18 November 2022

FODO update on eye care reforms in Wales

On the 28 September we published our initial response to Welsh Government (WG) plans to transform eye care services.

We welcomed news that WG planned to address chronic underfunding of the NHS sight test and invest more in clinical services provided in primary eye care settings. Together these had the potential to prevent avoidable sight loss. 

In our first statement we also raised some initial concerns about WG proposals, including:

• Negative impacts of cutting patient benefits to part fund planned reforms, especially during a cost-of-living crisis

• Risk to essential domiciliary eye care services

• Uncertainty about what will be included within clinical manuals, making it difficult for providers to understand the full scope and sustainability of WG plans.

Since WG confirmed its plans, many members have been in touch to express concerns about WG fixing prices for services that have not yet been defined, the risk that patients who depend on means-tested benefits will be worse off when accessing essential vision correction, and of a significant reduction in domiciliary capacity which will worsen eye health outcomes.

We have shared these concerns with colleagues at Optometry Wales (OW) and offered FODO and FODO member support to minimise unintended consequences of planned reforms.

At this stage OW has confirmed to FODO:

• Level 1 GOS will not require any additional optometrist time to deliver. Hence, increased funding is to help practice sustainability and address longstanding underfunding of the GOS sight test.

• Level 2 GOS will also not require significant new investment of optometry time per clinical visit. That increase in fees is so that WG can gain more access to capacity out of hospital and closer to home. Clinical manuals will therefore not add complex or additional burdens on practices.

• WG will not cap or otherwise restrict the number of practices which can offer Level 3-5 GOS.

• OW, like FODO and FODO members, remains opposed in principle to cutting patient benefits. OW has confirmed it has no negotiating role here as benefits are in the gift of Welsh Government and this was a WG initiative.
  
  WG has decided to cut this patient benefit in awareness that this will mean people on  means tested benefits will have less access to essential vision correction and might have to pay out of pocket to access similar standards of spectacles to those they were able to access before these reforms. OW also understands why sector bodies and providers might want to directly challenge this on the basis of increasing inequality in access in Wales.

In addition to this, the sector Domiciliary Eye Care Committee (DEC) has met with OW to discuss the potential impact of reforms on the sustainability of these essential services. DEC remains committed to working with OW to help avoid systems failure and harm to patients who are by definition some of the most vulnerable in terms of health, disability and income.

FODO will continue to share your feedback and concerns with OW who will share this with WG. Please do keep sending your feedback to us at [email protected] and of course also please feel free to contact OW colleagues directly by emailing [email protected]