'Better vision for all', produced by the Association of the British Pharmaceutical Industry (ABPI) Pharmaceutical Ophthalmology Initiative (POPI), was compiled based on desk research and in-depth interviews with over twenty key stakeholders in the eye health community and makes a number of recommendations to inform change within the new system.
The POPI group is formed of companies with a special interest in eye health and it aims to work with others to raise the standard of eye care in the UK.
The number of people registered as blind or partially sighted is rising fast. The NHS needs to adapt to meet this challenge if we are to avoid people losing their sight unnecessarily but the complexity of eye care delivery, spanning primary, secondary and social care and involving a mix of private and NHS providers, makes this difficult. A National Clinical Director for Eye Health, working inclusively and providing strategic leadership across the sector from within NHS England, is needed.
Lord Low, Chair of the All Party Parliamentary Group on Eye Health and Visual Impairment, said:
"With a service as fragmented as eye health, a National Clinical Director, supported by an advisory National Eye Health Network, is essential.
"Without a leader to drive the implementation of change, as has proven successful in services for cancer and cardiovascular disease, the system will fail to withstand the increasing pressures it faces and more patients will needlessly lose their sight."
A demographic time bomb
The total cost of sight loss to the UK economy is estimated at £22 billion.1 Reports of rationing and delays to treatment, acknowledged by Sir Bruce Keogh, the NHS Medical Director,2 suggest that the system is already struggling to cope with demand.
Demographic and other factors indicate the situation is only likely to get worse. An aging population and sharp rises in diabetes and obesity,3 4 which are known risk factors for sight loss, point towards the future health and economic burden of sight loss and the impact this will have on associated services.
Joe Brice, Chair of the POPI group, said:
"What comes out clearly in ‘Better vision for all’ is the strength of opinion about fragmented services in eye care. We hope that this consensus will help bring about change, with the potential for stronger national leadership to put services on a more sustainable footing across the country to meet rapidly growing demand to the benefit of patients."
For further information, please contact the ABPI POPI group secretariat:
Notes to Editor
ABPI Pharmaceutical Ophthalmology Initiative (POPI): formed of ABPI member companies with an interest in eye health. Its objective is to work with others to raise the standard of eye care and deliver the best possible outcomes for patients across the UK. Bausch + Lomb, MSD, Bayer and Novartis are members of the group and JMC Partners provides the secretariat. All recommendations in the report are those of the ABPI POPI group and may not represent the views of the full ABPI membership.
'Better vision for all' report recommendations:
1. A National Clinical Director (NCD) for Eye Health should be appointed by NHS England to take an overarching approach to eye care and drive change in a systematic and timely manner.
2. A National Eye Health Network comprising representatives from across the eye health community should be established to provide advice to the NCD and enhance the prospects of best practice being adopted across the country.
B. Prevention and awareness:
3. An eye health awareness campaign should be developed and executed to encourage the public and health care professionals to realise the importance of eye health and emphasise the importance of eye checks.
4. A question on eye health should be developed and added into the NHS Health Check to increase awareness of the importance of sight tests.
5. Public Health England should circulate a fact sheet on the importance of eye health to all Directors of Public Health and request that they ensure eye health is covered adequately in Joint Strategic Needs Assessments.
C. Access to Treatments & Services:
6. The National Clinical Director should be responsible for supporting CCGs in providing patients access to treatments and services based on the best clinical and cost effectiveness evidence.
7. Care plans should be developed for eye care patients, owned by one practitioner, to promote a seamless experience and integrated service.
8. A list of minimum standards should be developed to guide patients on what they should expect from interactions in primary, secondary and social care.
9. New pathways should be subject to audit to ensure that patient safety and outcomes are satisfactory.
10. Digital data sharing best practice should be developed across an eye care pathway as part of the Secretary of State for Health’s Digital Challenge.
11. A best practice approach to rationalising and improving eye care service delivery should be developed, based on a systematic demand and capacity gap analysis.
12. The completion of NICE Quality Standards across the four main eye conditions should be expedited. Its completion should trigger the development of integrated commissioning guidance by NHS England.
13. The National Clinical Director should produce an annual report to benchmark different areas and drive further service improvements and best practice.
14. The National Clinical Director should develop a local CQUIN framework to support commissioners in the implementation of best practice eye health pathways.
The report can be viewed in full here www.abpi.org.uk/our-work/library/medical-disease/Pages/better-vision-for-all.aspx.
Access Economics - The economic impact of partial sight and blindness on the UK adult population, July 2009.
Department of Health, Healthy Lives, Healthy People, October 2011.
Diabetes UK, State of the Nation 2012, 2012.