learning disabilities enhanced service schedule 3 final by 4guzW0


									SCHEDULE 3



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

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


2.1     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.


3.1     The service shall be provided at a time suitable to the patient and their

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.


4.1     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

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
              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.


5.1     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

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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