LOCSU News – NOC Special
News posted: 28/10/2014
- Key Messages from the NOC 2014Open
Leading the conversation on eye health policy, shaping health provision by working closer with primary care partners and keeping abreast of technological innovation, such as telehealth, are key activities for the community eye health sector, delegates heard at last week’s highly successful National Optical Conference (NOC).
Speaking immediately after the conference in Birmingham, Managing Director, Katrina Venerus, said: “We have certainly been successful in raising the profile of eye health within NHS England via the Call to Action and now we need to build on that.
“Meeting with senior NHS leaders at the NOC it is clear that there is a strong desire to develop a preventative approach through a new primary care strategy that will put community optical practices firmly in the mix of health provision.”
- LOCSU and Optical Confederation WelcomeOpen
LOCSU Executive Chairman, Alan Tinger, kicked off the 2014 conference, welcoming delegates and making a presentation to outgoing Chairman of the Optical Confederation (OC), Don Grocott, who said that relationship between LOCSU and the OC was a superb demonstration of what we can do together. “The NOC is a great opportunity to develop optical thinking,” Mr Grocott said.
Incoming OC Chairman, Chris Hunt, said that the community optical sector had a “wonderful skill set” and he was looking forward to a “thought-provoking conference”.
- Salix – From Dispenser of Medicine to Dispenser of HealthOpen
Communications is no longer a bolt-on but an integral part of the policy process, argued Sarah Wrixon from specialist PR firm, Salix & Co. Ms Wrixon, who helped develop and run a recent successful campaign for Pharmacy Voice, outlined why a higher profile among politicians, policy experts and the public is important if you want to achieve your strategic objectives. The Dispensing Health campaign, which delivered prominent coverage in the national media, was an important step change as it moved the perception of pharmacists from being seen as mere medicine sellers to dispensers of health. Sarah said that this approach, along with collaboration with other primary care partners, such as GPs, had the potential to position optometrists and dispensing opticians as expert eye health providers in the community with a “single, credible voice” while at the same time improving the profession’s standing.
Pharmacy Voice chief, Professor Rob Darracott, said that raising the profile of the pharmacy sector had been exceptionally helpful and that primary care partners were more than the sum of their parts. Pointing to a shared political party conference presence he said: “Four professions on one stand has been a winner!” He said there were a number of circumstances, such as GP appointments, and winter A&E pressures, where an alliance of primary care could speak loudly as one to those in the NHS and government shaping delivery and policy.
- NHS England, Taryn Harding – Call to Action for Eye HealthOpen
Introducing NHS England’s Taryn Harding, the keynote speaker for the conference, LOCSU Managing Director, Katrina Venerus, brought to the attention of delegates the words of NHS England Chief Executive Simon Stevens having launched a Five Year Forward View for the NHS that very morning “The NHS is at a crossroads and needs to change and improve as it moves forward,” Katrina told the audience. “We have all been advocating changes to the delivery of eye health services for rather a long time so I am delighted that the NHS is now up for change.”
The Call to Action naturally leads to how primary care services can promote prevention and early detection, Taryn Harding told the conference. The NHS lead, who is shaping the new primary care strategy, told delegates that the aim of the Call to Action – which received more than 400 responses – was to spread good practice, stimulate debate and improve how eye health services are planned, commissioned and delivered. Along with the other Calls to Action, from general practice, pharmacy and dentistry, the objective was to encourage a preventative partnership that would allow radical change by building primary care services at scale.
Harding identified a range of key themes emerging from the responses to the Call to Action central to a new approach. The NHS policy chief said that improving IT and communications; developing clinical leadership and changing organisational culture; developing pathways and making better use of skills; exploring new contractual opportunities and potentially reviewing GOS; and improving case management and improving accessibility to sight tests, are crucial to building community-based, preventative, patient-centred provision.
She said that these would help patients, their families, carers and communities to receive holistic, high-quality care that is accessible, proactive, responsive and co-ordinated.
“When it comes to health, we need to make every contact count,” Taryn told delegates.
