28 April 2023

FODO statement: Primary eye care reforms in Wales – consultation now open

The Welsh Government is running a consultation on changes to regulations to underpin its proposals to reform the ophthalmic services delivered in primary care in Wales. The consultation will close on 19 June.

Although FODO strongly supports providing more eyecare out of hospital in optical practices, Welsh members are strongly advised to read all five consultation documents in detail before replying to the consultation.

This is important because the consultation asks very high-level questions that are framed for a wider audience.

Lay people are likely to respond to questions without studying the complex detail in the consultation documents. In contrast practice owners and practitioners will want to review all the documents to ensure they have sufficient information and data to assess the reforms objectively, make an informed judgments and provide practical feedback.

For example, within the consultation documents there are:

• Many positives, with ministers acknowledging that primary eye care in Wales is already performing very well. The Welsh Government now needs to fund more care close to home to help ease pressures on hospital departments and meet growing need. Here the new Level 4 and 5 GOS proposals look to bring new and innovative models of care to patients, starting with a minimum of two higher qualified practitioners per GP cluster, although further detail is pending.

• Significant unknowns, with implementation groups yet to report on exactly what practices will be expected to deliver for each level. This makes it difficult to respond to some of the consultation questions as Welsh Government might wish.

• New statements which the sector had not previously been briefed on. This includes the consultation stating the sector has agreed to provide basic vision correction within new voucher bands. This could for example, given new voucher values, result in those serving populations on means tested benefits struggling to deliver NHS eye care post proposed reforms.

This is why it is important to take some time to consider all the proposals in detail and in the round before responding. Alternatively, if you do not wish to respond directly, you can send your questions and feedback directly to our policy team who will capture this in our response to the consultation. Simply email [email protected].

Harjit Sandhu, managing director of FODO, said: "As members know, FODO is very much in favour of delivering more care closer to home in primary eye care settings. This will help reduce pressure on hospitals and GPs but, most importantly, help reduce the risk of avoidable sight loss due to delays in waiting for a hospital appointment.

"However, this must be done in a sustainable way which does not disadvantage patients. Working as partners with clusters and local health boards, practices have to be able to make choices about how to meet patients' needs outside hospital locally."

He added, "When analysing complex proposals like these, it is important to review the economic data alongside clinical detail to ensure we minimise the risk of unintended consequences. For example, the last thing we want is to see people in most need experiencing reduced access and choice. Equity in access to care and sustainability of primary eye care services will be key tests we apply when reviewing these proposals."

FODO is working with sector partners, OW, ABDO, AOP and the College of Optometrists to review the proposals in detail. We encourage all members to get involved by emailing us at [email protected].