The Chair welcomed everyone to the meeting and introductions were made.

Transcription

1 Assynt House Beechwood Park Inverness IV2 3BW Tel: Fax: Textphone users can contact us via Typetalk: Tel MINUTE of MEETING of the HIGHLAND AREA OPTOMETRIC COMMITTEE Board Room, Assynt House, Inverness Monday 27 February pm Present: In Attendance: Mr Donald Goskirk, Optometrist (Chair) Mr Hugh Campbell, Optometrist Mrs Anne Gray, Optometrist Mr Charles Hall, Optometrist Mr Keith Laird, Optometrist Ms Ailsa MacInnes, Optometrist Ms Shona Pringle, Optometrist Mrs Margaret Steventon, Optometrist Mr John Wallace, Optometrist Mr Gavin Wreath, Optometrist Dr Paul Davidson, Associate Medical Director Mr Iain Ross, Head of E-Health Mrs Cora MacLeod, Optometric Adviser Miss Joanne Green, Administrative Assistant, Highland Council 1 WELCOME AND APOLOGIES The Chair welcomed everyone to the meeting and introductions were made. Apologies for absence were intimated on behalf of Mrs Melanie Meecham, Primary Care Manager, Mr Ian Fleming, Optometrist, Mr Calum Fraser, Optometrist and Mr Colin Pettinger, Optometrist. 2 NOTES OF LAST MEETING The minutes of the meeting held on 8 August 2016 were approved as an accurate record. 3 MATTERS ARISING There were no matters arising. 4 EYECARE INTEGRATION PROJECT UPDATE Mr I Ross provided an update on the Eyecare Integration Project during which he confirmed that the project documentation had been signed and the project was now live to deliver ereferral from Optometrists into secondary care. He explained however, that there is a further delay as Ophthalmologists need to have access to key information from GPs including past medical history to safely triage referrals. The Project Board had considered and decided that an information sharing agreement between primary and secondary care

2 was required in order to progress a solution for this. To achieve this, Mr Jim Docherty was attending the GP Sub-Committee on 28 February 2017 to request that a short life working group be set up to discuss the implementation of the information sharing agreement. Mr I Ross explained that it would take time to find a technical solution to transfer this information electronically and in the meantime it was suggested that a manual process is implemented by secondary care to contact GPs to request that GP summaries be created manually and ed to allow vetting to take place. Furthermore, Mr I Ross provided an overview of FormStream which was due for final testing with Mr D Goskirk on 21 March During discussion, Mr H Campbell highlighted some technical difficulties experienced with Cisco. Mr J Wallace also raised concern that the approach was Raigmore centred and asked for clarity re: Argyll & Bute as he understood the process would be via SCI Gateway instead of FormStream. In response, Mr I Ross confirmed that he would liaise with e-health department in Argyll and Bute and clarify the plan for implementation for that area of NHS Highland. The Committee noted the update from Mr I Ross on the Eyecare Integration Project and agreed that Mr I Ross would liaise with e-health department in Argyll and Bute and update re: the current position. At this point Mr I Ross left the meeting. 5. UPDATE FROM DR DAVIDSON S MEETING WITH HES CONSULTANTS Mr P Davidson confirmed that he had secured a meeting with HES Consultants which was positive and allowed him to introduce himself and present recent activity data showing an increase in workload. He also expressed the desire for developing enhanced working between primary and secondary care acknowledging the increasing demands/pressures faced by the ophthalmology service. He discussed the potential development for a teaching clinic in the future. Lastly, he offered to present any key issues to HES Consultants on behalf of the Committee. The Chair highlighted that communication between primary and secondary care was a key issue and would be picked up later during the meeting. The Committee noted the update from Dr P Davidson s meeting with HES Consultants. 6. ACF MEETINGS UPDATE Mrs M Steventon provided an update on the Area Clinical Forum Meetings during which she explained that she had been unable to attend the meetings in September and January but had attended the meeting in November which was also attended by the new Vice Chair of the Highland Health Board Ms Melanie Newdick who was attending all Committee meetings and Groups to introduce herself. Discussion had taken place on health promotion within the health service, encouraging all frontline staff to get a flu jab and realistic medicine. Mrs Steventon also confirmed that the next meeting would take place on 23 March Thereafter, Mr P Davidson advised that in relation to realistic medicine a secondary report called Realising Medicine had been issued on the 24 February 2017 with a launch event taking place today. 2

