The “wind is blowing” towards clinical commissioning groups (CCGs) developing more integrated, out-of-hospital local care, NHS England primary care co-commissioning programme director, Dr Julia Simon, told attendees at the Westminster Health Forum (12 May).
Increasingly, optometrists and other primary care providers like dentists and pharmacists will become part of these initiatives, she emphasised, adding: “This is the direction of travel … It’s still very early days, but the signs are very positive.”
But Dr Simon warned that progress might be slow, explaining: “Don’t expect anything rapid to happen.”
Eye health and vision impairment charity Vision2020 UK chief executive, Mercy Jeyasingham, asked Dr Simon about using the skills of optometrists in the community to prevent the flow of patients into secondary care.
Dr Simon replied: “This is still a little way off.”
Dr Simon emphasised that the feedback from CCGs is that integrated eye care is not their first co-commissioning priority. “What matters most is community pharmacy,” she highlighted.
Ms Jeyasingham told OT that: “It was disappointing that they’re starting with GPs and then pharmacists … I think when it comes to eye health, really it’s optometrists that need to be picking this up.”
At the forum, Dr Simon also emphasised that some CCGs saw primary care co-commissioning in a very different light from others. She highlighted: “Some have said, ‘Give it to us,’ while some have said, ‘Never give it to us.’”
Yet her Westminster Health Forum co-speaker and NHS Providers head of analysis, Sivakumar Anandaciva, emphasised that he saw big changes afoot within five years.
He envisioned that by 2021, outcome-based commissioning could be a reality.
He gave the example of Moorfields Eye Hospital measuring its success not by the number of cataract surgeries it does, but by the cases of preventable blindness that it and its multi-disciplinary team can prevent.
Mr Anandaciva said that when CCGs started to look at enhanced services provided by community optical practices, it demonstrated that they were on the right track. “We’re slowly catching on to that,” he emphasised.
Local Optical Committee Support Unit managing director, Katrina Venerus, told OT that: “Given the increasing pressure on hospital eye services, as highlighted recently by the Royal College of Ophthalmologists, and the drive to expand primary care, it is frustrating that developing new models of eye care is not a national priority for NHS England, or even a local priority for every CCG.
“However, we are making progress in a number of areas where local optical committees are working with commissioners and acute trusts to successfully implement pathways that utilise community optometrists as the first port of call for eye health along with bringing monitoring of conditions such as glaucoma into the community,” she highlighted.
Ms Venerus emphasised that sharing evidence of what works is key, adding: “We are delighted to be working with partners from the sector to support the NHS England eye care event that takes place next month.
“The event will showcase examples from across England to help commissioners understand what can be done to address demand and capacity pressures in the hospital eye service.”