OFNC advises profession against committing to “unfunded” ERS until negotiations complete

The Optometric Fees Negotiating Committee (OFNC) has advised Local Optical Committees (LOCs) and General Ophthalmic Services (GOS) contractors not to make any commitments to the electronic referral service (ERS) rollout until national negotiations are complete.

The OFNC has previously warned that plans for a national roll-out of ERS to practices with an NHS contract in England, announced earlier this month, were not fully costed and did not offer appropriate investment for delivery.

In a briefing published today, 24 June, the OFNC acknowledged that LOCs and GOS contractors have been approached directly by NHS England to encourage participation in the ERS rollout, “without any costed plan to support implementation in our sector.”

Dr Peter Hampson, chair of the OFNC, wrote: “While we understand the NHS’ managerial imperative to try and accelerate ERS rollout, this approach is premature as far as primary care optometry is concerned.”

“Important developments like ERS cannot be run as unfunded burdens on GOS as this may create unintended patient safety risks,” he shared.

As a result, the OFNC is strongly advising LOCs and GOS contractors against making any local commitments about ERS adoption until current discussions at government level are complete.

Important developments like ERS cannot be run as unfunded burdens on GOS as this may create unintended patient safety risks

The issues behind ERS funding and implementation

Explaining the issue of ERS funding, the briefing for LOCs and GOS contractors explains: “Regrettably the bulk of ERS implementation at practice-level and ongoing running costs are as yet unfunded, apart from a small amount of NHS infrastructure and training money to be spent over a four-year window.”

This would mean contractors would be required to put in significant new funding to make the plans work, the OFNC argues.

Hampson said: “Attempts by officials to rush out another IT transformation project that will require unfunded ‘goodwill’ is not something our sector can support.”

"This would also be further evidence of NHS England creating additional unfunded burdens on primary eye care practices that are the only part of the system which stands not to be remunerated for the extra work involved,” the briefing stated. The letter continued: “This is in stark contrast with the rest of the NHS, including other areas of primary care.”

Gathering evidence of cost pressures and unfunded activity

The OFNC also provided feedback from its recently held a survey to assess GOS workload, gathering evidence about unfunded activity linked to GOS delivery and related work, in addition to other cost pressures.

The survey closed on Monday (22 June) having received more than 1100 replies, with the OFNC commenting on the “high levels of contractor engagement.”

The survey results, which are currently being reviewed, will inform the current year’s fees negotiations with Government.

Clear themes have emerged from the results, however, Hampson said: “The vast majority of you can no longer afford – and are unwilling to continue – to provide services as goodwill without funding.”

OFNC has highlighted to Stephen Kinnock, Minister of State for Care, and Department of Health and Social Care officials “the significant stresses on practices and staff already caused by the low level of GOS fees.”

Actions advised and the ongoing national workstream

The briefing letter to LOCs and contractors sets out advice not to make any commitments to ERS until the national negotiations are complete and it is known what is, and is not, feasible in terms of funding.

This includes transitioning from, or building on, existing local versions of ERS.

The OFNC has also asked that LOCs and contractors make clear at any meetings with integrated care boards, NHS regions or trusts that: “ERS – and any other developments of this type – must be funded at practice level.”

The body has highlighted that OFNC members are available to participate in local meetings alongside LOCs and national NHS England colleagues. This can be arranged by sending an email marked FAO CEO to [email protected] or [email protected].

The OFNC also outlined ongoing workstreams at the national level – beginning with the collection of evidence around unfunded burdens affecting practices, which has now been completed.

Kinnock has established a ‘task and finish group’ with the sector to look at the evidence and potential ERS costs for further discussion.

This will be held on 29 June, once the analysis of the OFNC survey data has been submitted to the DHSC team.