Written evidence submitted by Local Optical Committee Support Unit (CBP0052)


About LOCSU Support services for Local Optical Committees (LOCs) in England | LOCSU

LOCSU is the Local Optical Committee Support Unit, supporting Local Optical Committees (LOCs) in England across a range of activities relating to primary eye care. Our work includes policy work and lobbying, pathway development, commissioning support, governance and compliance support, communication and training.

We drive innovative thinking about present and future opportunities and challenges within the primary eye care sector, to meet the changing needs of LOCs. Our role as an eye health innovator sees us work in collaboration with a wide range of partners across the optical and wider health sectors to enhance and promote the role of LOCs and primary eye care among health decision makers.

Hospital Eye Service Pressures

The challenges of overburdened secondary care are well known. This is particularly true of ophthalmology departments which has the largest number of outpatient appointments by any specialism. These existed before the pandemic and have been exacerbated by the drawing away of resources that was necessary during COVID to meet the unprecedented situation. These measures have called for new approaches to patient eyecare which we outline below.

Covid-19 Urgent Eyecare Service (CUES)
To ensure patient outcomes were met as best as possible during the pandemic a Covid-19 Urgent Eyecare Service (CUES) was developed by LOCSU, NHSE-I and the Clinical Council for Eye Health Commissioning (CCEHC), endorsed by the College of Optometrists and Royal College of Ophthalmologists. This single specification service is delivered via primary care optical practice, supported by hospital ophthalmology services, commissioned locally by CCGs.

In summary, the service allows patients to gain prompt access to a remote consultation leading to a care plan for the patient to:

More information can be found here: Covid-19 Urgent Eyecare Service (CUES) - LOCSU

Optometry First

Building upon CUES, Optometry First is a service commissioning and design principle to help manage this growing demand in a sustainable way by establishing a co-ordinated and comprehensive primary eye care service as part of the wider eye care delivery system, reducing pressure on the hospital eye service (HES) and benefiting patients and the wider NHS. It covers primary eye care’s contribution to both recovery and the transformation of eye care services to meet need.

Optometry First makes optimal use of the existing primary eye care workforce as first contact practitioners and to manage low risk patients with long-term conditions, to broaden the scope of care delivered in primary care beyond the sight testing service.  It aims to improve the efficiency and accuracy of case-finding, reduce the need for hospital attendances and improve patient experience and opportunity for selfcare.

The fundamental shift is that patients with suitable eye conditions are managed within primary care optometry; care navigated away from other parts of primary care or redirected from hospital eye services, and only seen in / referred to the hospital eye service if clinically necessary. This includes patients who are currently on regular follow-up plans within hospital but who can be safely transferred to a service closer to home.  In addition, the care is delivered more flexibly, with less emphasis on separate clinical condition care pathways (e.g. urgent care, cataract care, glaucoma care etc) so that the level of examination and management is simply that which is appropriate to the patient need at that time.

More information can be found on the NHS Futures Optometry First Page (requires registration): Optometry First Toolkit - Eye Care Hub - FutureNHS Collaboration Platform


Sept 2021