Optometrist and Lancashire & Morecambe Bay LOC member, Timothy Bagot, shares insight into the delivery of a MECS service in his local area that was launched three years ago
23 August 2019
01 In the Lancashire & Morecambe Bay area, we offer a suite of enhanced services, from glaucoma repeat readings and OHT monitoring to post-cataract assessment, and much more.As a local optical committee (LOC) we were keen to have a minor eye conditions service (MECS) in the area for quite some time before it was successfully commissioned by our local NHS Foundation Trust in September 2016.
Offering a MECS service was important to the LOC, as well as many local practices, because it increases patient access to a high level of care closer to home, without having to travel to the hospital, all in a more timely manner.
Typically, living in a rural area, means that eye care services have become a lot more accessible for patients, while it also provides practitioners with much more variety in what they do. Ultimately, it is good for practice finances too.
It strengthens the bond between the practice and the patient because you have more interactions with them than you would normally
02 Any practice within the local area is able to provide MECS if they wish, as long as they have gone through the required accreditation.After the service was commissioned by the trust as part of its Better Care Together initiative, there were a range of tasks at implementation stage that had to be completed prior to rolling out the service. This included setting up the care pathways to ensure that patients could access the service, ensuring the required IT systems and documents were in place for practices using the service, as well as establishing process protocols.
It was also important to the trust that the LOC could demonstrate what is referred to as ‘adequate coverage.’ In other words, we had to show that we had enough practices spread across the vast geographic area of Morecambe Bay to be able to provide MECS to patients efficiently.
When the service was initially launched, 23 practices signed up and we subsequently provided almost 4500 MECS appointments in the first year. Today, a total of 31 practices take part in the services and we have provided mover 16,000 MECS appointments to date.
03 There are various ways that a practice can integrate MECS into its daily work plan.At the practice where I am an optometrist and director, Bagot Opticians, we keep one or two appointments free each day for MECS appointments. Mondays have traditionally been very busy days and we run a rolling clinic on a first come, first served basis from 4pm onwards. From a clinical diary point of view, we are flexible and have to get creative sometimes.
Prior to being able to provide MECS in our practice, we had to make sure that all of our practitioners were accredited – this is a process that we continue to do when we take new practitioners on board.
Training was extended beyond the clinician too, which is very important with MECS. It’s very easy when someone calls up for an appointment to assume that they simply want to book in for a routine sight test. However, front of house staff are now trained to ask the right questions to ensure that people who attend the practice for MECS are managed in the appropriate time scale.
It means that eye care services have become a lot more accessible for patients, while it also provides practitioners with much more variety in what they do
04 We are a trust commissioned service rather than a Clinical Commissioning Group commissioned service.As a result, offering MECS has enabled us to build a very close relationship with the trust. Prior to offering MECS it could feel like it was very much us and them, but now there is a much more integrated way of working in place. Many ophthalmologists are happy for us to ring up and ask for advice if we have a tricky case, for example.
The strong relationship also means that have more involvement in local collaborative healthcare meetings and are invited to the trust’s training events, while some ophthalmologists come to our events as well.
This is important as the future of optometry lies in working collaboratively with hospital trusts. There are ultimately a lot of patients who can’t be managed by the hospital due to capacity demands and they will need to be seen in the community. By building a relationship, I think that opens doors to a lot more services in the future.
05 There are many benefits of offering a MECS service in practice.
Firstly, your patients like it. It strengthens the bond between the practice and the patient because you have more interactions with them than you normally would.
Secondly, while MECS covers the optometrist’s core clinical skills, it also provides practitioners with the opportunity to utilise their problem-solving skills that can provide a lot of job satisfaction.
Thirdly, from a business point of view, it is very beneficial. It supports from a patient retention and a practice building point of view, but it also makes you more appealing to new staff as it is a very enjoyable and rewarding experience as a practitioner.
Image credit: Getty/Greenleaf123
- As told to Emily McCormick.