Harding said that the NHS would be setting out its next steps and that these would include; setting out a collective vision, understanding gaps and the journey to where we want to be, appreciating the different models to deliver change, identifying priorities for transformation, and agreeing an action plan.
Taryn responded to a range of questions, including requests for template commissioning and the need for national consistency.
- Learning from Calls to Action for General Practice, Pharmacy and DentistryOpen
In another keynote session, leading players from pharmacy, dentistry and general practice agreed that the NHS needed radical change just to meet the demands of an aging population and that “more of the same will not do”, while transformation will be driven by outcome data.
Dr Graham Mennie, a GP and Commissioning Lead for ophthalmology at Gloucestershire CCG, gave a compelling local perspective and a stimulating presentation pointing to the stark reality that, with 17 people becoming diabetic every hour, the health production line needed to be more like the “lean” Toyota system than the individually-crafted Aston Martin. “We can’t rely on the traditional, one-to-one secondary care model,” Dr Mennie said.
The Commissioning Lead said that we need to build our services around real-life scenarios – and with a slide of TV coach potato, Jim Royal to set the scene – he urged the optical sector to consider the needs of people with multiple co-morbidities, often frail and elderly, to think of carers’ requirements and to innovate through the likes of polypharmacies. “The NHS is up for change; we face new challenges and require new solutions. You need to keep it simple and make it deliverable,” delegates heard.
Professor Rob Darracott, Chief Executive, Pharmacy Voice, said there were many similarities between the pharmacy and optical sector and this provided a focus for future collaborative working.
He said that a partnership of primary care providers could ensure that the forthcoming strategy expands access to public health services, continues to improve patient safety, supports people with long-term conditions and provides an easy access point for the management of common conditions and supported self care. The pharmacy chief told delegates that this would be “an investment in integrated care and innovation”.
John Milne, Chair, General Dental Practice Committee, British Dental Association, said that his profession were looking at a “blended contract” to end perverse incentives that favour treatment volumes over health outcomes – contrary to a more preventative approach. “The practitioner should not be penalised because they do the right thing,” NOC delegates heard, adding that shared records, NHS email addresses, electronic prescribing and premises support could benefit the whole of primary care.
- Local Eye Health Networks PerspectiveOpen
Following on from the presentations from Graham Mennie, Rob Darracott and John Milne, delegates watched a video from NHS England showcasing the role of the Local Professional Networks for dental, pharmacy and eye health and highlighting the influence the networks are starting to have. Dharmesh Patel, LOCSU Optical Lead and Greater Manchester LEHN Chair picked up the role of the Local Eye Health Networks (LEHNs) and said that one of the biggest impacts being made by LEHNs was that Commissioners were now approaching them for the clinical leadership, advice and guidance.
The Optical Lead said that LEHNs had been pivotal in co-ordinating local responses to Call to Action consultation. “LEHNs’ Call to Action events were able to bring all stakeholders together around the table and the breadth of stakeholders engaged in local events was refreshing,” Dharmesh explained.
These extensively included: optometrists; ophthalmologists; orthoptists; nurses; GPs; pharmacists; third sector; ECLOs; Public Health; CCGs; Local Authorities; patients; Healthwatch; carers and representatives from Social Care.
Dharmesh said that LEHN projects were now at the forefront of many innovations in service redesign: in health mapping, holistic pathway approach, minimum standards and compliance and collaboration on a range of eye health needs from cataract, through children’s vision screening to Minor Eye Condition Services.
A Q&A session with all four speakers highlighted the opportunity and the will to collaborate across primary care professions.
- The Enablers for the Call to Action Discussion PanelOpen
There were a wide and insightful range of views on offer during the enablers’ discussion panel with leaders from ophthalmology, general practice, commissioning, optometry and optics giving personal professional perspectives.
The eminent panel consisted of Elaine Grisdale, Head of Professional Services and International Development, ABDO, Dr Graham Mennie Commissioning Lead at Gloucestershire CCG, David Parkins, President of the College of Optometrists and Chair of the London Local Eye Health Network, Richard Smith, Consultant Ophthalmologist and Clinical Lead for informatics (Buckinghamshire Healthcare NHS Trust) and Trevor Warburton, Chair LOCSU Clinical Advisory Group, along with discussion chair, Katrina Venerus.
