The Hewitt Review: What it means for optometry

Last year, chair of NHS Norfolk and Waveney Integrated Care Board, Patricia Hewitt, was tasked with performing a review of how to enable integrated care systems (ICSs) to succeed.

Named the Hewitt Review, the high-level review was commissioned by the Government alongside the Secretary of State for Health and Social Care. As a result, a call for evidence was launched in December last year. The AOP’s clinical and professional director, Dr Peter Hampson, shares insight into the aim of the review, what it means for optometry, and the AOP’s response.

What is the aim of the Hewitt Review and why was it established?

The review has been set up to consider the oversight and governance of ICSs and how best to balance the opportunities and burdens they may bring. It is a slightly unusual consultation as ICSs are in their infancy and much of the good work they aim to do will not yet be benchmarked or performance managed in a meaningful way.

Why is the review important to optometrists and what they do?

The Health and Care Act 2022, amongst other changes, replaced Clinical Commissioning Groups (CCGs) with ICSs. ICSs are larger commissioning and geographical structures with the aim to provide a better way to integrate and join up different aspects of care across local areas. As the vast majority of enhanced services and shared care that optical practices provide will be commissioned by these bodies, it is important that we ensured that the voice of the optical sector was heard.

What is the AOP doing to respond to the review and why?

This review came with a tight deadline at the end of a busy year and bridging across the Christmas and New Year period. Despite that, the AOP managed to convene two meetings with sector partners, one immediately either side of the holiday period, to help project a united voice to the NHS and the Department of Health and Social Care (DHSC).

We hope that the Hewitt Review will promote the existing good practice and facilitate much needed IT connectivity that will truly enable new ways of managing patient care. This will help to fulfil one of the primary aims of the review, which is to empower local leaders

The call for evidence for the review has recently closed (9 January). What were the key points that the AOP made in its response?

The AOP, along with sector partners, focused on the existing examples of locally commissioned services, many of which have rich evidence bases for how they can help local health systems and in particular patients. Given the remit of the review, we also provided comment on the need for appropriate, but not burdensome, data collection, and how optical practices could help with wider NHS aims, along with a note of caution that ICBs are still only at the very beginning of their journey and that it may be too early to appraise what is working well. We hope that our response will both inform and highlight some of the important relationships that need to be developed across primary care and into secondary care delivery.

What happens now that the call for evidence has closed?

There will now be a period where the DHSC review team analyses and appraises the submissions before producing a final report no later than the 15 March.

What would the AOP like the outcome of the review to be and why?

There are common themes that have been running through optometry in England for many years, including the inconsistent commissioning of enhanced services such as minor eye conditions services, the COVID-19 urgent eyecare service, and shared care for glaucoma. These are services with proven clinical effectivity, but for some reason this hasn’t led to the universal uptake that would have been expected. We hope that the Hewitt Review will promote the existing good practice and facilitate much needed IT connectivity that will truly enable new ways of managing patient care. This will help to fulfil one of the primary aims of the review, which is to empower local leaders.

To read the AOP’s response to the Hewitt Review call for evidence, visit its website.