Education & Training
Report to East Yorks LOC from the LEHN
Current work locally in North Yorks and Humber area
- Integrated working with pharmacy Local pharmacy committees and the local pharmacy network are keen to work with the local optical committees to promote the eye health message. East Yorks CCG have agree to fund a training evening for pharmacy and optometry to encourage referrals between the Minor Ailments service and the Minor eye conditions MECS service as well as promoting the eye health message via the many patient contacts. This should reduce GP usage and make for quicker easier patient access for minor conditions. If funding can be identified the intention is to run a training event around the promotion of eye health for pharmacy in North Yorks. East Yorks CCG are also funding the direct supply of certain eye medications from pharmacy to optometrists in the MECS service streamlining the service for patients. Eventually it is hoped that a direct prescribing route will be possible across the area as other minor ailments and minor eye condition services are commissioned.
- Review of children’s screening services across the North Yorks and Humber area has started with a review of current provision as there is variability across the area from no service to gold standard using school nurses trained by orthoptists at reception entry screening. Ean Blair is leading this sub group if you have any information please email him on firstname.lastname@example.org. At present we are the scooping stage so full sub group yet to form.
- Review of low vision services. This had to be brought forward due to the Eye Health Needs Assessment in York so a brief survey has already been sent out in North Yorks and York area.
- Preparation for Dementia awareness week on 17th May involved sending information to optometry practices on dementia and on accessing dementia friendly training on line to become a dementia friendly practice.
- Falls team work. The LEHN has been working with the Hull falls team to ensure a consistent target range of questions are asked during the level one falls assessment to all patients who can then be signposted to eye services if required. It is hoped to share this work with all falls teams across the area.
- Eye Health week. Beginning 21st Sept 2015 North Yorks Eyecare forum( which is collaborative of all the charities) have a steering group who plan to have information stands in Scarborough Hospital, York hosp and city centre, Harrogate library and possibly in Selby. In addition they have information stands in some larger GP surgeries and are hoping to get press coverage. Currently in East Riding, Eye Heath bus to be sited in Bridlington and Goole with health trainers plus messages in local press and radio. HERIB ( Hull and East Riding Institute for the Blind) are leading in Hull with a stand in the Freedom Centre.The LEHN will be encouraging local practices to arrange for their free resource packs to be displayed in their practices to support this week. The local messages being given by the charities is get your eye tested.
- The LEHN has supported the commissioning of a MECS service in Harrogate are to a consistent pathway already present in Hull and East Yorks. It is hoped other areas will commission the same pathway.
- Vale of York review and Eye health needs assessment. The review was completed in March and the recommendations are being driven by a project group with representatives from all sectors of eyecare community. An easy win appears to the low vision hub which would provide a fully integrated visual impairment service of which low vision services is a part. The sub group is being lead by Phillipa Crowther of Wilberforce Trust. The EHNA is being produced by the public health team with some collaboration in North Yorks so it may eventually cover all of North Yorks. It should identify what is available now, what are future needs and where are the gaps in services. The review intends to look at all services and devise outcomes driven pathways rather than targets. This means the service will be judged on things such as the quality of care offered rather than how many patients it has seen.
- Stable glaucoma pilots. York Is proposing using the diabetic van with OCT, slit lamp, Goldmann but no visual fields at present. Screening will be either in the van or room in GP surgery and run by technicians gathering the data which will be reviewed by the team of optoms at the hospital under criteria set by consultants. Traffic light system to be used with green to stay in service, amber next check at hosp and red immediate referral in.. Clinic capacity is expected to increase from 10 to 30 and it is hoped 2,000 patients could use this service. Hull service being developed to using upskilled community optometrists in their practices with training and support from secondary care.
- There are other work areas planned such as engagement events to discuss the community ophthalmology framework due for released by the Clinical Council for eye health commissioning.
The Local Eye Health Network(LEHN) gives all eye care stakeholders the chance to engage, express their views and influence in the development of eye care services in the area and the chance to let their views be fed up to a national level. The LEHN needs your support and input to be the vibrant active influencing forum it can be. Time commitment is 4 meeting of 2 hours in the evening with a little reading before each meeting and then the requirement to feedback and take views of other Healthwatch and users. We are currently looking at using remote conferencing to help with travelling. Please feel free to contact me about the LEHN work and volunteers are always welcome to work within the various groups we have running currently. Please get in touch if you want to know more and any ideas you may have.
Chair of the LEHN in North Yorks and Humber
Call to Action for Eyes- Key Themes Nationally.
This took place over the summer 2014 and has certainly driven the local work streams. Healthwatch supported the dissemination of public feedback questionnaire which generated 150 local responses from the public. The outcomes were fed into the national forum as well as setting our local workplan.
- Expanded community health roles more services in the community.
- Need for national framework to be implemented locally for some pathways to offer better value and more consistency
- Need for health promotion interventions: public education on risk factors and benefits of eye tests including national awareness campaign
- Need for wider training. Ophthalmology training should be a basic part of eye health professionals training and more opportunities for continuous development in eye health professionals
- Need to incorporate eye health as a standard part of care plans and packages for particular patients such as stroke, falls, dementia etc.
- Fully integrated care pathways that allow optometry to be integrated into the NHS workforce. IT enabled
- Patients records can be accessed by all health professionals
- Need to increase accessibility of sight tests by mobile clinics, targeting disadvantaged or high risk groups, disabled home visits and use of technology.
The outcomes are not to published formally but the LEHN is taking the local outcomes and driving forwards.
Local Priorities for LEHN
- Education of public looking after your eyes to reduce risk factors of visual impairment eg smoking.
- Improve access/change in delivery of secondary care to meet increasing demands
- More follow up in community
- Develop an agreed glaucoma monitoring model esp around follow ups.
- Encourage more optometry independent prescribers
- Feedback loop. Feedback from secondary care to optometry for learning. Communication
- GP education around eyes
- More accurate coding for more accurate data to plan services
- Promotion of community optometry service to GP to increase usage eg CORRS service
- Analysis of the make up of follow up appointments so services can be accurately planned.
3 top priorites
- Communication between secondary care and optometry in fact all stakeholders
- Glaucoma follow ups
- Dry eye treatment educating GP and optometrists on the dry eye flow chart and treating dry eyes. Keep them out of secondary care.
- Cataract information pack for patients to reduce false positives referred to surgery.
- Roll out programme for training optometrists in ophthalmology clinics to increase community skills.
- Promote eye health to school children. Healthy eyes from birth
- General public survey of eye health services
- Eye Health needs assessment
- KPIs need to address all areas of eye health ( currently only for diabetes and ARMD so glaucoma gets left)
- Improved coding consistency data collection
- Improve communication between sectors. Suggestion of directory of key contacts.
- Engaging the wideer profession
- Education of wider public in eye health care
- Audit of late presenters at optometry practices to understand reasons why
- What type of things people need more support with, develop an understanding and therefore resources.
- Define what is good quality
3 top priorites
- Increase communication and engagement across stakeholders
- Eye health promotion and education
- Local directory of eye care stakeholders Quick win.