The College’s response to the publication of the NHS’s Medium Term Planning Framework for England

The College’s response to the publication of the NHS’s Medium Term Planning Framework for England

Dr Gillian Rudduck MCOptom, President of The College of Optometrists, commented, “The College of Optometrists is supportive of the NHS’s commitment to improving access to primary care and reducing unwarranted variation in access in England, but we are deeply concerned by the omission of primary eye care as a priority opportunity in the Medium Term Planning Framework.

“Ophthalmology is currently the largest outpatient speciality in the NHS, with almost 9 million appointments in England a year and long wait lists that lead to avoidable sight loss. As one of the four pillars of primary care, alongside GPs, pharmacy and dentistry, optometry is integral to increasing earlier intervention and reducing appointment pressures on hospitals and waiting times for patients. This framework is a missed opportunity to commit to universal funding and commissioning of enhanced primary eye health pathways across England as a critical service in Neighbourhood Health Plans.

“Optometrists have the clinical skills to provide a wider range of enhanced eye care services in the community to meet patients’ needs, including urgent eye care, pre- and post-cataract care, and glaucoma referral refinement services. For example, evidence from urgent eye care schemes that have been commissioned in some areas of England show that optometrists can safely manage most acute eye cases in the community, delivering timely care while reducing unnecessary hospital visits.

“We encourage ICBs to include enhanced primary eye care pathways as part of their detailed 3 year plans to deliver on the stated aims of the 10 Year Health Plan and enable all patients to access timely care and treatment close to home.”

FODO’s Response 

Harjit Sandhu, FODO chief executive, said: “The latest planning framework proclaims the ‘end of short-termism’ and promises to create headroom to tackle the ‘fundamental problems’ the NHS faces. It goes on to state that ‘most importantly, it marks the return of locally led ambition’ in the NHS.

“While the plan does not explicitly mention primary eye care, it establishes some core operating principles that strategic leaders will pay close attention to, including that top-down reforms are unlikely any time soon and local systems will be expected to drive change. These systems will be responsible for shifting care out of hospitals, closer to where people live. Digital first remains a key pillar, although financial viability, payment reforms (including dismantling block contracts) and balancing the budget are still priorities and key enablers for delivering the 10 Year Plan.

“Primary eye care can find some assurance in the clear commitment to put patients in control of their care, offering them more choice and empowering them to access care closer to home. While the use of non-evidence-based indicative activity plans remains a risk to enhanced eye care service provision, the latest planning framework helpfully sets out that ICBs must increase community health service capacity to meet growing demand, expected to be 3% nationally per year. We will be working with all PECS and LOCSU to ensure we use this and other strategic levers for the benefit of patients in local systems.

“Our members are the leading providers of primary eye care in England, and with them and our sector partners, we will continue to work together through strategic partnerships to protect and advance access to eye care services in the years ahead.”

While welcoming and supporting the NHS’s ambition to deliver faster care, Max Halford, ABDO clinical and policy director, said he was disappointed that “primary eye care, and the role of dispensing opticians in delivering this care, have not been explicitly recognised in the planning framework.”

He added that General Optical Council research shows that 34% of dispensing opticians are already involved in delivering enhanced eye care services for their patients and play an important role in supporting long-term eye health as part of the multi-disciplinary eye care services team.

Speaking about the next steps, he said: “We must continue to work as a sector to ensure we tackle gaps in commissioning enhanced services, which is why as a member of the OFNC we published the recent joint statement with the College of Optometrists and will continue work to develop national frameworks that enable the NHS to deliver consistent eye care services at local level and tackle the current postcode lottery.”