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									The launch of the East Lancs Minor Eye Conditions Service The first accreditation meeting for the East Lancs. Minor Eye Conditions Service was held on the 31st. January 2008 in Accrington. The meeting was well attended with 33 optometrists, and representatives from the East Lancs PCT, pharmacy, and ophthalmology. If you wish to be a provider on the scheme, but missed the meeting, contact Mike Broadhurst as it may still be possible to join a late group for accreditation. UK Vision Strategy Event - 8th. January 2008 The UK Vision Strategy is a consultation document with the aim of improving eyecare in England. The event will take place on Tuesday 8th. January 2008 at the Holiday Inn, Brighouse (nr. jct 25 of the M62) 6.30pm. - 10.00pm. Attendance is free to all optometrists. Please contact Ruth Cuthbert by email for more information, or telephone 01772-782220 A Minor Eye Conditions - Pilot Service information meeting held on 20th. December was attended by 23 local optometrists. Mike Broadhurst (PCT Optical Adviser), Michael O'Connor and Yvonne Grimshaw (PCT Commissioning Managers) informed delegates of the proposed new service and answered questions. Further discussions between the PCT and LOC will be held on minor refinements, but it is hoped to launch the scheme with an accreditation meeting in January 2008. Diabetic Screening It is now 9 months since the PCTs terminated their relationship with optometrists over diabetic retinal screening. There do seem to be problems with the new scheme judging from comments from GPs, optometrists, and patients. It is in everyone's interest that patients receive the best available care, at the right level of funding. If you have any comments, anecdotes, or suggestions you feel may help to improve the service, please let us know. Members of the profession may express views through the Members' Forum.

East Lancashire Clinical Effectiveness Unit office moved on the 5th. September to: Suite 226, Bizspace, Turner Road, Lomeshaye Estate, Nelson, Lancs. BB9.7DR.

Poll of local practices Practices within the East Lancs. Area have been sent a questionnaire regarding future participation in PBC schemes currently being discussed. If practices have not already done so, would they please return a.s.a.p. ELLOC meeting 14th. August 2007 At the meeting, Stuart Ingleby was appointed Vice Chairman following the move of Derek Pellowe to Treasurer. The Chairman, Clive Duerden, has made an appeal for any optometrists in the area willing to join the LOC to make contact with himself, or Secretary. He also announced an imminent review of the current cataract referral scheme The PBC sub-committee reported favourably back to the Committee regarding the establishment of a triage-type system on the lines of the First Choice Eyecare system in West Lancs. recommending that a poll be taken of local optometrists to determine the support for such an initiative. Despite Peter Worden's efforts to conclude the update in the HES contact lens fees, progress was slow. East Lancs. Area LOC meeting A meeting was held at the PCT offices in Nelson on Tuesday 5th. June to discuss the outcome of the AGM. Main topics for discussion were the formation of a company on the lines of the First Choice Eyecare successfully conceived and operated for 12 months now by the West Lancs LOC, the

increase in the statutory levy agreed at the AGM, and the early moves locally to establishing an LVA scheme.

East Lancs. Area LOC meeting A meeting was held at the PCT offices in Nelson on Tuesday 5th. June to discuss the outcome of the AGM. Main topics for discussion were the formation of a company on the lines of the First Choice Eyecare successfully conceived and operated for 12 months now by the West Lancs LOC, the increase in the statutory levy agreed at the AGM, and the early moves locally to establishing an LVA scheme. East Lancs. Area LOC AGM The ELA LOC AGM was held at the PCT offices in Nelson on 22nd. May 2007. The meeting began with a presentation by Mike Broadhurst, Optical Adviser to the local PCTs, on the opportunities which present themselves as local eyecare pathways evolve under changes in the NHS. Further items of discussion included the new LOC Constitution, Practice-based Commissioning, concerns over the newly introduced diabetic retinal screening service, and the number of 'non-productive' meetings the LOC was becoming embroiled in. A motion was passed to increase the Statutory Levy from 1/2% to 1% to cover additional professional advice which the LOC will need to have meaningful participation in the forthcoming negotiations with the local PCTs. Regret was expressed at the resignations from the Committee of Peter Worden and Janette Brown (Treasurer). NICE Guidelines update Intervention procedures (IPG209) - Implantation of accommodating intraocular lenses for cataract. Meeting News At the meeting of the Committee on Tuesday 17th. April, the final touches were added to the draft Constitution of the LOC, which required amending due to the changes in the NHS administration. All being well, this will be presented to the AGM on the 22nd. May for acceptance. It was also decided to propose at

