North Yorkshire Local Optical Committee

North Yorkshire LOC meeting 13^th October 2025

The Crown Hotel Boroughbridge 7:00pm start

LOC members present:

Philip Angel

Charlotte Turner

Katherine Friis

Deryck Watts

Katie Nicholls

Melanie Linegar

Observers:

Sejal Patel

Siobhan Haralabidis

Apologies:

Eleanor Mace

Kate Malyn

Sarah Farrell

Daryl Taylor

Jack Carr

Gill Carr

Online guests:

Debra Leadbetter (ICB – GOS contracting)

Penny Gray (ICB)

Hasan Daji (ICB)

Sid Maher (LOCSU)

Naomi Smith (PES)

Alex (PES)

1. Welcome from Katherine to room & online guests, apologies for absence
2. Review of previous minutes (July 2025) & confirmation of accuracy -> confirmed as accurate record by those in attendance & no matters arising from the minutes.
3. SPoA update
   • Hasan Daji & Penny Gray introduced, sit on ICB SPoA team & have been active participants in leading the two weekly meetings Katherine Friis (LOC chair) has been attending as LOC representative.
   • NY LOC SPoA update letter shared last week with contractors & performers in the NY LOC area.
   • Letter covers all the element of SPoA as they are to date. This covers what is the ICB’s purpose with SPoA for which elements from the ICBs own draft letter was used. The LOC letter then went on to detail step by step any issues that had arisen at any point by any of the contractors or performers. The letter went on to provide responses from the ICB & any other comments. (Letter will be available for review).
   • This letter was sent after ICB sent out their own letter regarding SPoA direct to performers & contractors for which they had requested LOC endorsement.
   • All three LOC’s (NY LOC, East Yorkshire LOC & North & North East Lincs) felt they could not endorse the ICB’s letter. Katherine replied on behalf of NY LOC after discussion with LOC committee. North & North East Lincs replied direct to the ICB. East Yorks replied implying that they did not agree to having the ICB letter sent out but it has not been confirmed the ICB has been formally advised of this decision by East Yorks.
   • Reasons not happy with the original set up was that it didn’t truly reflect the mixed outcome, that some practices are very happy with the set up & using it successfully but other practices have significant concerns about it & as such are not using it. The LOC felt it appropriate to share this information.
   • Thank you to Sid & the rest of the LOCSU team who have helped with a query around the use of the ODS code as this is not something Optometry practices have been previously asked to share as part of referral processes.
   • The LOC are in the process of arranging a meeting to aid resolution of the ODS concern.
   • Query from Charlotte, direct to ICB guests. In terms of the concerns raised through the LOC what steps are being taken to resolve the concerns.
   • Penny advised Hasan would be able to provide details on ODS code query. Penny advised from an ICB perspective they are not aware of any outstanding concerns. The ICB believe all the issues raised have either been resolved or are in the process of being resolved. Penny expressed it would be useful to get to a point where we shut down & have clear agreed view as to what if any are the outstanding concerns. Penny explained Katherine had expressed some contractors aren’t happy with the SPoA & are finding that difficult but feels they have not got to the bottom of what that detail is so feels either at this meeting or understand how we are going to get to that joint understanding together as to what are the outstanding concerns if any. Penny is more that happy to keep working with contractors through issues.
   • Penny wished to flag more generally that this has been a really interesting project for the ICB, a really interesting way of working & she has really appreciated Katherine’s support & input through the implementation group but one thing that Penny has reflected on & needs to be learnt from going forward is the ICB’s engagement with the LOCs & LOCSU are around clinical leadership. That was the ICB’s original (intent of) engagement with clinical networks. Penny feels this project has seen more involvement in IT / technological issues & feels reflection is required for the future & think about how does the ICB engage differently through a clinical route as that was the purpose for ICB engagement. Then what is more appropriate as ways of engaging more as a business & IT route. Penny feels that these areas have maybe led some of the challenges so worth reflection for the future.
   • Katherine explained the LOC’s role is to act as a conduit between our contracting practices who ultimately pay the LOC levy & are the reason for the LOC existing & rather than the ICB having to individually speak to every practice. The LOC have tried to act in the manner throughout. From a clinical point of view hopefully some of the LOC’s input in the actual process of the referral has been helpful as far as making it GOS 18 or equivalent. Penny expressed this had been helpful. Katherine explained it is as much the direct liaison with practices & their data governance teams that would be the main learning outcome. Penny agreed there has been helpful input but in the later stages there are lines that as an ICB they have not had experiences of before so they can reflect on what’s a better way to manage that more business relationship.
   • Hasan asked to add detail for any raised queries.
   • Katherine highlighted concerns raised in letter from LOC’s.
     • Governance arrangements. There has been some progress on it including having the DPIA which the LOC were able to share with practices. Some practices still feel this issue is unresolved.
     • Resolved issue, cost to Optometrists or pratices.
     • Concerns raised around Optometrists own NI number & personal mobile phone use. There was a clear explanation from the ICB as far as why that was needed but ultimately no work around if an Optometrist didn’t feel comfortabel doing that.
     • The use of a failsafe which is the nhs.net route. One practice has raised that they don’t have an nhs.net route so this could be a challenge for them to be using the fail safe.
     • Rejected referrals. As far as we know none have happenned so no trail runs however as far as we understand the process is safe & secure.
     • Managing staff permissions again progress made on this including ongoing progress with the locum facility.
     • The Optometrist as the named referrer which is linked to the use of the ODS code is main point of concern remaining outstanding.