LOCSU Optical Lead Poonam Sharma opened the session focusing on IT, workforce and governance. Poonam maintained that connectivity was not just about genuine grumblings about NHS email but fundamental patient pathway integration between primary and secondary care. Dr Graham Mennie said that it was time health provision “took the test to the patient” making the case for mobile screening particularly for rural localities.
Consultant Ophthalmologist Richard Smith told the audience that we need to be training for tomorrow. “It’s not actually about the enablers, it is about the process of managing change,” Mr Smith explained. David Parkins, meanwhile, told delegates that we need contracts based on outcomes for the future. Elaine Grisdale highlighted that dispensing opticians are often left out of workforce solutions. “DOs are underutilised and as specialists in low vision often create the relationship with the patient in the practice offering continuity of care. DOs should be frontline actors in children’s vision screening. Don’t overlook the skills, enthusiasm and geographical coverage of dispensing colleagues.”
- WOPEC Presentation to LOCSU Leadership GroupOpen
Delegates were invited to attend the WOPEC presentations to the LOCSU Leadership Group. Barbara Ryan presented certificates to the 2014 leadership group and we were joined by Alan Tinger who underlined LOCSU’s commitment to the programme. Potential candidates who were interested in applying for a funded place on the 2015 module were given the opportunity to ask questions.
On Friday, as part of the second set of parallel sessions, eight of the group made presentations. The themes included: “Enabling LOCs” researching whether LOCs have the internal resources, contribution and internal engagement they need in order to fulfil their external objectives effectively. (Shireen Bharuchi – Oxfordshire LOC); Is there a winning formula for Clinical Leadership in Eye Health (Paul Bradford – Devon LOC); Influencing Participation in Community Schemes (Andrew Bridges – Hampshire LOC); Factors affecting the take-up and activity in community optical services (Bruce Gilson – Buckinghamshire LOC); The need for effective leadership in the amalgamation of adjacent LOC committees (John Davidson – North of Tyne LOC); Raising the Profile of the LOCs with Newly Qualified Optometrists (Dan Dixon – Bradford LOC); and The Difference in Engagement Levels to Participate in Community Eye Care Services (Neelam Patel – Kent LOC)
- Parallel Sessions – Day OneOpen
Delegates were presented with a choice of four parallel sessions on the afternoon of the first day which were repeated allowing delegates to attend two out of the four. A diverse range of topics were covered – Long Term Conditions, Financial Efficiency for LOC Companies, Prevention including access, and Integration.
- Central (LOC) Fund AGMOpen
The first day of the conference ended with the chance to hear about the important work of the Central (LOC) Fund at their AGM.
- Networking MeetingsOpen
Following the glitz and glamour of the AOP awards, it was an early start for the LOC Networking Meetings. Following feedback last year, a new set of role-based networking meetings were devised with a choice of six different sessions: Business Managers and Administrators, Clinical Governance and Performance Leads, Commissioning Leads/LEHN Leads, IPs, Finance Leads and Treasurers, and New Officers. Feedback from these meetings has been collated and LOCSU plans to circulate a summary of key points to LOCs.
- LOCSU’s AGMOpen
The traditional LOCSU AGM held at the NOC started with brief presentations from Alan Tinger, LOCSU Chairman, and Katrina Venerus, Managing Director, on LOCSU’s work over the previous year. Alan focussed on the two main themes of his foreword in the 2013-14 Annual Report regarding transparency and ambition. Alan drew attention to the growing momentum around LOC Companies and highlighted that the company model allowed all types of practice to get involved in providing services.
Katrina reiterated Alan’s point that the direction of travel for LOC companies is very positive and explained that as more LOC companies achieved success in securing service contracts, and the nature of the services becomes more ambitious, LOCSU has had to continually review and enhance the infrastructure and practical support it has developed for the companies. “This is a journey and we are all in it together,” she said.
Questions addressed at the AGM included why some commissioners are engaging with the company model and others are not, what can be done to assist succession planning for LOCs, the inconsistency of commissioned services in England in contrast with Scotland, and when figures on reductions in attendances at hospital outpatients and eye casualty to support the business case will be made available.
