Commissioners' Guide - page 1

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Introduction
The purpose of this Guide is to explain the benefits to commissioners of the single provider model developed by the
Local Optical Committee Support Unit (LOCSU).
It describes how commissioners can utilise their local
Primary Eyecare Company
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as the Prime Contractor to allow
them to work with all optical practices in their area to give patients the best access to community services and choice
of provider, without the complexity or cost of having tomanage individual practitioner contracts.
The Guide also summarises how commissioning community eye health pathways can reduce pressure on existing
NHS services and help prevent avoidable sight loss.
This is essential information for all commissioners who are involved in planning eye health or ophthalmology services.
Why should commissioners be interested in eye health services?
Eye health services currently have a low profile, yet involve a high volume of patient episodes. Commissioning
effective and efficient services is an increasingly important way of reducing avoidable sight loss. Eye health
problems and sight loss increase with age ² and withmore than 10million people in the UK currently aged over 65
– with that number predicted to nearly double in the next 30 years – growing numbers of people will be affected.
Currently around twomillion people are living with sight loss in the UK, yet it is estimated that up to 50%of sight
loss is preventable. There is a clear economic case for early and effective intervention to prevent vision impairment.
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This rising number of older people living with eye health problems, combined with the availability of new
treatments for conditions such as wet AMD has increased demand for hospital eye services. In England,
ophthalmology has the second highest number of outpatient attendances for any speciality in the NHS.
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Patients with eye health problems can also create extra pressures on already stretched Accident and Emergency
departments. Nearly 350, 000 patients attend A&E in 2011/12 with eye problems
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, yet it is estimated that
more than three quarters of patients who attend hospital emergency units with eye conditions have non-serious
conditions that could be treated elsewhere.
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Improving eye health and preventing avoidable sight loss will benefit lives of many people who would otherwise
have been restricted by sight loss and whomay face social isolation. It will also savemoney for the NHS, as it will
reduce the direct pressures on hospital eye departments and the indirect costs fromvision-related problems like
falls and fractures.
Commissioners’ Guide to
Primary Eyecare Companies
The Single Provider Model for NHS Community Eye Health Services
Community eye health pathways can help commissioners achieve
both national targets and local health priorities
Since 2004, the Department of Health has been trying to encourage the delivery of more routine andminor
emergency eyecare outside hospital in community optical practices tomeet this need. Community eye health
pathways are central to QIPP and Right Care delivery, as they improve patients’ access, convenience and choice
and provide
the right care in the right place at the right time and at the right price
.
Community eye health pathways can:
reduce pressure on A&E departments and ophthalmology outpatient clinics by providing diagnosis and
management of minor eye conditions
free up hospital capacity to reduce avoidable sightloss bymaking sure that patients receive timely
interventions
support GPs who don’t have the time or equipment to assess all eye conditions.
©2014 LOC Support Unit
See page 8 for sources.
1 2,3,4,5,6,7,8
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