07 February 2025

FODO member update – 7 February

This week:

• Take part in GOC business registrant survey
• Community optometry workforce in Scotland
• Senedd event showcases primary eye care
• Health policy

Take part in GOC business registrant survey

The GOC has launched its second business registrant survey. Please consider completing the survey to help the GOC improve its understanding of the primary eye care providers it regulates.
 
The GOC said the survey will "contribute towards a review of business regulation that [it is] currently undertaking".
 
The survey will close on 28 February. Take part. 

Community optometry workforce in Scotland

Research published in Nature analyses the community optometry workforce delivering NHS GOS in Scotland.
 
The analysis finds that the number of optometrists delivering GOS has progressively increased, reaching 1,489 in 2023. However, the number of those working full time had gradually reduced, with 61.3% of optometrists working four or more days per week and 34.9% working an average of five or more days a week.
 
Alan Tinger, FODO director, said: "This latest evidence confirms that while the number of optometrists has increased slightly, the number of full-time equivalent (FTE) optometrists in Scotland has not increased at the same rate as more people are working part-time.

"The sector workforce model, hosted by the College of Optometrists, used various data sources and also estimated the FTE workforce in Scotland would be 1,486 in 2023. Using the model, we can forecast the future workforce in Scotland, including any impacts caps on education places in Scotland might have on the primary eye care workforce. We will combine this with insights from members and sector partners about future workforce needs. Taken together, we'll be able to act upstream to help primary eye care avoid the sorts of workforce crises we see in the hospital eye care service today."

Please email [email protected] to collaborate with or support FODO's policy work on education and training. 

Senedd event showcases primary eye care

Optometry Wales has hosted an event at the Senedd to showcase how WGOS reforms deliver real benefits for patients close to home and out of hospital. This showcase follows David O'Sullivan, optometric adviser to the government, who praised the sector in December for meeting more care closer to home. 

Health policy

NHS England reviews payment system
The HSJ reports on the unsurprising news that the NHS in England is now reviewing the use of block contracts/aligned payment incentive (API) models because of variations in costs and activity.
 
Harjit Sandhu, FODO CEO, said: "Regrettably, all the issues flagged in the latest HSJ article were predictable, with FODO and others highlighting these risks when the NHS in England first proposed an API model.
 
"The challenges come from bypassing established costing and pricing systems based on yardstick competition for large NHS trusts. The reality is that well-designed tariffs remain one of the most effective ways to keep waiting lists down and drive cost efficiencies. Fortunately, the NHS in England has maintained its costing data, so it can, for now, spot potential pricing distortions.

"Other challenges with the API model and block contracts, was that they did not align well with patient choice rights set out in the NHS Constitution. It also overlooked the evidence on how block contracts are likely to impact activity levels, even with a variable element via the API model.

"We have always known that block contracts/APIs would make shifting care from hospital to community more challenging. However, there is a green shoot in the HSJ article - others also now appear to share our concern that block contracts/API funding can result in higher costs and that this, as the HSJ reports, 'may not incentivise keeping patients out of hospital'. Hopefully, the planned review will help restore some drivers for systems change. If so, several barriers to shifting care from hospital to community will soften."
 
NHS England consults
NHS England is running annual consultations on the Standard Contract (closes 25 February) and NHS payment scheme (closes 28 February). Please note that the Standard Contract is used to commission all enhanced primary eye care services in England, while the NHS payment scheme sets out principles for setting local prices for enhanced primary eye care services. FODO will review the consultations on members' behalf and work with sector partners, including LOCSU, to assess the best way to respond with a collective voice.
 
Other policy news

• The third sector has responded to reports that Wes Streeting has vowed to break the culture of charities lobbying government. Read more.
• Baroness Camilla Cavendish, Naomi Eisenstadt CB and Phil Jordan become non-executive directors on the Department of Health and Social Care board. Read more.
• Alastair McLennan and Dave West share their view in the HSJ about NHS England's gradual decline and how it has now reached a tipping point. Unfortunately, the article is behind a paywall, and it would be unfair to share the punchline. If you are an HSJ subscriber, it is worth a quick read.