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Consultation launched into proposed changes to eye care

Monday, 16 October 2017

The Department of Health and Social Care (DHSC) has launched a consultation on proposals to modernise eye care on the Island. 

The six-week process follows the DHSC’s consultation into the National Health and Care Service (General) Scheme, which ran between 2 August and 12 September and contained plans to change the frequency of eye tests to once every two years with a £10 contribution towards each test.

The Eye Care Strategy consultation looks more closely at the services provided to the public and sets out a proposal to redesign services to enable more people to be seen on Island, developing on the success of the satellite service provided by Aintree Hospital at Noble’s Hospital for people with wet macular disease.

The DHSC spends more per head of population on eye health services than NHS commissioners in England – and a significant amount is incurred due to people with rare conditions needing to travel off-Island for treatment.

The population of the Island is ageing, a trend which is set to continue with the fastest growth among those aged 85 and over – the age group most at risk of eye disorders causing vision impairment.

Resources have been identified that need to be reallocated to allow more people to be treated on-Island, in line with the commitment laid out in the Programme for Government 2016-2021 to provide good value health and social care services.

The ophthalmology department at Noble’s Hospital deals with more than 12,000 appointments each year, but there are a number of conditions it is not currently able to treat. 

The proposed strategy therefore focuses on the need to remodel the service provided by ophthalmology staff, increasing what can be offered on-Island and, as a consequence, avoiding the need for patients, many of whom are elderly, to travel across.

The remodelling process may be accomplished either through improving the skills among staff at the hospital or through an extension of partnership arrangements with an off-Island provider, similar to that provided to patients receiving treatment for age-related macular degeneration on-Island by staff from Aintree University Hospital in Liverpool.

The strategy suggests a better use of resources would lead to the introduction of a screening service for diabetics and produce greater productivity in cataract surgery, and that high-street optometrists could ease waiting lists by meeting much of the current demand for the treatment of minor and stable conditions.

Situated around the Island, optometrists would play a key role in the proposed strategy, fulfilling a commitment in the Programme for Government to move more services from the hospital into the community.

The strategy proposes to change the frequency of eye tests – outlined recently following the consultation into the National Health and Care Service (General) Scheme – and suggests that any reduction in income for optometrists would be more than offset by taking on the treatment of minor conditions.

The DHSC currently funds eye tests on an annual basis, which is more frequently than that recommended by the College of Optometrists. The proposed policy therefore recommends that, where clinically appropriate, the interval between tests should be increased to two years as there is no evidence that providing tests more frequently can either improve health or represent value for money. The National Health and Care Service (General) Scheme consultation proposed that people should make a £10 contribution towards the cost of their sight test.

Jason Moorhouse MHK, Member for the Department of Health and Social Care, said:

‘The strategy is aimed at modernising eye care and bringing it into line with public expectations, as it has been identified that the service is currently not good enough.

‘It is clear we must stop sending people across in order to cut costs but also to ensure elderly people are not forced into making trips which may exacerbate other health issues. We must do that by improving the services on-Island – increasing capacity at the earliest stage in order to identify and treat problems efficiently.

‘I urge people to consider the proposals put forward, take part in the consultation and help the Department improve eye care in the Isle of Man.’

The consultation runs until Monday 27 November and is available at https://consult.gov.im

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