the AGM that the statutory levy be increased from 0.5% to 1% to provide funding for profession help in the forthcoming rounds of consultations with the local PCTs. Disappointment was expressed with the speed of progress with past consultations, and the number of 'dead ends' the Committee had experienced. Nevertheless, the LOC needs to maintain a continuous communication with the PCTs as there are some exciting opportunities for clinical advancement on the horizon. These will be announced at the AGM, so the LOC invites anyone on the Contractor and Supplementary list, and dispensing colleagues to attend the meeting. Please notify the Secretary if you wish to attend. Items for AOB MUST be notified to the Secretary at least 2 weeks in advance of the meeting. Anyone who is on one of the local lists is entitled to stand for the Committee, requiring only a proposer and seconder, who should also be on one of the lists. In the latest issue of ENGAGE, the East Lancashire NHS PCT magazine, credit is claimed for advances in optical dispensing. Page 7 of the publication states:
"Nearly sixty years ago, when the NHS was founded by Nye Bevan, everyone was grateful just to have the service itself. Never mind choice of hospital, or surgeon. Take NHS prescribed glasses as an example. Remember those bottle-glass lenses and the Milky Bar Kid-type frames in brown, and brown only? Take it or leave it, that was all that was on offer. Compare that to today's plethora of choice for frame, lenses, style and fit. I think you get the picture."

Apart from the factual errors regarding the range available at the time (prevoucher), optometrists, dispensing opticians, and manufacturers who were around pre-1985 may have a different view. Have your say in the Forum. (16/4/07) New NHS voucher values were announced this week effective from the 1st. April 2007. Download your copy from the 'Documents' folder in the Members' Area. (8/3/07) Meetings Calendar Tuesday 17th. April. LOC Committee meeting, PCT Offices, Nelson. 6.30pm Tuesday 22nd. May. ELLOC AGM, PCT Offices, Nelson. 6.30pm.

Tuesday 5th. June. LOC Committee meeting, PCT Offices, Nelson. 6.30pm. Anyone on the local Contractor/Assistant list is welcome to attend meetings. Please advise the Secretary in advance. Notice of AGM (9/1/2007) The AGM of the East Lancs Area LOC will be held at the PCT Offices, Kenyon Rd, Lomeshaye Estate, Nelson (just off M65) on Tuesday 22nd. May at 6.30pm. Refreshments will be provided. Would anyone interested in attending, and requiring refreshments, please notify the Secretary. If you wish to raise any issue, or ask a question of the Committee, please let the Secretary have notice at least 14 days before the meeting. LOC Meeting 9th. Jan. 2007 The East Lancs Area LOC met on Tuesday 9th. January at the PCT Offices in Nelson. Topics of discussion included: Revised contact lens fee structure for NHS supply. The local LVA situation. Results of the feedback from optical practices on the advice given by the LOC on the PCT questionnaire. Practice visits by the PCT and LOC advice to contractors. Vouchers and clinically necessary tints. Current relationship with the local PCTs and the newly formed Liason Committee. For more information on the above, please refer to the 'Latest News' in the Members' Area PCT questionnaire The LOC has sent out a letter of advice regarding questionnaires sent out by local PCTs. Information on practice visits by PCTs

PCTs are entitled in law to inspect the premises, equipment and records of a practice offering General Ophthalmic Services (GOS). Section 4 of the Terms of Service states that ‘ a contractor, on receipt of a written request ……. shall admit at all reasonable times for the purpose of inspecting his accommodation or equipment an authorised officer … of the Primary Care Trust’. Section 4 also applies to equipment used by mobile contractors. Section 6 stipulates that ‘ a contractor shall retain … records … and shall … produce them when required to do so by a Primary Care Trust … within such period, being not less than 14 days, as the Primary Care … may specify.’ Points to note:
1. Clinical Governance is not currently a GOS requirement. Optometrists

are free to opt out, or comply with local pilot schemes as they see fit. 2. The AOP, ABDO, and FODO have expressed the opinion that it is unacceptable for PCTs to question clinical reasoning on patients’ records selected for Post Payment Verification (PPV) visits during the course of a PPV visit. 3. It is inadvisable to mix PPV with any other type of visit. 4. It is in the interest of both parties that the purpose of the visit is clearly agreed beforehand. A more detailed explanation of the purpose and content of the following visits can be obtained from the LOC Secretary, or Chairman: Terms of Service (TOS) Post Payment Verification (PPV) Subsequent TOS and PPV visits Clinical Governance BwD presentation postponed The BwD PCT presentation due to be made on the 27th. September has been postponed until early next year following concerns expressed by the LOC regarding modifications made by the PCT representatives to the LOC approved version of a Clinical Governance Framework Document. The DoH appears to

