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The national plans for enhanced services produced by the LOC Support Unit look very promising and I look forward to progress being made across the county when these move forward. This is also an exciting time with the new LOC Constitution being presented at the AGM in April. The whole committee will stand down and there will be elections for a new committee and, new to the AGM, elections for the posts of Chair and Treasurer. Optometry in Buckinghamshire keeps changing - we have had major changes to referral pathways twice in as many months. Not surprisingly, there has been confusion amongst optometrists, GPs and hospitals. We are working to improve this unacceptable situation, into which we were pushed. We are also working with the ophthalmologists to improve feedback, which is very variable and patchy in some places. If the present committee is re-elected we will strive to keep pushing optometry forward in Buckinghamshire and Milton Keynes. BRUCE GILSON Chair Bucks LOC PEER REVIEW After the successful re-establishment of the Milton Keynes Peer Review group the next meeting will be held on the 23rd March 2009 at the Milton Keynes Village Hall at 7.00pm. Further details will be mailed nearer the time but if you would like any further information please contact Claire Ranger. The Chiltern and South Bucks group will be meeting at Amersham Hospital at 7.00pm on the 25th March 2009. Further details of this may be obtained from Anne Frier. 2 CET points are on offer for each meeting. This method of learning is felt by all who take part to be very constructive and informative as well as being enjoyable. It is suitable for all ages and experience and is strongly commended. . EDUCATION EVENINGS MILTON KEYNES SUB-COMMITTEE is still planning a series of education evenings . It is anticipated that they will be held on a Tuesday evening at the Post Graduate Centre at Milton Keynes Hospital. The exact dates are still to be finalised but will be notified in good time. They will be both generally educational and locally specific. The first topics are likely to be Suitable Conditions for referral to the BUS clinic and New AMD treatment and its treatment in Milton Keynes which,it is hoped will start soon. Any suggestions for future topics would be appreciated. It has been decided not to hold the bi-ennial Refresher Course this year. CONSTITUTION The Local Optical committee has to change its constitution under the direction of the new contract. The model on which it is based can be viewed on the AOP or Primary Care Contracting website. The Bucks LOC has made a few changes of detail, not substance to the model. The main change is that contractors and performers are to be represented in equal numbers. The constitution allows for a minimum of 3 from each group. No maximum is specified. There is also provision for co-option. Also performers who are not on the PCT list but work in the area may be elected. Previously the officers have been chosen by the elected committee. In future they will be elected by the main meeting, from the previously elected committee. The document is both vague and thus also complex so an appendix has been added to more fully describe the activities of the the LOC. As this was thought to be a convenient time there was discussion as to whether the Milton Keynes sub-committee should become an LOC in its own right. It was decided however that the resources available would be better used in continuing as we are. ANNUAL GENERAL MEETING Wednesday 22nd APRIL 2009 POST-GRAD CENTRE SMH The AGM this year is a special event . Following the introduction of the new contract, LOCs are requested to have a new constitution. The model of which has been drawn up by the DoH in conjunction with the professional bodies. A copy of the proposed constitution will be sent to you with the official notification of the meeting. It is essential therefore that we have a good turnout , particularly from the larger contractor representatives. A new committee will be elected on that evening Even more interesting we are pleased to be welcoming Prof. James Wolfsohhn from Aston University to speak to us on  Evaluating surgical treatment of Presbyopia . This promises to be a very worthwhile and entertaining topic from an excellent speaker and will gain a very useful 1.5 CET points. The meeting will start with light refreshments at 6.30pm and the meeting proper commencing promptly at 7.00pm. Cyclo If you decide to do a cyclo refraction on another day and the child fails to attend the GOS1 can not be submitted for payment as the sight test has not been completed. This situation also raises child protection issues and if the family fail to respond to your efforts to persuade them to attend then you should consider contacting the designated nurse for child protection. Second opinions There is no provision within GOS for a second opinion sight test. Patients should be urged to go back to the place where they had the original sight test and they may then be able to have a non-tolerance re-test. Patients who aren t happy with their GOS sight test should be encouraged to speak to PALS at the PCT. Wet AMD forms Forms for direct access retinal clinics in cases of suspect wet AMD are available from Novartis, Anita Lam anita.lam@novartis.com Small prescriptions and small changes Please be aware of the College guidelines on issuing small prescriptions and small changes to otherwise satisfactory spectacles. Issuing low plus prescriptions to children is of particular concern and you must be able to justify why you have prescribed. Justification means clinical tests and not some vague assumption that  everyone knows that small prescriptions can help . Consider other reasons for any symptoms and always ask further questions about headaches. Issuing GOS vouchers GOS3 vouchers can only be issued in certain circumstances, the main one being to eligible patients immediately following a GOS sight test. Anyone, including a child, who is eligible for an NHS sight test but chooses to have a private sight test is not entitled to a voucher. This is a change from the advice I gave a couple of years ago and the change is because the Department of Health has looked more closely at the wording of the regulations. The current interpretation reflects the need, if necessary, for PCTs