SCHEDULE 3 SERVICE SPECIFICATION – DOMICILIARY OPHTHALMIC SERVICES TO SEFTON RESIDENTS WITH OR WHO HAVE LEARNING DISABILITIES 1 SERVICE OUTLINE 1.1 The service provides for Domiciliary Ophthalmic services to Sefton residents who have Learning Disabilities who cannot attend a community practice unattended, or who would be best served by obtaining the service at a day centre in partnership with carers 1.2 The service is provided by local ophthalmic contractors who have a range of equipment to facilitate detailed examination of the eye, as well as employing or engaging ophthalmic performers with the specialist knowledge and skill. 1.3 The service is accessed by patients direct from the local ophthalmic contractor, either by: Self-referral to the service Referral to the service by a carer or relative When re-examination is due, as advised by the ophthalmic performers employed by the contractor 1.4 The service is available to all persons registered with a Sefton GP practice with a learning disability who do not satisfy the standard General Ophthalmic Services (GOS) terms and conditions for a domiciliary eye examination and who cannot reasonably attend a high street optician unaccompanied. 1.5 For the purposes of these services, “Learning Disabilities” includes all Autism Spectrum disorders and any other general learning difficulties, which require specialist care 2 SERVICE AIMS 2.1 The service aims to improve health and reduce inequalities by providing increased access to primary eye care for people with Learning Disabilities in the community. 2.2 The service is expected to reduce the number of unnecessary referrals from primary care to secondary care, supported by the provision of more accurate referral information. 2.4 The knowledge and skills of community ophthalmic performers and contractors will be better utilised. 3 SERVICE PROVISION 3.1 The service shall be provided at a time suitable to the patient and their representatives. 3.2 An ophthalmic performer or other person employed or engaged by the Contractor in respect of the provision of the services under the Contract ("other responsible person") may refuse to provide the service if an ophthalmic performer is unavailable to provide the service. 3.3 On receipt of a referral (including a self-referral), the ophthalmic performer or other responsible person shall arrange for the assessment. 4 SERVICE SPECIFICATION & CRITERIA 4.1 Eligibility for services 4.1.1 The patient should be diagnosed with Learning Disabilities 4.1.2 The contractor must satisfy themselves, after consultation with carers and relatives that adequate consent has been given to provide the service to the patient. If no relevant person is identified to support the individual, then due regard will need to be given to referring to the Independent Mental Capacity Advocacy (IMCA) service. 4.1.3 If a patient wishes to communicate using a language other than English, or uses non-verbal communication, then the Contractor shall have access to the interpretation and translation service available through the PCT. 4.2 Procedures 4.2.1 The ophthalmic performer employed by the contractor shall undertake all procedures as deemed clinically necessary by the relevant performer during assessment of the patient to provide a service as close as possible to that provided during a standard GOS sight test. 4.2.2 The nature of undertaking tests for such patient groups is more likely to necessitate more than 1 visit to the patient, in order to obtain an adequate result and complete the sight test. 4.2.3 Patients with Learning Disabilities may require ophthalmic services more frequently than most patients, particularly after their first access to the service. The performer working for the contractor should record in the patient record card the timescale recommended for sight test intervals for each patient. 4.3 Equipment 4.3.1 The Contractor shall have equipment to the same standard and range normally expected for provision of Additional General Ophthalmic Services 4.4 Referral and Patient Pathway 4.4.1 The contractor shall refer patients seen under the contract as appropriate and within the terms of the Opticians Act 1989 and the Rules Relating to Injury or Disease of the Eye 1999 made by the General Optical Council. 4.4.2 The contractor should take into account the additional needs of a patient diagnosed with Learning Disabilities with regards to deciding whether referral is appropriate. Liaison with carers and family will assist the decision to refer and ensure the patient is adequately supported to attend secondary care. 4.5 Service Review 4.5.1 The Contractor shall co-operate with the PCT as reasonably required in respect of the monitoring and assessment of the services, including- Answering any questions reasonably put to the Contractor by the PCT Providing any information reasonably required by the PCT Attending any meeting or ensuring that an appropriate representative of the Contractor attends any meeting (if held at a reasonably accessible place and at a reasonable hour, and due notice has been given), if the Contractor’s presence at the meeting is reasonably required by the PCT 4.6 Information 4.6.1 The Contractor shall provide all information specified in this Schedule in a timely manner, ensuring its accuracy and completeness. 4.6.2 From time to time, it may be necessary for either party to make ad-hoc requests for information from the other in order to respond to internal or external queries. On occasions, and depending on the sensitivity or relative risk associated with the issue, this information may be required in a short timescale. The parties, subject to this Contract, acknowledge this and agree to undertake the following: To minimise ad-hoc requests and ensure that short timescales for responses are not requested, unless absolutely necessary or where no choice is considered to exist Where an ad-hoc request is made, the party asked to provide the information commits to ensure that every reasonable effort is made to provide it within the given timeframe. 5 CLINICAL GOVERNANCE 5.1 In addition to the contractual requirements detailed in the main body of the Contract (including clauses 25, 28 and 66), the Contractor must participate in the PCT's Quality in Optometry Scheme (as amended from time to time). 5.2 The Contractor must participate in any other PCT Clinical Governance programme, which the PCT introduces. 5.3 Information Governance The Contractor must participate in the PCT programme for completion of the Quality in Optometry Information Governance audit. 5.4 Infection Control The Contractor must participate in the PCT programme for completion of the Quality in Optometry Infection Control statement. 5.5 Serious Untoward Incidents 5.5.1 In addition to the requirements of clause 66, the Contractor shall within seventy two (72) hours, specifically notify the PCT Professional Lead - Optometry and the Infection Control Team of any incidents of significant post examination/intervention infection. 5.5.2 Fitness to practice concerns shall be reported by the Contractor to the PCT Optometric Adviser and will be investigated by the PCT. 5.6 Clinical Audit 5.6.1 The Contractor shall participate in any clinical audit process as reasonably required by the PCT, and maintain appropriate records to evidence and support such activity, including an electronic spreadsheet showing the outcome of each clinical audit. 5.7 Patient Experience 5.7.1 During the first year of service provision, the number and nature of written complaints are to be reported by the Contractor to the PCT on a quarterly basis, together with any action plan, where appropriate. In subsequent years, reporting of complaints by the Contractor to the PCT will be on an annual basis, subject to a review of the service. 5.7.2 The Contractor will participate in any annual patient survey provided by PCT. 6 PAYMENT 6.1 The PCT shall pay the Contractor a sum equivalent to the standard Additional Services GOS fee for each patient appointment, inclusive of a sum equivalent to the appropriate GOS domiciliary visit fees for first, second and subsequent patients at a single address. 6.2 If further visits become necessary to complete the original sight test, the contractor may claim further sums equivalent to domiciliary visit fees only, at the appropriate rate, but may not claim a sum equivalent to a further Sight Test fee. This will be subject to a sum equivalent to a maximum of 3 domiciliary visit fees per patient per year. 6.3 Patients seen under this service who would normally be eligible for a GOS spectacle voucher, under the GOS regulations, will also be entitled to the same monetary value according to the equivalent code letter amount to put towards spectacles supplied by the contractor following completion of the sight test. 6.4 Future payments will increase in line with sums equivalent to the usual increases normally announced by the Department of Health. 6.5 Payment will be made to the Contractor on a monthly basis as part of the Contract payment. The contractor will submit an invoice to the Optometric Adviser of the PCT after the last day of each month for payment. The invoice will itemise each patient seen under the services, including the appropriate examination fees and voucher value of any spectacles dispensed.
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