification of existing services, for example MECs, as needed locally. The service is designed to be delivered using established models of delivery.
The service will be time-limited, however there is scope that once the COVID-19 immediate crisis is over the service could potentially evolve into a new level of primary eye care on top of the national sight testing and preliminary case-finding service.
Commenting on the service, Richard Everitt, Programme Manager for Optical Services Commissioning at NHS England and NHS Improvement said:
“NHS England is proud to have contributed to the development of this important service by facilitating collaborative working between primary and secondary care organisations. We have been inspired by the willingness of all stakeholders to work at pace during these exceptional circumstances to develop what is effectively a brand new service pathway, endorsed by The College of Optometrists and The Royal College of Ophthalmologists. The outcome of this extraordinary effort is the provision of urgent and emergency services to patients who would otherwise have no alternative points of access. We encourage all CCGs to adopt this service to meet the urgent eye care needs of their local population.”
LOCSU will support all LOCs and PECs with their discussions, via the Optical Leads team.
For reference, the LOCSU Optical Leads are:
- East of England: Binal Patel
- London: Richard Rawlinson
- Midlands: Richard Rawlinson
- North East/Yorkshire/Derbyshire: Nizz Sabir; Zoe Richmond
- North West: Tom Mackley
- South East: Helen Haslett; Richard Rawlinson
- South West: Max Halford; Amar Shar; Helen Haslett
Source – LOCSU News Flash 17/04/2020