- Parallel Sessions – Day TwoOpen
Delegates were able to participate in a second set of parallel sessions following the LOCSU AGM. Topics included LOC Company Governance, Leaders and Followers, LOCs of the Future and The IP Optometrist in the NHS. As with the Thursday sessions, delegates were presented with a choice of four different parallel sessions which were repeated allowing delegates to attend two out of the four.
- National Eye Health WeekOpen
David Cartwright outlined some of the highlights of National Eye Health Week that included eye health featured on daytime TV, an early-day motion in Parliament and a reference in the Beano comic to get the message out to schools, parents and kids.
Mr Cartwright told NOC delegates that, to date, the media campaign has generated over 536 pieces of coverage and 137 million opportunities for the public to read, see and hear positive eye care advice.
“This year, our media campaign generated high levels of simultaneous press coverage about the importance of having regular sight tests and advice on how lifestyle can impact on your eye health.”
Top coverage included supplements published in The Times, The Guardian, The Independent, the ‘I’ newspaper as well as Dr Hilary Jones promoting NEHW and eye health on breakfast television.
The College’s Susan Blakeney also took part in a NEHW feature on ITV’s This Morning alongside Dr Chris Steele, Philip Schofield and Amanda Holden.
NEHW saw increased stakeholder engagement with CCGs across the UK and Public Health Wales hosting event and raising health issues on social media.
With forecasters predicting that the number of people living with sight loss will double to four million by 2050, it is alarming that, according to the Eyecare Trust, one in 10 British adults has never had an eye examination. Furthermore, one quarter of over 60s say the quality of their vision affects their daily routine.
“Time and again studies show that sight is the sense we dread losing the most yet people are either not educated or motivated sufficiently to care for it,” David said. “NEHW aims to address this. It is a unique week, the only one that does this work in the UK.”
David revealed that the date next year NEHW is Sept 21st to 27th. He said his key request though is to get every practice involved. “I’d ask for every LOC and LEHNs to spread the message to other practices and organisations.
“Clearly without third party support there is no NEHW and less than half of one per cent of UK optics annual marketing spend would make a massive difference. So if you have influence in organisations that would like to help, contact me and get involved.”
- NOC 2014 Poster CompetitionOpen
Devon LOC was chosen as the overall winner in the inaugural poster competition for its “Public Health” category entry. The independent judging panel consisting of Rob Darracott, CEO Pharmacy Voice, David Parkins, President of the College of Optometrists and Barbara Ryan, Director Postgraduate Taught Programmes (WOPEC), had the difficult job of choosing one overall winner from the posters exhibited. There were seven short-listed entries across the four categories: (Engagement Strategy, Service Redesign Initiative, Collaborative Working and Public Health).
The runners up were: Camden and Islington LOC (Collaborative Working), Essex LOC (Service Redesign Initiative), North East and Cumbria LEHN (Public Health), North Yorks and Humber LEHN (Engagement Strategy), North Yorks and Humber LEHN (Public Health) and Tees LOC (Service Redesign Initiative).
- Looking to the FutureOpen
As the conference neared its close Katrina Venerus got out her metaphorical crystal ball to look ahead at what might be in store for community optics. Innovations from smart spex to enhance the lives of people living with sight loss to light treatment for diabetic eye disease were showcased but the emphasis from Katrina was on the future role of optometrists and opticians in providing more of the “out of hospital care” that NHS leaders want. Katrina told the audience that we need to use our collective resources and intelligence and provide support from a local and national level to define and deliver models of integrated care, and that the Clinical Council has a national leadership role to play. Katrina also said that a lot more work was needed to test out the modelling around diabetic eye screening and to ensure that Commissioners understand the benefits of providing screening via optical practices. She stressed that there is a lot to do but the future is certainly bright!
The key take home message was that in partnership with our colleagues in general practice, pharmacy and dentistry we need to make sure we hold NHS England to account in terms of creating some action out of the Call to Action. NHS England has called for it, we have told them what to do and now we need to help them to do it.