be moving away from 'clinical' to a more broadly based 'quality' document, of which CG will become an integral part. The LOC are currently entering into negotiations with local PCTs to assist in achieving the DoH aims, and reach targets set for the PCTs, without compromising the rights of optometrists under their Terms of Service (TOS). Clinical Governance update The ELLOC has been enthusiastic in its approach to CG, and has produced its own CG Framework document in consultation with the CG team at BPR PCT. Several PCTs outside the area have adopted this document, making their own modifications. It was launched in BPR last year, and on the 27th. September, it will be launched in Blackburn with Darwen. The ELLOC has just been advised that changes have been made to the document pre-launch. As we have not been informed as to what these changes are, we are unable to comment further at the moment. However, for the benefit of local practices, the ELLOC approved version can be found at the following links:
Domain #1 - Safety Domain #3 - Governance Domain #2 - Clinical & Cost Effectiveness

Domain #4 - Patient Focus Domain #5 - Accessible & Responsive Care Domain #6 - Care Environ. & Amenities Domain #7 - Public Health

Please remember, CG is not part of your Terms of Service at the moment, and you are not obliged to submit completed Framework Documents to the PCT. However, The ELLOC feel that awareness of the contents of the Document can only serve to enhance your practice and improve your service to patients. Notice from the Blackburn with Darwen PCT You are invited to an informal session for all Blackburn with Darwen Optometrists on Wednesday 27th September. The evening will provide an opportunity for you to meet the Integrated Governance Team, who will be able to advise you on help and support available in relation to compliance with the Standards for Better Health (Department of Health 2004). The event will commence at 6.00p.m. with registration, followed by a buffet and refreshments. During the evening there will be a presentation on the Standards for Better Health by the Integrated Governance Team.

Guest speaker; Mohammad Abdul-Nabi will present 'Recent advances in cataract and vitreo-retinal surgery'. The evening will end at approx. 8.30p.m. If you wish to attend this event please complete the section below and return it to The Integrated Governance Team, BwD PCT, Guide Business Centre, School Lane, Blackburn BB1 2QH or Telephone 01254 267064 to reserve a place. We look forward to meeting you. CET Accreditation applied for Blackburn with Darwen PCT - Integrated Governance Team Name: ..................Contact Telephone No: .............. Job Title: .................Base: ..................... East Lancs LOC AGM The Elloc AGM was held on 23rd. May. Chris Hill from the BPR PCT presented the results from the completed CG Framework submissions at the launch in February, with some interesting observations. Following the AGM, a Committee meeting was held when protocols and guidelines were discussed and approved for members' reference when completing the CG Framework document. These, and the analysis of returns, is published in the Members' Area. During the meeting, new members were coopted onto the Committee - David Cleasby and Peter Worden (Optometrists) and Val Pellowe (Dispensing Optician). ELLOC Study Day, Wednesday 26th. April Account in preparation. East Lancs LOC AGM will be held on Tuesday 23rd. May at 6.30pm The East Lancs LOC AGM will be held on Tuesday 23rd. May at 6.30pm. at the PCT offices, Kenyon Rd., Lomeshaye Industrial Estate. All optometrists on the local PCT lists are invited. This is an ideal opportunity to express your opinions on the working of the LOC, and recently introduced schemes. Access to the PCT offices is via the Brierfield exit of the M65. Take the west exit from the large roundabout, down the hill and turn left at the second miniroundabout. Continue right to the end, and the road runs directly into the PCT car park.

"Which?" publishes a report on Daily contact lenses - response by BCLA The British Contact Lens Association has responded to an article comparing Daily lenses with Monthly lenses by the magazine "Which ?" The BCLA has reiterated its advice to wearers that they should not change the type, or wearing, of their lenses or the solution regime without consulting their contact lens practitioner. The full statement can be found at GOC drops case against eBay The case against eBay was dropped on the 6th. March when the GOC offered no evidence. Follow the links for the full story.

