In October 2023, we saw the beginning of a new contract for Wales, in line with the Welsh government’s ‘A healthier Wales’ policy, which aims to ensure that people stay healthy and independent for as long as possible.
This policy has led to several changes within health and social care, with more community-based services being utilised and greater communication and collaboration between the different services through primary care clusters.
These primary care clusters include GPs, pharmacists, dentists, nurses, allied health professionals, social care professionals, and representatives of the local health board, as well as representatives from primary eyecare. Clusters meet regularly to assess the needs of the local population, and identify any improvements that could be made to the services on offer locally. They also foster a greater understanding of the way each profession works, and the challenges they face.
Smart service provision
In line with this new way of working, the new contract was designed to “improve people’s access to eye health services, ensuring that support is delivered by the right professional, in the right place across the entire eyecare pathway of primary care optometry [which includes dispensing opticians] and specialist hospital eyecare services”.
By up-skilling primary eyecare professionals to take care of more minor conditions and monitor stable pathology, more urgent cases can be seen sooner by hospital eye departments and waiting lists can be reduced.
Providing a minor eye conditions service in the local community is also of immense benefit, given the rural nature of much of Wales, where the distance to the nearest hospital eye department can be as much as 70 miles.
The new Wales General Ophthalmic Service (WGOS) provides a number of different services including:
• Eye examinations
• Examinations for urgent eye problems
• Low vision assessments
• Referral refinement of certain eye conditions such as glaucoma and agerelated macular degeneration (AMD)
• Monitoring of certain eye conditions such as glaucoma and AMD • Independent prescribing services
All NHS registered optometrists in Wales must provide the first two services; additional training is required for the remainder, and funding is available from Health Education and Improvement Wales (HEIW) for this training. WGOS mobile services provide for eligible individuals who are unable to attend an optical practice.
The new contract has been generally well received by the profession, but what do the changes mean for dispensing opticians (DOs) in Wales?
Possibly one of the most positive points is that all DOs practising in Wales are eligible for a CPD grant. This comes on top of the HEIW funding for DOs to become low vision practitioners, to continue studying to become contact lens opticians (CLOs) and for CLOs to undertake acute eyecare training to deliver minor eye conditions type services.
What’s important from a dispensing point of view is the restructuring of the voucher values, and the requirement for practices to make available a pair of basic spectacles to patients who have been issued with a voucher, so that the full cost of the spectacles is covered by the voucher.
Vouchers A, B, F and G were reduced in value, while the remainder were increased to reflect the higher cost of more complex lenses. While many were disappointed by this reduction of some vouchers, it’s too early to say how this will impact patients and the profession, but provision has been made for this to be reviewed annually.
Make your voice heard
The Welsh Optometric Committee (WOC), which advises the Welsh government on eye health care and its delivery, along with colleagues at Optometry Wales (OW), are currently looking at all opportunities for DOs to advance their careers, so it’s an ideal time to make your voice heard.
One of the best ways to do this is to join your local regional optical committee (ROC). There are three ROCs covering Wales:
• South and West Wales covering the Powys, Swansea Bay and Hywel Dda health boards
• South East Wales covering Aneurin Bevan, Cardiff and Vale and Cwm Taff health boards
• North Wales covering Betsi Cadwaladr Health Board
ROCs are keen to welcome new members, and it’s possible to go along to a meeting as an observer initially; most meetings are held online. Becoming a member of the committee allows you to have a say in delivering local eyecare. Representatives of ROCs also sit on the WOC, helping to influence policy at a national level.
The ROCs are supported by OW, the professional umbrella organisation for the primary care eye health profession in Wales, representing all community optometrists, DOs and optometric practices. With all the changes happening in Wales, it’s important for the dispensing profession to be involved, and to help shape any future developments.
For more information about your local ROC, contact OW via its website – or via your regional lead for Wales. Even if you feel that ROCs are not for you, ensure that you sign up for OW newsletters to keep yourself abreast of the latest developments.
Abi Crutcher FBDO CL Prof. Cert. LV is ABDO’s regional lead in Wales. Email acrutcher@abdoregions.org.uk
This article appears in the July/August 2024 print issue of Dispensing Optics.