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What will the first sweeping changes to NHS and eye care provision create from the White Paper?

What will the first sweeping changes to NHS and eye care provision create from the White Paper?

Integration and Innovation, the white paper in February is the first serious attempt to reform the Lansley reforms of 2012.

The reforms would allow government to transfer functions at arm’s length without primary legislation. So even robust bodies like the CQC and NICE could feel the wind of change or even be closed down.

However the pandemic has shown that intra professional working has proven to bring swifter and in the main harmonious new working practices and pathways often involving cross party actions over a span including primary, secondary and yes even social care.

If these successful actions are the drivers for change then the Integrated Care Systems (ICS) that have been influential in these moves will be heralded as the way forward and may make way for easier negotiations in primary care pathways. That is a hope but the devil is in the detail and only time will tell. The ICS will be given a statutory footing according to the white paper.

Richard Murray, CE of the King’s Fund says”By sweeping away clunky competition and procurement rules, these new plans could give the NHS and its partners greater flexibility to deliver joined up care to the increasing numbers of people who rely on multiple different services.”

Of course flexibility to some is a free for all to others. But if we truly want to see an end of turf wars between professions and an improvement in patient journeys, as long as safety is sacrosanct, does it matter who does what along a patient pathway?

Rules that have appeared to have made sense in the past have often made electing for a NHS service more difficult. You might be surprised how many direct phone calls PHN receives each week fro m elderly or vunerable patients asking for help in finding Opticians who provide Home Visits in their area.

We try and help but many want an independent practitioner not a large domiciliary company and we struggle as many independents have not informed our education site that they provide the service. We do go the full mile and contact local independents by phone asking for information, but almost always we are told that no optician wants to, or can afford to do home visits.

As the ICS role will be to look at help in community care and social care this might be one area they could be more flexible in adoption.

NHS England – eye care priorities for 2021/22

In its latest priorities and operational planning guidance, NHS England (NHSE) says it hopes to “reduce variation in access and outcomes”, by maximising elective activity and “taking full advantage of the opportunities to transform the delivery of services”. As part of this initiative, it expects the NHS to “implement whole pathway transformations and thereby improve performance” in “eye care with support via the National Pathway Improvement Programme”.

Its implementation guidance sets out how NHSE plans to shift some of its direct commissioning functions to new Integrated Care Systems (ICSs). Although NHSE is still consulting on legislative change proposals, it “anticipates” ICSs will take on general ophthalmic commissioning from 1 April 2022 onwards.

What FODO says:

David Hewlett of FODO said: “FODO and every other optical body has stressed the importance of preserving the national sight testing and case finding service and infrastructure on public health grounds.”

He added: “Irrespective of where in the system contracts are held, the priorities for FODO and the other optical bodies , must be to protect choice and access for patients and minimise bureaucracy for primary eye care contractors.”

FODO has also responded to the Health and Select Committee inquiry into healthcare reforms, calling for the national sight-testing and case-finding service to be preserved and patient choice to be strengthened Read FODO response here

Meanwhile like Pandemic Relaxation powers Wales they also make the first moves in eye care reforms and optometry

Following the 11 March announcement of plans to reform eye care services in Wales, the Minister for Health and Social Services, Vaughan Gething, has announced that over £8.5m will be “invested to create a new Electronic Patient Record and digital Electronic Referral system for eye care in Wales”. National digital eye care patient record system.

NHS Wales and the Welsh Government has published “Future approach for optometry services.” Pages 38 to 42 provide a good summary table of what the government hopes will be delivered across Level 1 to 4 of the new GOS model.

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