East Lancs LOC Study Day The East Lancs LOC Study Day will be held at the Dunkenhalgh Hotel, Clayton-le-Moors on Wednesday 26th. April. There is a maximum of 9.5 CET points available. See the Members' Area for more details. East Lancs LOC pioneer launch of Clinical Governance. Wednesday 8th. February at the Dunkenhalgh Hotel saw the launch of Clinical Governance in East Lancashire. The evening was jointly sponsored by the Burnley, Pendle & Rossendale PCT and Keeler Instruments. The event was attended by around 30 optometrists from the BPR area along with guests from adjacent PCT areas. Following an introduction by East Lancs PCT Optical Advisor, Mike Broadhurst, ELLOC Chairman, Clive Duerden gave an insight into the past, present and future of Clinical Governance, stressing the importance of optometrists taking a leading role in the development of CG schemes. Clive then passed the baton to Dr. Chris Hill, Clinical Governance Co-ordinator with the BPR PCT who, with her assistant, Cath Coughlan, gave the PCT approach to CG and National Standards with encouragement and offers of support to all optometrists in the locality. Finally, Derek Pellowe from the LOC gave a brief overview of the CG Framework document (available in the Members' Area) which had been made available to delegates. It was pointed out that, as this was a pioneering move into CG by an LOC,

Chris's team had offered to analyse any completed documents, and give the respondents the benefit of individual advice on the way forward. During the interval following the presentations, delegates were able to view the range of instruments displayed on the Keeler stand. The final event of the evening was an extremely interesting talk on Ocular Hypertension by Mr.Annaswami Vijaykumar, Consultant Ophthalmic Surgeon at the Burnley General Hospital. Further details on CG available in the Members' Area. ELLOC meeting 13th. December 2005 The ELLOC held a committee meeting at the PCT offices in Kenyon Road, Nelson, on Tuesday 13th. December. Issues discussed were: Proposed NHS changes currently going through Parliament; development of the recently launched PDT referral scheme; plans for the launch of CG on the 1st. February 2006 and the production of protocols in support of CG; progress on the CET course arranged for next Spring at the Dunkenhalgh Hotel; development of the ELLOC website. Optometrists nationally may have access to the ELLOC Members' Area. Anyone involved in optometry requiring access details, please email the webmaster. BPR PCT/Novartis/ELLOC launch fast track referral system for AMD. On Wednesday 7th. December 2005, a meeting was held for all optometrists practicing in the East Lancs. Area at which Miss S.A. Abugreen, Consultant Ophthalmic Surgeon with the BPR PCT, explained the procedure for direct referral of patients with recent onset wet AMD by optometrists to the PDT clinic based in Blackburn. The evening was sponsored by Novartis, the company manufacturing Visudyne™ used in PDT. Delegates were awarded 1.5 CET points. At the meeting, Clive Duerden, Chairman of the ELLOC, gave an account of the involvement of the LOC, and took the opportunity to repeat his request to optometrists to provide the LOC with email addresses. Mike Broadhurst, although well-known to delegates through his LOC activities, and as a CET provider in the area, introduced himself and outlined his new role as Adviser to the PCTs. He also announced a provisional launch date of Clinical Governance

in East Lancs as 1st. February 2006 (see Members' Area). The meeting will also include a talk by a local Consultant. CET points are being applied for. ELLOC in discussions with Consultants in the BPR PCT area on management of age related maculopathy. With recent advances in the treatment of wet maculopathy, the ELLOC are discussing an early referral scheme with consultants in the BPR PCT. Early diagnosis and treatment can greatly reduce visual loss. General Optical Council takes legal action against eBay on sales of contact lenses National newspapers and The Optician are reporting the GOC is to take eBay to Court as a result of sales of contact lenses which have taken place on their web site. Watch this space. ELLOC meeting 13th. September 2005 A meeting was held at the PCT offices, Brierfield. Subjects under discussion were the proposed restructuring of PCT's and SHA's, the Review of General Ophthalmic Services announced recently by Health Minister Rosie Winterton, and development of local Clinical Governance and Clinical Audit. Preliminary discussions were held regarding another CET day to be held next Spring. The Committee would welcome comments and suggestions from optometrists on subject material. Increase in screening fees paid to local optometrists With effect from 1st. September 2005 the BPR PCT have agreed an increase in the fee paid to optometrists for diabetic screening. Contact the Secretary for more information. ELLOC meeting 14th. June 2005 A meeting of the ELLOC was held at the PCT offices in Nelson when Chris Hill, from the BPR PCT outlined recent moves in clinical governance as it related to optometrists. The Committee also met the new BPR PCT Optical Advisor, Mike Broadhurst who answered questions from members of the Committee on his role as PCT Advisor. Mike stressed he was available to all optometrists in the area, and agreed to his contact details being included in the website.