3 Discussion then took place on the variation across Health Boards regarding the decision nto list for cataract surgery and increasing waiting times and the impact of this on patients experiencing falls and meeting driving regulations. The Committee noted the update on ACF Meetings and agreed it would be interesting if there was research evidence regarding falls and accidents experienced by patients who had one cataract operation compared to patients who had bilateral cataract operations. 7. HES UPDATE Ms C MacLeod provided an update on the Hospital Eye Service during which she explained changes in the current staffing arrangements. In relation to articles in the press regarding waiting times for cataract surgery she advised that there were issues due to a vacant consultant s post and a national shortage of theatre nurses. In this regard, Ms C MacLeod confirmed a meeting to discuss the way theatres were run had taken place and the Assistant Divisional Nurse Manager (William Craig Macleman) agreed to ensure an appropriate level of staffing was maintained. With regard to the RTT for cataract (referral to treatment target), Ms C MacLeod reported that it was slipping however this was a general trend nationally. Ms C MacLeod provided an update of the progress in relation to the Elective Care Centre at the UHI Campus which was one of six across Scotland which the Scottish Government had promised to deliver on. She also highlighted the ophthalmology department recognises the opportunities to use the centre as a teach and treat facility and to improve the integration of community eye care with secondary eye care.during discussion, concern was raised in relation to the impact of the work (optometrists attendance at the teach & treat clinics) being undertaken on a voluntary basis and Ms C MacLeod confirmed that consultants recognised this as a potential limiting factor and were considering seeking funding as part of service development to employee staff on a sessional basis. Furthermore, Ms C MacLeod provided an explanation of the Ophthalmology peer review and transforming out-patients project (TOPS) and confirmed that a further update would be presented to the next meeting. The Committee noted the update on the HES. 8. HIGHLAND FORMULARY UPDATE Ms C MacLeod provided an update the Formulary review that had taken place on 8 September 2016 with the changes being ratified on the 25 October 2016 by the Area Drugs Therapeutics Committee. In this regard, she explained that there were few changes to the eye section and this involved re-categorising the location of items. Specifically, it was reported that eye bags were not available in Highland and only a few eye products were available on the minor ailments scheme which would be confirmed following the meeting. The Committee noted the update on Highland Formulary and agreed that Ms C MacLeod provide clarification of the three eye products available for minor ailments. 9. NES FUNDING FOR TRAVEL AND SUBSISTENCE AND NORTH TUTOR POST 3

4 Ms C MacLeod reported that travel support was now offered for some NES events on a case by case basis and that interviews were taken place today for the North Tutor post. The Committee noted the position regarding funding for travel and subsistence and the North tutor post. 10. HIGHLAND OPTOMETRY WEBPAGE DEVELOPMENT Ms C MacLeod explained that she had held various meetings with Mr I Ross, Head of E- Health and colleagues regarding the development of the Highland Optometry webpage. Consideration had been given regarding the various sites available with it being decided that the best option was to host the webpage on the NHS Highland external website because Optometrists did not have access to the NHS Highland Intranet. The plan is to post on the webpage information regarding clinical guidelines, stationery details, practice inspection documents, visitor timetables and waiting times (which would be regularly updated) and also teaching and learning resources. It was highlighted that this information would also be accessible to patients so it was therefore important to carefully consider what to include. It was anticipated that the webpage would be live within the next couple of months and therefore feedback was welcomed. The webpage would be reviewed and updated on a quarterly basis. The Committee noted the progress of the development of the Highland Optometry Webpage. 11. UPDATE ON CLINICAL GUIDELINES Ms C MacLeod provided an update on the clinical guidelines during which she explained that permission was being sought from the Royal College of Optometrists to adapt their guidelines to include localised protocols applicable to the Highland area which was the same process Grampian had undertaken successfully, however there was no plan to introduce patient group directives in connection with any localised guidelines Ms A MacInnes expressed praise for the well written, easy to read letters issued by Stanley Keys (Hospital Optometrist)on cataracts and glaucoma which Ms C MacLeod confirmed she would feedback to the author. Ms M Steventon raised a query regarding waiting times for cataract surgery and in response Ms C MacLeod advised that additional assistance at weekends to clear/reduce the backlog of >600 would be provided by a private company (Synaptik). It was also confirmed that Optometrists would be updated regarding current waiting times via the webpage. Ms A Gray expressed gratitude at the superb service provided by HES triage. In this regard, Ms C MacLeod reported that new telecoms modular system would be introduced which would help prioritise calls and divert calls to the correct department within the next few months as the Nurse Practitioners in the HES were currently laising with Telecomms to implement the new system. The Committee noted the update on clinical guidelines. 12. NHSH FLU VACCINATIONS FOR OPTOMETRIST CONTRACTORS GROUP 4

