LOCSU Annual Report 2013/14 - page 21

CASE STUDY – Adding Value
A more co-ordinated approach with the Optical Lead
using a wider evidence base, best practice examples
and national models, paid dividends in Cumbria where
Commissioners agreed to a new IOP Repeat Readings
Scheme that improved on the existing pathway and
added value.
Zoe Richmond had worked with the LOC, who, although
not technically in the North East, decided to join under
the aegis of Primary Eyecare North East (PE(NE)) and
secure the benefits of being part of a regional company.
Zoe explained: “As LOCSU Optical Lead, I was able to get
the ear of the Commissioners and negotiate on behalf
of the LOC to help secure the service.”
The IOP Repeat Readings will involve up to 60 practices
across Cumbria seeing about 1,000 patients as part of
the pathway and is an improvement on the previous
service. “It has better sign up from practices and gives
Commissioners improved quality assurances.
“The 12-month contract brings an uplift in fees, and
the service specification is improved to bring it in line
with the LOCSU pathway. The service also utilises the
OptoManager module and the payment disbursement
Outlining the dual benefits for Commissioners and
patients, Ray Beale-Pratt, Allerdale and Copeland
Finance Business and Performance Manager, NHS
Cumbria Clinical Commissioning Group, said: “We first
came across Primary Care North East when we were
reviewing the options for our Glaucoma Refinement
Scheme which, at the time, was characterised
by low levels of take up from optometrists, and
correspondingly, limited effectiveness in preventing
patients attending hospital when they did not need to.
“We studied alternative refinement schemes and were
attracted by the breadth of acceptability and scope of
the specification being rolled out in the North East. We
were particularly struck by the apparent benefits for both
Commissioners and providers. Commissioners had a
single body with whom to negotiate which represented
the collective optical practitioners in the area. This
avoided the difficulties of bringing together a large
number of independent practitioners to agree a single
solution. From the providers’ perspective, it gave them a
stronger and more focused entry point into the CCG.
“Operationally, it is a much more streamlined process
for the CCG. There is just one monthly transaction
between the CCG and PE(NE) rather than the large
number of small value transactions with each
practitioner that would otherwise be necessary.
The flow of activity information regarding the service
is also much more effective with PE(NE) acting as the
single point of contact for data management.
“The service is in its early stages but the CCG looks
forward to the first stage of evaluation and is confident
that the results will demonstrate a better service for
patients, providers, and the Commissioner. We also
expect that, as a consequence of this service, challenges
around the pressures of demand and capacity within
secondary care ophthalmology will be alleviated,
which in turn will contribute to shorter waiting lists
and waiting times.” – Ray Beale-Pratt, Allerdale and
Copeland Finance Business and Performance Manager,
NHS Cumbria Clinical Commissioning Group.
Explaining the benefits of the LOC Company model to
both the LOC and Commissioners was the start of the
process of increased collaboration and adding value to
services in Oxfordshire by LOCSU and the Optical Lead.
Oxfordshire Clinical Commissioning Group had an IOP
Repeat Reading Service in place and was looking at
their options for recommissioning, but did not want it
to involve a number of contracts.
LOCSU Optical Lead, Poonam Sharma, assisted
Oxfordshire LOC in discussions regarding the single
provider model with the CCG, providing examples from
across the country where this model has been working.
They clearly articulated how the single provider model
encourages more practices to participate by being an
inclusive model.
In addition, the LOC and the Optical Lead saw an
opportunity for expansion of the existing service, by
providing evidence-based data from similar services
commissioned elsewhere that also included visual
fields repeat testing. The CCG could see this would
bring additional value to patients and agreed to adopt
the proposed approach.
In fact, the CCG has found the process so beneficial
that they are now looking to commission a Minor
Eye Condition Service using the LOC Company single
provider model.
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