Primary Eyecare Services

Concepts

• ophthalmologist services
• lewes
• service sustainability
• service continuity
• seamless service integration
• service capacity
• service delivery
• primary
• eyecare
• secondary care providers

Location

Lewes

Description

Adult cataract referral, and post-operative pathway. The service facilitates the direct referrals between optometrists and secondary care providers and then post-operative care of a cataract patient. The service is provided by accredited local ophthalmic practitioners who have the necessary equipment to facilitate detailed examinations of the eye, as well as the specialist knowledge and skill to counsel and provide advice to patients with cataract. - Ophthalmic practitioners will: • Hold a WOPEC accreditation for cataract. • Attend training events organised by local NHS trusts annually • Be registered with the General Optical Council • Follow NICE Guidelines for management and referral and GOC required procedures The service is available to all persons over 18 residing, or registered with a GP practice, in the Coastal West Sussex area. Intraocular Pressures (IOP) Repeat Readings Service The service assists the Hospital Eye Service in the deflection of unnecessary secondary care referrals for possible glaucoma related conditions. The Intraocular Pressures Repeat Readings pathway will reduce patient anxiety and increasing capacity issues within the overburdened hospital glaucoma clinics. The service is provided by accredited local ophthalmic practitioners who have a range of equipment to facilitate a detailed examination of the eye. The service is available to all persons residing, or registered with a GP practice, in the Coastal West Sussex area. Electronic Eyecare Referral Service (EERS) PES provides optometrists access to an EERS called OPERA. This is used to make referrals and communicate between primary eyecare and secondary care. This is a Provider Selection Regime (PSR) Contract Award Notice. The awarding of this contract is subject to the Health Care Services (Provider Selection Regime) Regulations 2023 Direct Award Process C. For the avoidance of doubt, the provisions of the Public Contracts Regulations 2015 and the Procurement Act 2023 do not apply to this award. This award is for a maximum period of 12 months, from 01/04/24 to 31/03/25 with the option to extend for a further 15 months until 30/06/26. The service value is £132,000.00 per annum.

Total Quantity or Scope

Adult cataract referral, and post-operative pathway … The provider selection process was based on five key criteria, each weighted to reflect its importance in service delivery, value, and sustainability: o Quality & Innovation (30%) - 30% is allocated to quality and innovation to ensure the service is performing to the standards expected and to demonstrate the provider is able to innovate with the commissioner as per the ICB's expectations. o Value (20%) - 20% is allocated to value to ensure our population is getting value for money from the service provided, and to ensure we are spending taxpayers' money efficiently. o Integration & Sustainability (25%) - 25% is allocated to integration, collaboration, and service sustainability as integration is key to upcoming ICB plans, and along with collaboration as system wide engagement is required to ensure improvements are made to ophthalmology care and experience. o Access & Health Inequalities (15%) - 15% is allocated to improving access, reducing inequalities and facilitating choice as these are important factors that must be considered for all services ICB's commission. o Social Value (10%) - 10% is allocated to social value as services should be able to provide additional benefits to the wider population, not just those who access the service, and local social, environmental, and economic benefits, e.g. reducing CO2 emissions. The decision to award the contract to Primary Eyecare Services (PES) was made through review of the above structured evaluation of key criteria, selection standards, and PSR compliance, which demonstrated that PES continues to provide a high quality service for our population whilst ensuring the best value and service continuity for NHS Sussex. The assessment of the current service is as follows: Quality and innovation: • Clinical Quality: PES maintains a high standard of clinical quality, complying with NICE guidelines and the Royal College of Ophthalmologists' Commissioning Guidelines. • Accredited Workforce: The service is delivered by ophthalmic practitioners with WOPEC accreditation and annual NHS trust training, ensuring a high level of competency. • Digital Innovation: PES uses Opera, allowing direct referral pathways to Hospital Eye Services (HES), reducing administrative burden and improving patient flow. • Pathway Alignment: PES has aligned its processes with the updated integrated cataract pathway, ensuring no fragmentation of care and enhancing service continuity. • New Service Developments: PES is involved in pilot schemes such as Glaucoma Enhanced Case Finding, improving early detection and reducing unnecessary hospital visits. Value: • Cost-Effectiveness: PES operates a cost-per-episode payment model, ensuring financial efficiency and value for money. • Reduction in Hospital Workload: By managing cataract pre-referral assessments and post-operative follow-ups in the community as well as reducing the number of glaucoma referrals, PES reduces reliance on secondary care, allowing hospitals to focus on complex cases • Tariff Alignment: PES adheres to standardised tariff structures across Sussex, ensuring financial transparency and preventing regional disparities in patient costs. • Efficiency of Service Delivery: KPI reports confirm timely and accurate billing, with minimal administrative discrepancies. Integration, collaboration and service sustainability: • Service Integration: PES is fully integrated with Opera IT, allowing seamless referrals and patient tracking across NHS Trusts and independent providers. • Collaboration with Key Stakeholders: PES has strong working relationships with NHS Trusts, SpaMedica, Optegra, and local optometrists, ensuring continuity of care for cataract and glaucoma pathways. • Standardisation of Care Pathways: Efforts are ongoing to align protocols across all Sussex providers, reducing fragmentation and ensuring a consistent approach to pre- and post-operative care. • Data Flow & IT Interoperability: While Opera IT integration is strong, some independent sector providers lack full data-sharing capabilities, which can hinder seamless service integration. • Sustainability Measures: PES is working on workforce development initiatives, including training programmes for optometrists to expand service capacity and enhance long-term sustainability. Improving access, reducing health inequalities, and facilitating choice: • Broad Patient Access: The service is available in the Coastal West Sussex area, including rural areas, ensuring comprehensive patient reach. • Reducing Health Inequalities: The community-based model improves access for underserved populations, reducing dependency on hospital-based services. • Patient Choice: The AQP model allows patients to choose their provider, ensuring accessibility and convenience. Social value: • Workforce Development: PES invests in training programs for optometrists, supporting skill development and employment. • Environmental Impact: The community-based model reduces the carbon footprint by minimising unnecessary hospital visits. • Economic Contribution: By working with local optometry practices, PES supports local businesses and job stability.

Award Detail

Award Criteria

CPV Codes

• 85121281 - Ophthalmologist services

Indicators

• Award on basis of price.

Legal Justification

This is a Provider Selection Regime (PSR) confirmation of contract award notice. This contract has now been awarded under the Health Care Services (Provider Selection Regime) Regulations 2023. For the avoidance of doubt, the provisions of the Public Contracts Regulations 2015 and the Procurement Act Regulations 2023 do not apply to this award. This contract has now been formally awarded using Direct Award Process C.

Other Information

This is a Provider Selection Regime (PSR) confirmation of contract award notice. This contract has now been awarded under the Health Care Services (Provider Selection Regime) Regulations 2023. For the avoidance of doubt, the provisions of the Public Contracts Regulations 2015 and Procurement Act Regulations 2023 do not apply to this award. This contract has now been formally awarded using direct award process C. There are no identified conflicts of interest. Contract Period: 1st April 2024 - 30th March 2025 with the option to extend until 30th June 2026. The total price for the full contract period will be £1,188,000 exclusive of VAT. The procurement is approved by the Deputy Chief Delivery and Strategy Officer and Director of Strategic Commissioning Written representations should be sent to robert.kitt1@nhs.net