MINUTES OF A MEETING OF CALDERDALE & KIRKLEES LOC, HELD ON MONDAY, 1st FEBRUARY 2010 at 6.30pm
Present – Rena Souten (in the Chair), Graham Phipps, Stephen Allott, John Wright, Steven Selbie, Nora Bradley, Andrew Thornton, Steve Dando and Russell Ramsden.
1. Minutes of last meeting held on 30 November 2009 .
The Minutes had been previously circulated and were agreed.
2. Matters arising from the Minutes
Andrew Thornton sought clarification on Item 10 (Optometric Advisor’s Newsletter) as not clear from minutes what was agreed. Rena’s memory of the meeting was that we would invite the Optometric Advisors when we have something particular we want to talk to them about or if they ask to come and talk to us about something specific.
3. Apologies
Gareth Hart.
4. Members’ Declarations of Interest
Rena Souten – Director of LOCSU, WREC and Glaucoma Referral Refinement; Graham Phipps – nothing to declare; John Wright – Glaucoma; Steven Allott – Director of WREC and Glaucoma Referral Refinement; Steven Selbie – Glaucoma Referral Refinement and Diabetes Photography; Nora Bradley – Secretary of WREC and Glaucoma Referral Refinement; Andrew Thornton – Glaucoma Referral Refinement; Steve Dando – Glaucoma Referral Refinement; Russell Ramsden – Glaucoma and Diabetes.
5. Chairman’s Report
Rena had attended an extra LOCSU meeting earlier today, where the LOCSU business plan was discussed. Every LOC is being offered the opportunity to undertake a relationship mapping exercise, to identify those people at the PCTs that we need to be talking to and the people on the LOCs that should do the talking. It was agreed that Rena should contact LOCSU to inform them that the LOC would like to volunteer to be mapped.
6. Treasurer’s Report
Anna had submitted details of the LOC’s accounts.
Honoraria – After consideration of whether the honoraria should be reduced or increased for certain members, it was agreed that the figures should be retained at the same levels as last year. Anna to be asked to make the appropriate payments.
Physically Disabled and Visually Impaired Committee meetings – Rena will attend. Steven Dando volunteered to attend as well. Rena to provide information.
Levy – Members of the Committee needed to consider the level of the levy to be recommended to the AGM; the levy is purely for running the LOC and nothing to do with the Central LOC Fund (which was the amount of the voluntary levy, now fully paid to the Central LOC Fund and therefore empty, as agreed at the last meeting).
Two proposals were considered, one to reduce the levy to 0.75% and one to maintain it at the existing level. After further consideration, and the proposal by Andrew Thornton, it was agreed that the Treasurer should recommend to the AGM that the LOC should reduce the levy to 0.75% (5 votes for, 4 votes to do nothing).
7. Secretary’s Report
John Wright said he had very little to report, other than a Hot Brief was due to be sent out shortly; the last one was sent out by email, with hard copies only to those not on email (contractors only), reducing postage/printing costs. In Calderdale, have 14 email addresses for contractors out of 22 (so well over half) and 20 email addresses out of 46 for Kirklees. ABDO and FODO would be prepared to push their members to supply their addresses, which would help considerably.
It was agreed that this matter should be raised at the next LOC/PCT meeting for everybody to be provided with an NHS email address. The LOC Secretary would then be able to go to their directory and pull off all the optometrists’ names. When people change their Broadband supplier they don’t have to change their email address.
8. Parliamentary Lobby Sub-committee Report
Concern was expressed that we were running out of time and although people had been emailed, there had been no response whatsoever. Russell had taken it upon himself to find a list of prospective candidates in Halifax and sent some emails to those, but again, no replies received. If any responses had been received, Russell had planned to arrange a meeting at a practice, but hadn’t got as far as deciding who would be at that meeting.
It was agreed that a more co-ordinated approach was required. MPs will ask for a Friday or Saturday, when they’re in their constituency, unless they are prospective, in which case they can come any day they like. A list had been circulated of lobbyists they recommend we talk to, but they aren’t going to want to come in April because they will be canvassing pre-election.
It was agreed that we need to concentrate efforts and report back to each other by email by the end of next week. This lobbying is essential to get MPs on our side but also the opinion leaders in councils and PCTs, so that people are aware that LOCs exist.
9. Last LOC/PCT Meeting Report
This is a non-starter because the meeting was cancelled because of the weather. Now going to be 22nd February.
10. PCT Business Continuity Plan – Response.
Consideration was given as to whether we should respond to this or ignore it. Trevor’s viewpoints were considered relevant and it was agreed that John should write to the appropriate person to pass on those viewpoints. Rena to pass contact details to John.
11. Devolvement of GOS Budget to PCTs and its implications
Andrew had asked for this to be considered for two reasons; a) because interesting to note the subtle differences between the DoHealth document and what LOCSU are telling the LOC, and b) because of what was said at last week’s Cataracts & Diabetic meeting. The funding is being devolved down, with money available next year from the PCT’s fund. However, in future years there will not be a separate pot and PCTs will be looking to save money on GOS funding. The DoHealth document says the budget may have to go down by 7.7% the year after next.
It was agreed that it should be raised at the LOC/PCT meeting that we are still not sure what the remit of the new Optometric Advisers is; at one of the earlier meetings, we were told that commissioning new services was not part of their remit. It goes back to who we should be talking to and if they are not part of the commissioning process, who we should contact.
12. New Members training 28 January 2010 report – S Dando & J Wright
John went on the training, with Steve. It was very useful, and reassuring that there is a pool of people available who will have a definitive answer on any problems, personnel issues etc and the templates on enhanced services that they develop.
