Open letter - IT connectivity for primary optical care

Open letter to Simon Stevens and Matthew Swindells at NHS England from the AOP, ABDO, FODO and LOCSU

Open letter to NHS England

Dear Simon and Matthew

We are writing to you urgently on behalf of the representative bodies for the community optical sector. Our members are one of the pillars of NHS primary care, delivering 13 million sight tests and many other NHS services in the community every year. They also have the potential to provide much more NHS care in primary settings in future. That is a key aim of the Long Term Plan, and would relieve the growing pressure on hospital eye services, the largest out-patient specialism by volume in the country. However, we are concerned and frustrated that it is being needlessly jeopardised by ongoing delays in providing IT connectivity between optical practices and the rest of the NHS.

As you will know, last year the All-Party Parliamentary Group on eye health recommended that NHS England and NHS Digital should “urgently implement IT connectivity between community optometry and the wider NHS to improve patient care and efficiency”, as part of its inquiry into eye clinic capacity problems. This relatively simple change is long overdue. Many optical practices still rely on faxes to hospitals, or letters to overstretched GPs, to refer patients into secondary care – in stark contrast to the vision of a high-tech NHS set out by the Secretary of State.

IT connectivity would also open the way for better two-way communication between primary and secondary providers, enabling more integrated care and the delivery of more services in convenient and cost-effective community locations. As you will know, connectivity is key to delivering NHS England’s Transforming Elective Care programme for ophthalmology and the forthcoming Getting It Right First Time report.

In the last two years, NHS England has twice identified potential primary care budget underspends of up to £10m, which we were led to believe would be used to fund optical connectivity. However, both times this opportunity fell away because the funds could not be used in the very limited time available. At a recent quarterly update meeting with NHS England and DHSC officials, officials told us they now believe it will cost only £750,000 to connect up every NHS optical contractor in England, using NHS Digital’s preferred “internet first” FIDO2 connectivity option. However, we were alarmed to be told that further progress in implementing this solution depends on identifying another underspend later this year.

This long-awaited project will offer benefits many times its cost – both in terms of immediate patient care, and the longer-term scope to deliver key elements of the Long Term Plan. However, the benefits clearly will not materialise if NHS England continues to rely on finding budget underspends which cannot be used in the time available. We therefore ask you to prioritise the relatively small amount of expenditure now required for IT connectivity between optical practices and the rest of the NHS from current budgets in 2019/20, to avoid the need to rely on an end-of-year underspend which may not allow enough time for implementation. This would ensure that the benefits for patients can start to be realised so that the optical sector can finally realise its full potential in helping the NHS meet the growing demand for eye healthcare in England.

We will be publishing this open letter and sending a copy to the Secretary of State for Health and Social Care, given his public commitment to overcoming obstacles to IT modernisation in all areas of the NHS. 

Yours sincerely, 

Sir Anthony Garrett CBE
General Secretary, ABDO

Henrietta Alderman
Chief Executive, AOP

Harjit Sandhu
Managing Director, FODO

Richard Whittington
Chief Operating Officer, LOCSU


cc: Rt Hon Matt Hancock MP, Secretary of State for Health and Social Care