• • Hasan explained.
    • In regard governance he reflects similar to Penny & feels the DPIA has been shared & is available on the FAQ website also provided by ICB.
    • ICB have responded to a number of queries. Hasan referenced the named referrer query as being bought up as key & explained the ICB has worked with the digital provider to resolve this. Hasan explained the ICB are showing willing to try & resolve this.
    • Hasan explained the ICB will continue to reach out to all practices, Optometrists, contractors who do have concerns & encourage the LOC to continue to raise concerns with the ICB.
    • The NI & phone number is a national ask. Hasan explained there is no leeway with this as it is a national expectation from an IG perspective & this is the same for anyone with a smart card. There is no alternate but Hasan states is completely secure & has shared the privacy notice which may also be on the FAQ.
    • Rejected referrals. Nhs mail goes back to the GP / gateway. Anybody that signs up to gateway with ODS code will recieve their own rejected referrals.
    • ODS codes. Reason why access to these is required as to be the named referrer on the cataract referral.
    • Historically, cataract referral sent in on GOS 18 form stating Optometrist at given practice. As no access to ODS code (ICB have done work in background to get right ODS code parented to right space which has been a technical issue for ICB) had been using GP as proxy making GP named referrer on ERS. GOS 18 would have X Optometrist the referral in ERS (electronic referral service) also known as choose & book would have had Dr xxx from given GP practice as no access to ODS codes.
    • ODS code access allows use by ICB as administrator access with specific code which generates proxy referrer. No access to clinical systems or ODS code as whole in general. All ICB can do is refer as proxy on ERS. Hasan likened this to what a medical secretary would do in GP practice.
    • Cataract referral sent via GOS 18 to ICB admin team they then have script conversation; patient chooses provider & ICB refers through ERS with Optometrist as named referrer as opposed to Dr xxx at x practice.
    • Hasan explained all GP practices bar two have provided ICB proxy access across all Humber & NY as this is a standard approach. ICB do occasionally get questions from them also however they continue to be the data controller the ICB doesn’t have access to clinical systems or notes or anything to do with ERS other than acting as proxy referrer.
    • Staff permissions. Hasan feels opened a can of worms nationally but in a good way. Pharmacists that work across the country don’t have to be attached to a practice they can have special ODS code (5S) that all pharmacists are attached to & allows then to attend multiple practices & use ERS & other relevant processes. ICB are lobbying national team to do this for Optometrists across country. This is likely long-term ambition but would resolve many issues going forward.
    • Hasan explains ICB are automating as many of these processes as possible with the IT provider so the people who have signed up the the gateway system in recent times have a much slicker process compared to York & Scarborough.
    • When someone leaves there will be a more automated removal process & new starters can be added easily.
    • RA is mentioned, registration authority who provide the access to the SmartCards which give access to the system.
    • Hasan thanked & Katherine opened to questions from committee.