to be able to view the sight test records related to each voucher claim. PCTs do not have the right to view private records. However, if 1) a patient s financial circumstances have changed by the time of dispensing such that they have become eligible for a voucher, or 2) if a no change Rx was issued at the time of the sight test and the glasses subsequently break, then a voucher can be issued. In both these cases, changed financial circumstances and breakage following a no change Rx, patients should, whenever possible, obtain the voucher from the practice where they had their eyes tested to ensure that one hasn t been used already. It is not appropriate to perform a further sight test in either of these circumstances. GOS4 repair/replacement vouchers can be issued for any patient who is eligible at the time of the repair. Remember anyone over 16 can only apply for a repair voucher if the damage to their spectacles was caused because of their illness and prior permission must be sought from the PCT (TVPCA finance team). Also bear in mind that GOS4 forms can only be used for the current Rx. Frequency of sight tests The Memorandum of Understanding on the Frequency of NHS Sight Tests was issued several years ago and practitioners were asked to enter a code on the GOS sight test form if a patient was seen sooner than stated in the guideline. It was never intended as a guide to when people should be recalled. For instance children who can see 6/6 R & L and have no problems do not need to be seen every 12 months, neither does everyone who reaches 70 years old! There will always be the occasional patient that you feel you need to monitor quite closely but your records should clearly indicate the clinical reason. Pre-reg Students Newly qualified optoms cannot see any NHS patients until they are on a PCT Performers List. All pre-reg students should apply to a PCT about 3 months before they hope to qualify as the paperwork takes time REFERRALS IN BUCKS Almost immediately after the letter was circulated from the PCT concerning referrals last October, they made the decision to close the referral facilitation centre at Reading at very short notice. The procedure with regard to referrals has therefore taken a retrograde step and all referrals , except those for Emergencies, Wet AMD and The Practice should now go to the patients GP. This includes direct cataract referrals. You should indicate to the GP whether you want them to simply pass on the referral or see the patient. You should obviously also tell the patient. Work is being done to endeavour to return to a more satisfactory direct referral system. This situation does not apply to Milton Keynes MK BUS CLINICS AND FORMS A new Milton Keynes BUS clinic referral form is being trialled at 2 optometry practices and 2 GP surgeries. An audit will be carried out shortly and if satisfactory the new form will be sent to all practices. MK DIRECT CATARACT FORMS Further supplies of Cataract Referral forms and information booklets should now be obtained from the Patient Support Centre at Shipley Court, tel no 0800 028 4517. BUCKS CATARACT FORMS Supplies of these for Bucks are now available from Emma Haffenden at Rapid House tel no 01494 555541, Information leaflets will also available on our website for downloading should you run out.. EMAIL ADDRESS Thank you to the 4 people who sent me their email address. It really would be most helpful if you could take 5 minutes to send me a simple email so that we may disseminate information more easily and quickly. I have email addresses for about 1/3 of those on the performers list at present. Many Thanks. REFERRALS Please make sure the following details are included and legible in all referrals: Patient s name, dob, address, phone no, & NHS no (if known.) Your practice details Reason for referral - tentative diagnosis Information for GP or onward referral required Symptoms, signs & duration Your test results including visual field plots Current medication if known Relevant social circumstances Intended outcome from referral e.g. diagnosis & treatment, advice for future management, confirmation of normal variation or benign lesion, advice on when to re-refer if necessary If surgical - patient prepared to consider surgery NOTES FROM THE OPTOMETRIC ADVISER If you have any questions about the topics on this page please contact me - Jill Ellis Job Vacancies  Secretary/Liaison Officers This interesting position has become available following the retirement of Peter Chilton. It provides a rare opportunity to continue the development of optical services in Bucks. The position consists of management and secretarial support to the LOC including communication between the LOC and the PCTs concerning shared care, clinical governance and GOS issues. It also involves communicating with the providers of optical services in Bucks. The following attributes are desirable: An interest in the development of the optical profession locally. Ability to work from home. IT skills (basic word processing & email) and internet access. Flexible working and ability to attend some day-time meetings. The positions are for a flexible total of 25 hours per month for Buckinghamshire and 20 hours per month for Milton Keynes. Both positions may be awarded to one person if desired, requiring 45 hours per month. If you are interested and would like an application form or would like to find out more please contact: Peter Chilton - pete@wainhill.co.uk - Tel 01494 728059 H14:@FLRX^x~ Blockquote H1hbn&r 2N:P G$ *,0}T "$ *,7 9""  0R "$ *,9"0R "$ *,9" *0L$ *,   *0N $ *,7    *0L$ *, *0R "$ *,9" "|"|" " 0R "!$ *,9"! *!0!L$ *, > *!0!2.'($ c=(= zPzT " $ *,7 9" "  *0T "$ *,7 9""   *0R "$ *,9" *0H1hx(8HXhx|||||||||||||||||| | | | | | | | |have any questions about the topics on this page please contact me - Jill Ellis Job VacanciQ 4dfrB^xz02Nhj,Jfhj2P"$`xl` :V " A""""#D#n#p#&&>'N')**---0 0<0@1B11:5<5f5p:0?(B*B\BGG" Bz2Nj*,HbdfhPPPPPPPPPP\" $J>" `" $J>" Z" $JV" $J02B PPZH8" >"  "|" :" $"   D "Z "" $6     >" D "b" $JD "V" $JZ" $JB "$`zr :"""p#''**ll|" $h*,7 >"  " >" V" $J "" 7 >"  "" >"  " " 7 >"  "" >"  " 7  "!" " >" **---0 0<01000r "" $T,9">" f" $T,>" j " $T,7 >" 1>1@1B11:5<5f5.6~<<j " $T,7 >" r "" $T,9">" f" $T,>" " $T,>" D "H " .60?8?(B*B\BGG" r "" $T,9">" j " $T,7 >" f" $T,>" HHHIIN:\" $J>"  "!" 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