The HSE Primary Care Eye Services Review Group Report, published in June 2017, set out current levels of service, models of service provision and the consultation process undertaken with patients, advocates, ophthalmic staff and representative bodies. It also highlighted the limitations of the current model of service delivery, including the impact on waiting lists, and set out the way forward for a significant amount of eye services to be delivered in a primary care setting.
The Report estimated that 60% of existing outpatient activity could be moved to primary care thus enabling hospital services to focus on patients who require more specialist diagnostics or treatments. This Report remains current and the HSE has advised that it will advance the transfer of care for children aged 8+ years to local optometrists, thereby reducing waiting lists and enhancing access to primary eye care services.A project team with a wide-ranging membership was established in late 2019 / early 2020 to progress this initiative. The work of the team was paused due to the requirement to focus resources on the COVID 19 pandemic. However, the project team has been reconvened and is progressing matters in relation to this initiative.
The Community Ophthalmic Services Scheme (COSS) is a national fee-per-item scheme which was introduced in 1979. Under the COSS, medical card holders aged over 16 years can be seen by ophthalmologists, community ophthalmic physicians, optometrists or dispensing opticians.
Eligible patients can receive an eye examination and be provided with prescribed optical appliances in accordance with a national schedule of approved optical appliances.
The Health Professionals (Reduction of Payments to Ophthalmologists, Optometrists and Dispensing Opticians) Regulations 2013 (SI 274 of 2013) sets the fees for optometrists and dispensing opticians under the Community Optometric Services, Community Spectacle Dispensing Services and Health Amendment Act Card Schemes.
I am committed to increasing the fees payable to contractors for a standard eye examination under the COSS. This is a priority for my Department, and work with stakeholders is ongoing to implement this change in 2023.