Consultation on plans to cease NHS Digital General Ophthalmic Services Workforce and Activity publications

Closed 29 Nov 2019

Opened 18 Oct 2019

Results expected 13 Dec 2019

Feedback Updated 20 Dec 2019

We Asked

We consulted on the future of the General Ophthalmic Services: Workforce and General Ophthalmic Services: Actiivity Statistics publications produced by NHS Digital. Our proposal was that we would cease these publications due to issues with data quality, relevance and usage.

You Said

Seventeen responses were received from a range of organisations, including NHS organisations, central government, professional bodies, regulators and charitable organisations. The responses received did not support our proposals to cease the General Ophthalmic Services Workforce and Activity publications.

They highlighted the following key points in response to our proposal:

  • The publications are the only source of information for ophthalmic services and inform decision making, planning of service provision and funding processes.
  • Although data quality issues are recognised, the current publications are nonetheless used to measure activity, monitor change and analyse development. Many respondents asked us to investigate the data quality issues and improve the quality.
  • Ceasing the publication would have a negative impact on the ability to make informed evaluations and decisions regarding primary care ophthalmic services.
  • Concerns were raised that once collections and publications are ceased; they would not resume.
  • Efforts should be made to work with the relevant central bodies and data providers to improve data quality especially as a new source for data in England will be available during 2020.
     

We Did

We have reviewed the responses and will undertake the following:

 

  1. Using the existing Central Ophthalmic Payments (Open Exeter) data source, in 2020 we will publish:
    • General Ophthalmic Services: Workforce (England and Wales) 2019
      and
    • General Ophthalmic Services: Activity Statistics (England) 2019-20 publications


These will be the final publications using the current data source and although they will have similar content to previous releases, in accordance with the EU Web Accessibility Directive 2016/2102, they will be made available in HTML rather than in PDF format. Any accompanying data may also be released in CSV and/or an interactive visualisation tool to enable users to perform their own analysis.

 2. Beyond 2020, for both the Workforce and Activity publications, we will investigate the availability, quality and relevance of data from the new provider of Ophthalmic primary care support services in England. We will engage with the relevant organisations to understand responsibilities relating to data assurance and publication to determine whether the General Ophthalmic Services publications can continue. If so, any future releases may differ in scope and form to those produced currently according to the completeness, coverage and quality of the information available. We will provide further details as appropriate.
 

3. Ophthalmic Workforce statistics – Wales: The new data source does not include workforce information for Ophthalmic practitioners in Wales so at this stage NHS Digital are unable to commit to continuing a workforce publication for Wales after the 2019 release. 
 

Overview

NHS Digital collect and publish two data series relating to the General Ophthalmic Services (GOS) arrangements. These services include preventative and corrective eye care for children, people aged 60 and over, people on low incomes and those suffering from or pre-disposed to eye disease. The two ophthalmic data series published by NHS Digital are:

  1. The General Ophthalmic Services: Workforce Statistics for England and Wales report, which shows the number of ophthalmic practitioners who were authorised to carry out NHS funded sight tests as at 31 December each year. The annual workforce reports are available here
  2. The General Ophthalmic Services: Activity Statistics for England reports, which present summary information about GOS activity for the financial year, April to March. This includes the number of NHS-funded sight tests and vouchers used for repair or replacements. The annual activity reports are available here.

Why We Are Consulting

NHS Digital are carrying out this consultation to ensure that the data it collects and publishes are accurate, relevant and meet the needs of users. It follows on from the notification in the 2018 Ophthalmic Workforce publication, released on 7 March 2019, that we would be reviewing this publication series to ‘assess their use, data quality, availability of data sources and the resources needed to produce publications’.

We intend to cease the General Ophthalmic Services: Workforce and General Ophthalmic Services: Activity Statistics publications. The main reasons for this are

  1. Data Quality

Workforce:

The raw data are an annual extract downloaded from the Central Ophthalmic Payments (COP) system (known as Open Exeter) maintained by NHS Digital. This is a list of ophthalmic practitioners who were authorised, by NHS England regions in England and Local Health Boards (LHB) in Wales, to carry out NHS funded sight tests. The payments system is currently in the process of being moved to a new provider, Primary Care Support England.