5 Ms C MacLeod confirmed that it had been agreed that Community Optometrists would be included in the programme for flu vaccinations for Winter 2017/18 which would be arranged though Occupational Health (OH). During discussion, clarification was sought on whether the flu vaccination was for all practice staff or only Optometrists. In response Ms C MacLeod explained that OH had only asked for the number of Optometrists to be vaccinated but she would liaise with OH about additional staff and ensure that there was clarity before the programme began. In this connection, concern was raised regarding the need for relevant staff to be vaccinated against Hep B however it was advised that the Royal College of Optometrists only recommended the flu vaccination and did not have a recommendation in relation to Hep B. At this point, Mr J Wallace raised concern in regard to the challenges experienced by Community Optometrists particularly in the Argyll and Bute area where the referral pathways were different because the area was covered by NHS Greater Glasgow and Clyde. In response, Dr P Davidson confirmed that a Northwest Scotland Ophthalmology review was underway and that the various issues raised by A&B Optometrists to Ms C MacLeod had been escalated to the Argyll and Bute Management Team. The Committee noted the position on NHS Highland flu vaccinations for Optometrist Contractors Group. 13. UPDATE ON EYECARE INTEGRATION PROJECT Mr D Goskirk outlined the requirement to adopt the web browser based e-payments systems so that VPN access was in place for the roll out of e-referrals. In this regard, Ms A MacInnes highlighted that a webinar on e-payments would be taking place soon. Ms C MacLeod stressed the importance of ensuring that the necessary business process were in place for HES re: ereferraland confirmed that the Eyecare Integration Project Board had proposed that a trial would therefore take place with Donald Goskirk and Ailsa MacInnes with the GP practices in Dingwall and?southside Road once approval had been received from the GP Sub-Committee re: information sharing agreement. In relation to technical issues raised, Mr D Goskirk confirmed he would speak to Mr H Campbell about logging into both VPN and Cisco systems and that he would test various browsers to ensure they were compatible with the e-payment system. It was highlighted that PSD had announced they would be charging for paper claims as of 1 st July l however HES vouchers could still be submitted by post with no charge as there was no epayment mechanism for these to be processed. Ms C MacLeod also provided an update of work being undertaken to introduce e-vetting using Skystore.. The Committee noted the update on the Eyecare Integration Project. 14. PPE AND SEE CAN I CLAIM BOTH? Discussion took place on situations which had arisen where it was necessary to be able to claim both PEE and SEE. There was consensus that the regulations did not reflect local arrangements and it was therefore agreed that examples of circumstances when a PEE & SEE could be in the patients best interest (excluding SEE 2.0 & 2.4 which can already be claimed on the same day as a PEE) be provided to Mr D Goskirk to collate as evidence to send to Mrs C MacLeod with the intention of seeking changes to the regulations. 5

6 The Committee agreed that local examples of where it was necessary to claim both PEE and SEE be provided to Mr D Goskirk to collate and send to Mrs C MacLeod with the intention of seeking changes to the regulations. 15. ANY OTHER COMPETENT BUSINESS 15.1 ARGYLL AND BUTE Mr J Wallace expressed concerns in relation to the lack of communication between NHS Management Teams and Optometrists in Argyll and Bute and the difficulties working with both NHS Highland and NHS Greater Glasgow and Clyde due to the different processes in place. In particularly, he highlighted that there was not an e-referral system being used. In response, Ms C MacLeod highland that Mr I Ross as Head of ehealth was responsible for ereferral delivery across NHS Highland incl. A&B and provided assurance that the Eyecare Integration Project Board included ehealth colleagues in A&B. The Committee noted the position 15.2 UPDATE ON PERIPATETIC SERVICES Ms C Macleod provided an update on discussions with Ms Janet Pooley regarding the lack of regulations relating to peripatetic services during which she confirmed that Ms J Pooley was fully committed to this issue and Scottish Government colleagues were also in agreement that there was a role for peripatetic services in GOS provision. In this regard, Ms J Pooley had been tasked with reviewing the regulations and the Scottish Government had asked for Optometric Advisors in Highland, Ayrshire and Grampian to be involved in the development with the intention of making progress although it was recognised that changes to the regulations could take at least a year to implement. The Committee noted the progress being made. 16. DATE OF NEXT MEETINGS It was noted that the next meetings would be held on 26 June and 23 October 2017 both in the Board Room, Assynt House, Inverness. The meeting ended at 4.15 pm 6