In view of the complexity of the clinical governance issue, it was decided to set up a small liason group of Committee members, PCT Optical Advisor, and representative of the PCT. BPR PCT goes public on revised diabetic screening The following article, which appeared in the May 24th. issue, is reproduced by kind permission of the Burnley Express newspaper :

Diabetics to have better screening for eye conditions
DIABETES sufferers in Burnley who are at risk of losing their eyesight could soon benefit from an improved screening programme. Burnley, Pendle and Rossendale Primary Care Trust will adopt a national eyescreening programme which can help to prevent the onset of retinopathy, a disease affecting the retina. Diabetes sufferers are particularly prone to retinopathy and, although screening is currently done in East Lancashire, the existing scheme has been described as "ad hoc". There are 3,802 diabetes sufferers in Burnley, and Pike Hill has already been identified to begin screening in August. Mr. David Peat, chief executive of the PCT, said: 'We intend to adopt the process being delivered by the National Screening Committee to ensure that retinopathy can be spotted at an early stage. Around £200,000 has been invested in Burnley. "The existing scheme is popular but not nationally compliant. It is screening less than 60% of the estimated diabetic population which we want to see increased. "We have set ourselves a target of a minimum of 80% of people with diabetes to be offered screening as part of a sytematic programme meeting national standards by March. "By December 2007 we hope that all diabetes sufferers at risk of retinopathy will be offered screening by digital photography"

A report into the existing scheme revealed that screening is currently done at locally-accredited optometrists and no hard copy image is available. The screening is also not quality assured and there is no performance monitoring. Mr Peat added: "People with diabetes will be advised to continue to attend their optometrist's annual review until they are invited for retinal photography. "Those with no recent record of screening will be invited first. Any cause for concern will be flagged for fast-track treatment." ****************** Call for email addresses Would all optometrists and dispensing opticians in the BPR PCT area please advise the Secretary of an email address the ELLOC could use for communications. Although items of general interest will be posted on the website, it may be necessary to make contact direct on matters of urgency or sensitivity East Lancs LOC Refresher Course On Thursday 12th. May, the ELLOC, in conjunction with Replay Learning, hosted a refresher/CET course at the Oaks Hotel, Burnley. The guest speakers were Ian Cameron (Physiology not Laboratory), Dr. Robert Harper (Detecting Glaucoma), Dr. Edward Mallen (Myopia), Mr. Tayo Akingbehin (Refractive Surgery Update), Peter Charlesworth (Optometrist's Guide to Referral), and Dr. Philip Morgan (Corneal Infiltrative Events). Workshops were available in Contact Tonometry, Indirect Ophthalmoscopy, and Optic Disc Assessment. Delegates had the opportunity to gain further CET points by successfully completing the poster session. If you attended the event, comments and suggestions to any Committee member for the next course would be appreciated. East Lancs LOC AGM 2005 The East Lancs. LOC AGM was held on Wednesday 13th. April 2005 at 6.30pm. at the BPR PCT offices, Turner Road, Lomeshaye Estate, Nelson. Mr. Michael O'Connor, FHS Manager, attended to discuss the new Department of Health Guidelines. Following the discussion, general business of the

association was conducted, and more information for members will distributed in the near future. During the meeting, 3 additional optometrists present were invited to join the Committee, Jawad Malik, Keith Johnson and Michael Birkett. Contact details are on the Home page The website is currently very restricted in the facilities it can offer due to the ISP adopted, and the service is very basic. The meeting agreed to consider a change of ISP to possibly incorporate a secure area for the profession to exchange views and information through a forum, and for the electronic distribution of practitioner related material. All optometric and dispensing practitioners are encouraged to let the Secretary have their email details as this will relieve the high demand on communication resources.

East Lancs Local Optical Committee establishes Internet presence In January 2005 the East Lancs Local Optical Committee first published its web site on the internet, Through its pages, the public can receive information on current local changes and policies relating to optometric services in the Burnley, Pendle and Rossendale PCT areas. Available will be lists of premises, and practitioners providing optometric services, along with information regarding allied services, and references for further research. The Committee is currently composed of 5 local optometrists, whose contact information is displayed on the Home Page. The ELLOC works closely with the Burnley, Pendle & Rossendale PCTs, and local consultants and through these good relationships has helped to establish a shared care scheme for diabetics, and a direct referral scheme for cataracts in the area. The Diabetic Shared Care Scheme was one of the first in the country some 9 years ago. The ophthalmic aspect of diabetic care is currently under review to encompass the new technology now available to the profession.

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