Transcript PEC [HoWM] launch presentationx

Sandwell and West Birmingham
Solihull
Eye Care Services
Launch Evening
Guest Speakers
Birmingham LOC
Sandwell LOC
Solihull LOC
Webster Health - Gian Celino
Introduction
We are launching 3 schemes simultaneously:

Cataract

IOPRR

MECS
Introduction
We will be throwing a lot of information around…
give it some time
Questions as we go
Contract awarded
competitive tender
process
Clinical
Governance
Requirements
The LOC communicates with
PEC (HoWM) Ltd both giving
and receiving feedback.
Directors
Charles Barlow
Ian Hadfield
Peter Rockett
Peter Bainbridge
Dan Saunders
David Stevens
CCG
Webstar
LOC
Practice
Practice
PEC(HoWM) Ltd
Practice
Practice
Practice
Practice
Practice
PEC (HoWM) Ltd
are responsible for
all practice
owners.
This makes us
pretty tough on
compliance.
Your commitment

Information Governance

Accreditation

Infection control

Safeguarding

Patient care
the right care at the right time [follow the protocols]
Everything is done via Webstar, Optomanager Software.
Eliminating administration, generating insight
The package of web platforms called OptoManager has been
developed for Local Optical Committee Support Unit (LOCSU) by
Webstar Health. The technology virtually eliminates manual
administration of optical services, helps with data collection and
generates insightful performance reports.
The Services
Sandwell and West Birmingham
•
Cataract
•
IOP repeat measures
•
MECS
Birmingham Cross City
Birmingham South Central
•
Cataract
•
IOP repeat measures
Solihull
•
Cataract
•
IOP repeat measures
•
MECS
Who is entitled to these services
The services are commissioned for patients registered with either a
Sandwell and West Birmingham CCG GP or a Solihull GP
We will only pay for appropriately registered service users.
We will not pay for people who just live in Solihull, Sandwell or
Birmingham.
– it all depends on who their GP is not their postcode
Who is entitled to these services
So a patient whose GP is in Birmingham Cross City or Birmingham South Central
CAN NOT be seen under the MECS service
You will have to manage through GOS /private sight test and any additional private
services you provide.
You are advised to fully explain any fees before providing additional private services
Cataract Referral Pathway
Reduce unnecessary referrals to the hospital eye service and provide a
more cost effective service with a greater number of patients being
managed within the primary care setting.
 Requires dilation appointment, separately or at the same time as eye examination
 Patient Self Assessment Questionnaire
 Patient Information Leaflets
Cataract Referral
Patient meets eligibility
Offer Choice of provider
Complete record online and Optomanager will Fax
referral to chosen provider
and copy to GP for information
You can print off the record and referral for your
records
IOP Repeat Measures Service
Referral refinement has been shown to reduce onward referrals by
as much as 77%
The IOP repeat measures service provides primary care repeat
readings to deflect unnecessary referrals to secondary care.
Patients who are identified as having IOP > 21 mmHg and no other
signs of glaucoma during a GOS or private sight test will have
immediate slit lamp GAT or Perkins tonometry assuming the
optometrist is contracted to provide the service.
Minor Eye Conditions Service (MECS)
Purpose of Service
Using the skills of primary care optometrists to triage, manage and
prioritise patients presenting with an eye condition,
To deal with recent onset eye problems that are not appropriate for
sight tests and to reduce referrals by GPs and Optometrists to
secondary care
Experience elsewhere shows 70-80% deflection
It is no good seeing patients and referring most anyway
This will be monitored closely
Minor Eye Conditions Service (MECS)
Patient care will be improved by:

Reduction in unnecessary referrals to eye casualty clinics thus
supporting CCGs and NHS trusts to manage ophthalmology capacity

More cost-effective care

Speedier access to care

Care closer to home in a more convenient setting

Easier access for patients through self-referral

Retention of patients in primary care where possible

Reduction in antibiotic prescribing
MECS
You will need to provide





Triage [staff training, forms available]
Same day appointments
48 hour appointments
Report to GP….generated
Referral if required
MECS Triage
Take care
Flashes and Floaters in particular
VA
Dilate
Check for Schafer’s sign and record
Indirect exam, 8 directions of gaze, wide field Volk
Careful record
Give F & F advice sheet
Give drops advice sheet
MECS is for All (relatively urgent) minor eye
conditions
BUT
Not for:
Wet AMD found during ST
Refining referrals from a ST (e.g. glaucoma/cataract)
But can use for F & F
F & F stable for >3m
2nd incident of F & F within 1 month of 1st (follow up)
Repeated dry eye within 4 months of 1st MECS
Repeated removal of lashes within 4 months of 1st MECS
Where a sight test would be more appropriate
Take care
More not for…
Adult squints
Longstanding diplopia
Repeat field tests
AMD
Previously identified
Severe eye conditions
needing HES
Herpes Zoster
Tumours
Yet more not for…
Where other enhanced
serviced are appropriate
Cataract referral
Cataracts post-op
Repeat IOP
Diabetic retinopathy
MECS outcomes
GP report
Treat and discharge
Reassure and discharge [patient leaflets available]
Follow up
Refer to GP
Routine referral
Urgent referral
Emergency referral
Direct referral to eye casualty clinic
If your patient requires Eye A&E or fast track Wet AMD
Make sure everyone in the practice has a copy of the protocol
from Sandwell and West Birmingham NHS trust City Hospital

For A&E Telephone first

Triage options are same day or urgent clinic 24/48 hours

Patient contact details (telephone numbers) and brief referral
details . Give patient a copy to take with them.

