Eye health need to be ‘innovatively disruptive’
The eye health sector has a crucial role to play within New Care Models and Vanguard reforms, NHS England’s Head of Primary Care Commissioning told the NOC.
Dr David Geddes reminded delegates that visual impairment was a real problem in relation to an ageing population, rising numbers of people with co-morbidities and long term conditions.
He said that better and earlier intervention of community eye health services could help get upstream of some of the problems that made older people more reliant on costly social and personal care.
And he urged the sector to make its voice heard though LEHNs, and through better evidence and outcomes data, to educate and influence Commissioners about the need for local eye health services as part of their local primary care strategy.
Geddes, a practising GP in York, told delegates: “Visual loss arising in the context of aging and co-morbidities bring opportunities for community eye health services to better support patients.
“By 2035 almost a quarter of the population will be over 65 and a growing number over 85.
The health chief said the NHS needs to move away from “single disease” approach that still typifies secondary care services and highlighted an RCGP study estimating primary care costs for LTCs will mushroom by £1.2 billion.
Delegates heard that people with vision impairment are twice as likely to have falls, have a higher prevalence of hip fracture and that the direct and indirect cost of blindness in the UK is £28 billion per annum.
“Loss of vision is connected with entry into care homes and care support. With constrained budgets, can we really have growing numbers being dependent earlier on social care?” he asked.
He acknowledged that collaboration and communication are “still missing” between GPs and optometrists, dentists and pharmacists in primary care.
Geddes made the link between a lack of eyesight assessment and huge difficulties in day-to-day functioning causing a “double jeopardy” for those with long term conditions,be they dementia or mental health issues compounded by social isolation.
“We need to think about it across the whole spectrum of health we deliver and the implications for local primary care strategy,” he said.
He called on those who work with LEHNs to use them to ensure that local strategies addressed clinical services and public health issues that arise as a consequence of ageing and disability.
“If your local CCG is not that interested in eye health you need to be able to highlight,for example, that the falls that they are paying significantly to manage could well be reduced if theyadopted a more holistic approach on patient care.”
He said that we need to redefine how we carry out local needs assessments and become better at measuring outcomes.
“There is no single solution to the ‘wicked’ problem of where we are. We need to be able to test things out. We need innovative disruption but we still need stability. We need good clinical engagement and good patient involvement. In reality we have easy to ignore groups – rather than hard to reach groups.
Dr Geddes said there were no national solutions and that we need to go beyond old ways of contracting and delivering health. He revealed that the NHS was looking at “health care navigators” who would steer patients to best source of care earlier in process, rather than GPs being the first port of call for all patients.
Follow this link to the full presentation.