20 October 2023

FODO member update - 20 October

This week:

• England - Provider Selection Regime (PSR) in brief
• WGOS goes live
• College mask wearing guidance
• Study to track avoidable sight loss
• Other sector news
• Health policy news - PSR detail

England - Provider Selection Regime in brief

In brief:

• The Provider Selection Regime (PSR) is the new NHS procurement regime for England.
• PSR regulations and draft statutory guidance to ensure compliance with PSR regulations were published on 19 October.
• There are no planned changes to GOS.
• ICBs will have more flexibility when making decisions about commissioning enhanced eye care services.
• At this stage, regulations and guidance are subject to parliamentary scrutiny and agreement.

The above is all as expected because FODO and sector partners have worked together to ensure the Primary Ophthalmic Services (POS) framework and PSR work as intended. For more detail on the PSR, see our health policy update below.
 
FODO will analyse the regulations and all supporting documents in full on behalf of members and the wider sector and issue more detailed guidance in due course. Meanwhile, if you have any questions, please email [email protected].  

WGOS goes live

Today, 20 October 2023, marks the start of the new Welsh General Ophthalmic Service (WGOS) (and contract) in Wales which is a huge achievement.
 
We have kept members up to date throughout the implementation process and will continue to be here to support you throughout the transition period. If you have any questions or need any support, please email [email protected].
 
WGOS offers the opportunity to deliver sight-saving reforms throughout Wales, and FODO and members in Wales fully support these goals and will work hard to implement them successfully for all patients and population in Wales.
 
At the same time, it is regrettable that the Welsh Government has chosen to take £4.8 million out of existing patient benefits to part fund clinical reforms. We appreciate that members will try to close this funding gap to support the most vulnerable patients but also that this may not always be possible. With Optometry Wales and other sector partners we will track the impact on patients and are pleased that Optometry Wales, Welsh Government and NHS Wales have agreed to review both fees and voucher values on an annual basis to check they are working as intended in Welsh Government impact assessments including covering costs.
 
Please send us updates in confidence on how your patients and practice are responding to the reforms by emailing [email protected].

Please also continue to check the Eye Care Wales website for regular updates and news on WGOS.  

College mask wearing advice

With increasing prevalence of Covid-19 in some regions, the College of Optometrists has advised undertaking a practice-based risk assessment and to consider reinstating universal mask-wearing as part of enhanced IPC measures. Read more. 

Study to track avoidable sight loss

The Royal College of Ophthalmologists has announced that BOSU Surveillance will collect data on sight loss due to delays in accessing the hospital eyecare service (HES).
 
Previous studies in 2016 and 2019 showed a significant number of patients suffered preventable sight loss from delays in accessing HES. It is widely understood that ongoing capacity challenges in HES, including those due to workforce challenges in ophthalmology, continue to put sight at risk.
 
That is why Principles and Priorities for primary eye care calls for more enhanced eye care services to be commissioned so that patients can access timely care and the NHS can prevent cases of avoidable sight loss caused by delays in care.
 
All UK ophthalmologists can report cases through the BOSU email reporting system. The Royal College is encouraging all ophthalmologists to take part by submitting data. Learn more and participate. 

Other sector news

• Duncan and Todd welcome new CEO. Read more.
• Moorfields to manufacture new scleral contact lenses. Learn more.

Health policy news - PSR detail

The Department of Health and Social Care (DHSC) introduced the long-awaited Health Care Services (Provider Selection Regime) Regulations 2023 into Parliament on 19 October 2023.
 
The Provider Selection Regime (PSR) is the new NHS procurement system for England. Subject to parliamentary scrutiny and agreement, the PSR will come into force on 1 January 2024. Until then, the Public Contracts Regulations 2015 and the Procurement, Patient Choice and Competition Regulations 2013 will remain in place.
 
As planned, NHS England has also published draft PSR statutory guidance to support compliance with the PSR. It has also produced a PSR toolkit to aid implementation of the new regulations. PSR statutory guidance will not be final until Parliament has agreed the regulations.
 
Although material changes to the draft guidance on primary eye care services are not expected, FODO will continue to monitor and respond to this as necessary and keep members up to date.
 
As FODO and sector partners have called for, the draft regulations and guidance mean:

• The GOS sight test and optical vouchers are recognised as core NHS primary care services.
• Mandatory services: NHS sight testing and the provision of optical vouchers must be commissioned by the NHS in all areas of England using the National General Ophthalmic Mandatory Services Contract.
• Additional services: Mobile NHS sight testing and the provision of NHS optical vouchers must be commissioned in all areas of England using the National General Ophthalmic Additional Services Contract.
• Mandatory and additional services are to be commissioned under a direct award, using what the PSR refers to as circumstance B. This means, as now, ICBs cannot limit the number of providers available to patients and will not be required to apply basic selection criteria. Contracts will run on continuously.
• The process that must be followed when awarding a contract under direct award process B is set out in Regulations 6(4) and 8.

The guidance also makes clear that Enhanced services which include but are not limited to:

• minor eye conditions services
• urgent eye care services
• referral refinement
• stable glaucoma monitoring
• post cataract care

cannot be commissioned under direct award circumstance B. This is because the specified conditions in the regulations will not be met. If, however, an ICB is satisfied with an enhanced service and provider(s), the ICB might use circumstance C under the PSR to continue with existing arrangements without running an expensive and unnecessary procurement exercise at the end of an existing contract.

For more detail, see Annex C of the PSR draft guidance which sets out how the regulations should apply to primary care services.