13. Enhanced Services – Cataracts, Child Referrals & Glaucoma
Cataracts – Andrew had circulated most information received. However, another budget received from the PCT today and tariffs increasing by a significant 20%, making it easier for us to justify our figures. First appointments are being increased from £110 to £124, and second appointments from £53 up to £67. A recent audit showed that 50% of people have been going back to the hospital for their pre-op assessment, and a biometric measurement has been done on a separate day (with another fee being paid); a two week appointment after the first cataracts, and then a return visit to hospital again following that. The aim of the new pathway is for the hospital to lose two of those appointments and, in doing so, enough money should be freed up to fund what LOC is proposing. If we get the pre-op scheme up and running we would also be sending less people to the hospital, so reducing the number of first appointments. More work required on the actual statistics, but scheme progressing nicely.
Child Referrals – Nothing to report, other than a reminder that it was promised over 6 months ago that this would be sorted out urgently. Agreed that it should be a future LOC/PCT meeting agenda item.
Glaucoma – It was agreed that somebody was needed to take over the lead, who knows the LOCSU format and our current format inside and out. We need to be talking to them now about the fact that we should have had an increase in our fee last year and didn’t. Andrew raised it at the last Calderdale meeting, but it should be raised again at the next LOC/PCT meeting and increased by the rate of inflation. Russell volunteered to take the lead on this,
Nora said that for the scheme to work effectively, they were looking to have everyone onboard, even those who don’t have the equipment. Most practices appear to have signed up, but a lot of practitioners who have signed up don’t seem to be using the scheme and, as an LOC, we need to find out why. If we don’t find out before the PCT does, there is a good chance of losing the Glaucoma scheme. Most likely reason is a new optom in a multiple, who has no idea about the scheme. Other issues may be the forms and lack of equipment or training.
We need to know who is doing it in Kirklees as well; Russell cannot get a grip on it if he only knows who is doing it in Calderdale.
A lot of work will be involved for Russell, because the next step is the ocular hypertensives now being handled by the hospital. The next stage therefore needs to be sorted out, a year on from NICE issuing its guidance; we have been referring people, who will now be coming back for them to be seen again and we’re going to refer them back in. It was agreed that Graham should help Russell on this stage.
On housekeeping, the College had issued new guidance, reminding everybody when using non-contact tonometry and it’s on the patient for the first time, and it’s high, they should repeat it again another four times before they start going on to referral refinement.
Also, if a patient is aged over 65, with pressures less than 25, and everything else normal, then don’t need to refer. If the patient is 80 or over, pressures less than 26mm and everything is normal, we don’t have to refer those either.
14. Public Response to Press Article in Huddersfield Press re Diabetic Screening
A copy of the text was circulated.
It was agreed that a response statement should be submitted, to reassure patients that if they have diabetes and they are used to having diabetic eye screening on the NHS and it is now not available to them, they can have a normal eye examination and some opticians will do more than that, albeit for a fee. This will remind patients that optometrists have a core competency in diabetic eye disease management, but we must not use the words “screening service”.
John to produce draft response, to be circulated to LOC committee members, before submission to the Examiner.
Steven Selbie suggested we should also write to GPs, to make them aware that this was badly handled by the PCTs at the commissioning stage and we told them that these problems would probably exist.
It was agreed that two letters should be produced, one to the press and a separate letter to the practice based commissioning people (where we can be a little more blunt). It was agreed to see what happens at the LOC/PCT meeting and then we could say “well we have to respond to the Examiner”.
15. Publicity, Website, Newsletters, Hot Briefs etc.
Feedback from training sessions is that the Hot Briefs are very good. They are relatively easy to produce and only concern is that they are getting longer and more regular.
Steven Selbie expressed concern that minutes were not on the website yet, because they might contain too much detail. It was agreed that as long as they contained nothing controversial or libellous, they should be published in their entirety, once confirmed at the next meeting, as a record of what was discussed and proof of how much is considered during meetings. An item would be added to future Agendas to consider those items to be discussed in private session (reserved minutes) as agreed by the Committee; the appropriate sections would be re-confirmed that they are to be in private at the next meeting when confirming the minutes as a whole. It would be an LOC decision and not that of an individual Committee member, in case something is queried in future.
16. AGM Preparation 21.4.10, Business Plan
The person that Rena had suggested inviting to the AGM could not attend. After consideration of a number of alternatives, it was agreed that Rena should invite John Hearnshaw to talk on a document he has written about the new DoHealth recommendations regarding Acute Opthalmic Services. These are based on a Red Eye scheme already implemented in Somerset but to be run out to all PCTs. John has already promised to email the document to Nora. His remit for the AGM will be to talk about the Somerset scheme and if he is not happy with that, we can withdraw the invite.
It was also agreed that John should invite LMC Chairmen, Steven Cleasby, the medical director Matt Walsh, Louise ???, Kirklees Chief Exec and Gary Snowball (WREC), LOC Chairmen from Bradford, Leeds and Wakefield, plus the Optometric Advisor to be asked to report to the AGM.
John had produced the bare bones of the Business Plan, based on the LOCSU template. Comments to be forwarded to John within next two weeks.
17. Any Other Business
Andrew reported that in the audit mentioned earlier in the meeting, no records could be pulled out for Huddersfield, so of the 500 records asked for, and 363 actually audited, all were for Calderdale.
18. Action Points
18.1 We are all going to talk to John about Business Plan and get back to him within 2 weeks re comments.
18.2 Rena to give John details of who sent the Business Continuity Plan so he can write back with Trevor’s viewpoints.