Hancock and Stevens warned over delays to referral plans

The College of Optometrists and other representative bodies from the sector want NHS England to find dedicated funding to connect community optometrists to the NHS electronic referral system.

At present, optometrists can refer patients into secondary care, but they rely either on fax or writing to their patients’ GPs who then refer them on.

The college, the professional body for optometry in the UK, wants health service leaders to find capital to develop a “web-based platform” to “allow optometrists to connect to e-referrals and to enable them to make electronic referrals directly to the hospital eye service”.

Its calls are backed by several other optometry and optical organisations: The Association of Optometrists, ABDO, FODO and LOCSU.

It told health service leaders in an open letter that this work would cost as little as £750,000. This would free up GP time and resources as well as enhance patient care “by making the referral system more robust and effective,” the college added.

NHS England and representatives from the optometry sector have been discussing developing a national connectivity programme to do this for several years.

However, the NHS has stipulated the work would have to be funded from primary care budget underspends, the letter said.

This has stymied procurement efforts over the past two years because underspends only materialise later in a financial year, leaving officials little time to run a formal procurement process.

The college is “very concerned” further delays will combine with the NHS’ plans to shut off fax machines by 2020 and so “will cause more patients to lose sight”, according to the letter, signed by the college’s chair of trustees.

Increasing pressures on hospital eye services and the impending decommissioning of the fax system mean “alternative referral arrangements need to be implemented without delay”, Mary-Ann Sherratt wrote.

The letter was addressed to Simon Stevens, NHS England chief executive, and Matthew Swindells, the national director for operations and information, and copied to health and social care secretary Matt Hancock.

“This is particularly important for urgent referrals, such as those for patients with wet age-related macular degeneration,” Dr Sherratt said. “Failure to implement such alternative referral arrangements has already raised patient safety implications and will continue to do so until these are in place.”

Connecting optometrists to the NHS system would also “free up considerable GP time and resource,” she added.

The college was joined by four professional bodies that represent optometrists in the UK in calling for money to be found in the NHS’ budget to pay for the system.

They wrote: “In the last two years, NHS England has twice identified potential primary care budget underspends of up to £10m, which we were led to believe would be used to fund optical connectivity.”

But on both occasions “this opportunity fell away because the funds could be used in the very limited time available”. They said NHSE and Department of Health and Social Care officials had told them a move “to connect every NHS optical contractor in England” would cost £750,000, but it would again have to be funded from an underspend.

A DHSC spokesman said: “It is absolutely crucial that all IT systems can talk to each other across the entire health and care sector to improve patient safety, free up staff time and ensure every pound is spent wisely.

“Through NHSX and our long-term plan we will introduce new standards which demand all systems allow the seamless flow of information from one organisation to another,” he added.

An NHS England spokeswoman said: “NHSX will be considering this and other funding bids for IT investment later this year.”

Update: this article was amended on 26 April at 17.29 to include a comment from NHS England.