Data in the current system may be affected by the extent to which the guidelines relating to maintaining lists are followed. Practitioners who have not provided General Ophthalmic Services (GOS) for six months should be removed from the lists and removing inactive practitioners is through agreement with the optician. NHS Digital are unable to assess the extent to which these guidelines are being followed and over time this could have led to list inflation with more individuals on lists than are providing services.

As data are from an administrative list not all practitioners recorded will necessarily have carried out NHS sight tests in the year. NHS Digital are unable to determine the amount of time a practitioner works or devotes to NHS activity.

Lastly, as there is no incentive to improve the quality of the data associated with each practitioner on these lists there is concern that these may be of low quality. An example is the unique General Optical Council registration number which for many records on the COP system is incomplete or in an incorrect format. This means that where validation of records occurs, it is an inefficient manual process.

Activity:

There are similar data quality concerns around the GOS activity data. Specific examples include data relating to regional breakdowns. It has been identified data is incorrectly assigned at NHS England region level. NHS Digital are unable assess or implement corrections therefore all data released since this issue was identified are aggregated to national level. Robust breakdowns of optical vouchers, vouchers for repairs and replacements by eligibility (e.g. age band) are not currently available. Therefore, these items are not included in the report, tables or charts.

Similarly, there is no incentive to improve the quality of the GOS activity data. Currently there is no method for NHS Digital to assure the data quality, which impacts the integrity of the publication. As a result of the reduced data availability, the GOS activity statistics no longer meet the highest standards of trustworthiness, quality and public value; therefore, the National Statistics badging has been removed from this product.

        2. Data Relevance and Usage

These data collections have not been reviewed in over 10 years and NHS Digital have doubts over whether these data remain relevant and have enough use to justify their continued collection and publication.

Workforce:

These data only cover those practitioners who are providing General Ophthalmic Services to eligible NHS patients (see overview), while a large proportion of the population will receive sight tests privately. NHS Digital are unable to assess how many practitioners provide services privately.

The publication currently consists of a limited number of data items which are: the total number of practitioners; practitioner type (Optometrist or Ophthalmic Medical Practitioner) and practitioner gender by region. The Welsh data has one additional item, Ophthalmic or Supplementary List type, but the list type regulations do not apply to England.

There appears to be limited demand for these data. The following table shows the number of unique page views and downloads on the NHS Digital website for the last 3 publications:

Publication

Publication Date

Total Unique Page Views

Total Unique Downloads

General Ophthalmic Services, Workforce Statistics, 2016

March 2017

319

300

General Ophthalmic Services, Workforce Statistics, 2017

March 2018

429

231

General Ophthalmic Services, Workforce Statistics, 2018

March 2019

154

81

 

Of the 90 publication series released by NHS Digital the General Ophthalmic Services Workforce publication series has the lowest number of downloads and second lowest number of page views.

These data also generate few requests for further information and no Parliamentary Questions. We are unaware of any other processes that make use of the data and have recorded zero requests for the data during 2018-19. Although we would also acknowledge that as there are a limited number of data items and all are published on the webpage, most user’s needs may be met by accessing the publication on the web rather than via direct requests.

Activity:

These data only cover the number of NHS-funded sight test and vouchers used for repairs and replacements. NHS Digital is unable to include eligibility information or regional breakdowns.

The publication currently includes a limited number of data items which are; the number of NHS sight tests, percentage of domiciliary sight tests, number of NHS optical vouchers processed, vouchers for repair or replacements and sight tests by practitioner type.

The following table shows the number of unique page views and downloads on the NHS Digital website for the last 3 activity publications where data are available:

Publication

Publication Date

Total Unique Page Views

Total Unique Downloads

GOS activity statistics – England, year ending March 2017

Jun 17

1,485

969

GOS activity statistics – England, year ending March 2018

Jul 18

612

260

GOS activity statistics – England, year ending March 2019

Aug 19

160

82

These data also generate few requests for further information and no Parliamentary Questions. For the activity region-level breakdowns which are not available, there were 4 requests for these data. As with the workforce data as there are a limited number of data items and all are published on the webpage, most user’s needs may be met by accessing the publication on the web rather than via direct requests.

 

What Happens Next

The responses to this consultation will be analysed and preferred options will be implemented by NHS Digital.

 

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