Making that incisive pass

Being old enough to recall tear-stained memories of Wembley 1996 and Turin 1990, you’ll forgive me for watching the game through interlaced hands.

It needed a story of the very biggest magnitude to shunt the fallout of Matt Hancock’s resignation from the headlines. As every commentator has noted, his successor faces a metaphorical ministerial in-tray of hard-to-imagine complexity. And yet, few would expect Sajid Javid to have any sort of political honeymoon period; the need to act and to achieve results quickly is too great.

Near the top of the pile will be the publication of the forthcoming Health and Care Bill, which had been expected in the last week of June, just before Parliament’s summer recess.

The new Secretary of State has been warned that any delay risks derailing critical elements of the Government’s NHS reforms – but it is unclear when, or indeed if, it will be published.

Reflecting on the situation, NHS Confederation chief executive, Matthew Taylor, said: “A slight delay in the legislative timetable is understandable, given we have a new health secretary. But if a delay of a few days turns into a delay of a few weeks, this risks leaving us in flux at a pivotal moment. At worst, it could set us back a year and lose the vital momentum NHS leaders and their colleagues in social care have built up both prior to and during the pandemic.”

“We need to break down barriers between services and work in partnership across health and care services – and the planned legislation will helpfully take this one step further,” he added.

This desire for a new way of thinking and working was highlighted in an interview I had with Melanie Hingorani last month.

Hingorani speaks from a unique perspective, working as clinical lead for the National Eye Care Recovery and Transformation programme, a consultant ophthalmologist at Moorfields Eye Hospital, chair of UK Ophthalmology Alliance, and chair of professional standards at the Royal College of Ophthalmologists.

In a wide-ranging conversation, she told me that even before COVID-19, “in the world of optometry and ophthalmology we knew there was a big problem brewing – we just weren’t coping.”

COVID-19 has intensified this she added, saying: “We have a huge backlog of patients – how many, we simply don’t know. People with glaucoma and retinal problems need to be seen on time and the truth is they have not been. We are talking hundreds of thousands of patients who are being affected.”

But despair is not the order of the day, and Hingorani is quick to highlight the evidence to support the role of optometry to tackle the backlog.

“My experience through the shared care work I have done…is that patients were really happy to see their optometrist; they already knew them, and it was so much more convenient to arrange a visit locally.”

For Hingorani, the digital revolution is coming to eye care and will help to drive a new way of collaborating. Her two areas to look out for are:

1. Digital hubs – “By pulling all the data into one source, it gives us the opportunity to develop artificial intelligence, as we are seeing at Moorfields at its department of digital medicine”
2. Home vision monitoring – “Patients are in their own diagnostic hub, while in the comfort of their armchair.”