Fax Wet AMD to the fast track clinic
Important Points
Record all MECS patient contacts on practice record card.
All patients must be seen by optometrist:
Within 24hrs for urgent
Within 48hrs for routine
Optometrists must, within reason, be able to offer a MECS examination
within 48 hours of the day that the appointment has been requested
(excluding weekends and public holidays) unless it is for routine
assessment.
*If you don’t have an appointment you must find them one elsewhere
Optomanager demonstration
This service would not be possible without Webstar Health
Gian will run through how Optomanager works
Part 2
Quality Issues and Auditing
A full Audit trail will be established so that detailed analysis of outcomes
etc. can be monitored.
Outliers will be asked to explain.
Patient Satisfaction Questionnaire must be completed
Therapeutics
Topical Eye Formulary
We must bear in mind that GPs are rightly, very concerned about costs of their drug
budget. if you know a patient is going to request a prescription from their GP, Please
initially choose first line ocular lubricant.
For patients using a dry eye preparation long –term, and where allergic response may
be a problem, then recommend a suitable preservative free lubricant. Preservative free
products using a bottle with a microbial filter or a “wine bag” type design generally work
out cheaper to supply and use than do single dose preparations. Hycosan is generally
available on prescription.
Communications
Will provide Leaflets & Posters to





GP Surgeries
Pharmacies
NHS111
Yourselves
Anything else we can afford




Birmingham LOC website
Sandwell LOC website
Solihull LOC website
The Company website
http://www.loc-net.co.uk/birmingham
http://sandwell-loc.co.uk
http://Solihull-loc.co.uk
www.eyecarewm.co.uk
To do List
Nhs.net
MECS email
Testing MECS
MECS software tweaks
oh! and the contracts
LAUNCH DATE
1st March 2016
How to Start…
1. Register with Webstar
2. Book the OSCE quick! (dates to be confirmed)
3. Certificates ready to upload onto Webstar
4. NHS.net emails? (To be confirmed)
OSCES
Most have already completed these
Thankyou for your support and patience
More sessions in the process of being organised.
BUT
If you haven’t completed or even started your MCQs get signed
up more details in your pack
LOCSU training provided by WOPEC
Request your unique WOPEC authorisation code from Ian Hadfield,
[email protected]
You will receive an email with full instructions which include
Go to the WOPEC website www.wopec.co.uk and choose to either
‘Register’ or ‘Login’.
In the green ‘Code’ box on the website’s homepage enter your code. This
will be made of two parts, a prefix (example: LOCSU) and a code
(example: 1234567).
Next steps
Once you have passed the MCQs you will then be required to sit the OSCE
exams for MECS
To find out when the next OSCEs are,
please contact [email protected]
The OSCES are comprised of five 5 minute stations which are designed to
assess whether a practitioner is able to reasonably and safely perform a
MECS clinical examination.
Getting signed up with Webstar
Once fully accredited, please email [email protected] with the following
information:
• Name of accredited optometrist
• Practice where you will be working
• If the practice does not already hold a subcontract with PEC [HoWM] Ltd
the owner will need to apply [certain conditions are mandatory]
• Both the practice and each of the optometrists will need to register to use
Optomanager
Clinical Governance
Requirements on Practices
QiO GOS contract [Level 1] –at start of scheme
QiO NHS Contracts– all 3 sections and audits
Accreditation Requirements through WOPEC
Safeguarding Certificates
(adult and children) needs completion by 1st March 2016
 Public Liability Certificate
 Email [email protected] if you have not received
instructions on what to do




Performance
KPI’s
• The system records the time
• Reports are done quarterly
Activity levels for each service by month
Activity levels by each practice per month
Number of referrals by practice
N.B Patients to be seen within 30 minutes of
appointment time
Non compliance what does it mean for you
Must complete the sub contractor requirements
Must complete the patient record on line
You won’t be paid if it is not completed
The CCG needs to spend its money wisely so we have to check
and take action if you are an outlier.
Common outliers in other services are
Doing too many
referring more than the average or not enough
Not having available appointments
In your packs…
Contract & Protocol Key Points
Pathways
Service Specifications
Managing Performance
Complaints policy
 Complaints about MECS must follow PEC (HoWM) Ltd policy
 Must be reported via IT
Information leaflets
Prescribing policy
Patient Questionnaires
Much more on line
Fees and Finances
Subcontractors Receive




MECS £50.00
Cataract £30.00
IOPRR 1st Reading £20.00
IOPRR 2nd Reading £25.00
Thanks to
LOCSU
WEBSTAR
THE LOCs
HAYLEY ROWBOTHAM
The Directors and Staff
In particular:
The awesome PETER ROCKETT
You, the sub-contractors
Also a big thankyou to those who supported us on the night
Charles Barlow and Peter Bainbridge for meeting and
greeting and their assistants …you know who you are
Paul Sidhu for the website
Thank You
Katrina Venerus managing director LOCSU for all the behind
the scenes stuff……and for coming to the second city to join
us for the launch.
And most important you
Together we will be AWESOME