• • Charlotte advised that a lot of information has been put forward to digest & queried if this information will be shared more widely. Katherine advised can be found in LOC letter & FAQ’s.
  • Hasan happy to take further questions if required at later date.
  • Penny suggested Hasan provide a summary for the committee of ICB’s responses to LOC concerns & for Katherine to provide feedback from committee to ensure understanding of outstanding concerns & timescale for resolution if there is resolution.
  • Sid (LOCSU), helping support LOC on navigating SPoA so that it works for everyone. There has been a lot of new things to learn a lot of technical things. Sid sent Hasan an email last week because reading through the B1102 code & proxy & technical side of it Sid took it away to the LOCSU team who spent time trying to understand & they came back with a few questions for LOC. LOC were happy for these to be sent to the ICB.
  • Sid explained the example of a medical secretary at GP practice using proxy provided by Hasan earlier would not be comparable to an Optometrist. Where would the liability lie. An Optometrist sits outside, is a separate entity whereas the medical secretary & GP the liability is under one roof. Main concern would be in event of patient delay not due to referrer or if mis-match in records causing patient delay again not due to referrer. Sid explained LOC is looking for assurances against unintended risk & clarification of clinical responsibility & that there is medico-legal liability & clinical risk & possibly having some written confirmation around that. Sid believes once the Optometrist refers that’s where the liability stops & SPoA liability begins.
  • Sid will send email onto Penny & would appreciate answers to each as suggested for earlier comments.
  • Any other questions on SPoA?
  • Charlotte asked about post cataract, previously advised this would be discussed as part of this SPoA project.
  • Katherine explained that Post Cataract was a separate work stream. A draft contract had been shared from the ICB but strictly for view of LOC chairs only which Katherine had questioned if this could be shared with committee for full & proper opinion, but she was specifically told no to this request. After back & forth chairs were granted the option to share the clinical enquiry form which a number of practices have completed. Katherine needs to return this to the relevant work stream.
  • Chairs have been specifically advised they cannot share draft contract.
  • LON (local optical network) have a collective agreement of what would be a fair renumeration for this work & are happy to share this. ICB haven’t commented if that will be a number they will be working on.
  • Penny explains there is still the intention for a post cataract offering but explained it has been a more complicated procurement process than envisaged & that is the reason for the delay. It will have to go to procurement & that is why financial details cannot be shared.
  • Penny feels this relates to her initial comments in taking care in how the ICB works with the LOC focusing on clinical matters not allowing an unfair commercial & competitive advantage. There will be some things the ICB won’t be able to share with the LOC. Penny advised the ICB will take onboard views & concerns put forward by the LOC that may impact the pricing mechanism but ultimately pricing is a commercial advantage so won’t be able share as will have to go to open procurement.
  • Katherine explained this was an ongoing frustration for the LOC that a lot of Optometry practices cannot say whether they can provide a service until they know it is a viable service & part of that needs to be what qualifications / skills / inclusions are required but largely as all practices are privately run financial considerations are key. There is no good creating the perfect clinical pathway if no practices can financially afford to take part in it.
  • Charlotte took on board Penny’s point about focusing on clinical matters but explained that as the LOC is here representing the contractors from both a clinical but also a contractor viewpoint the LOC is here as a voice of Optometry in this area which means the LOC is representing the grass roots that the ICB is trying to get on board with their services. This means the ICB need to recognise they need to work alongside the LOC on all elements of the project not just clinically.
  • Penny explained her understanding was that the LOC is not a constituted trade body that has equal representation rather that it is a voluntary organisation or voluntary set up.
  • Katherine explained this is incorrect. The LOC is a constitutional  body.
  • Penny explained engagement would in her opinion need to be with a more formal market engagement route.
  • Katherine further explained the LOC is constitutional in the NHS GOS contract which means we do have representation.
  • Charlotte asked if Sid could provide Penny/ICB with an understanding of LOC as a body & the LOC’s role in the local area.
  • Katherine explained the LOC is representing both a clinical but also contractor / market engagement & this is a delicate balance the LOC plays. LOC members are always aware of their personal conflicts or interest & these are readily disclosed.
  • Sid happy to send Penny over understanding of LOC, Penny happy for this to aid future discussion.
  • Penny also wanted to raise about liability concern her understanding is the automation of referrals doesn’t change liability or process around activating referrals. A digital solution doesn’t change liability or responsibility of referrals.
  • Debbie wanted to raise her thoughts that for a GOS contractor there is not a procurement process rather it is a application & contract granted process. For the lead of the post cataract work stream they may want to engage with local contractors to ensure they are set up for successful take up.
  • Sid highlighted a quick google search explained a local optical committee is a statutory body within the NHS act 2006 & set up in 1949. However, Sid more than happy to send over information from LOCSU.
  • Sid states in regard Penny’s point of liability what we need is assurances in writing for the performers & contractors who we represent & that will solve a lot of the outstanding queries.
  • Penny feels that comes back to GOS 18 being specificized in the contract.
  • Penny will discuss with Sid her understanding of LOC as she is concerned about what she feels is representation as a commercial body. What are the commercial & business interests of LOC & how is that managed by the ICB in terms of market engagement. What are the assurances around ensuring commercial sensitivity & any commercial advantages are delt with & managed through a market engagement approach.

Hasan & Penny left meeting.

6. CECS / GRR update
   • Welcome Naomi Smith & Alex from PES (primary eyecare services)
   • Alex joined clinical lead team previously a telemed Optometrist background in high street practice & hospital optometry.
   • Ongoing active process for PES & LOC jointly being pushing for increase to renumeration fee for CECS service & have IP element as part of that.
   • Currently proposal sat with Charlotte Liddle (ICB contract lead for North Yorkshire). Report prepared & proposal is for board but awaiting response from Charlotte.
   • Naomi explained Charlotte is fully supportive of inclusion of IP element with associated fee & for inflationary related fee increase.
   • Charlotte was invited to this evenings meeting but unfortunately did not RSVP.
   • Naomi explained there will be an upcoming contract meeting PES & ICB in next 6/52s.
   • Awaiting update on new ICB contract lead for Vale of York / York central area.
   • Katherine requested details shared from Naomi when provided.
   • Slideshow presentation shared from Naomi highlighting PES performance in area. No concerns raised.
   • Naomi explained PES perform regular audits Q4/Q2. A few points of note. Contractors would be contacted as necessary. GOS referrals into MECs seeing patients on GOS ST’s. A few referring outside of opera a lot. No major concerns but wants to advise of regular audits & contact to practices where data sits outside of routine.
   • Also reviewing monthly data & looking into duplicates are these genuine second appointments or should they go through as follow – ups.
   • More practices are preparing to sign up to PES in York area.
7. LOCSU update
   • Sid formal introduction
     • Thanks for support with SPoA
     • Sid supports 15 LOC’s & has previously supported on similar SPoA type projects.
     • Secretary of Gloucestershire LOC & Low vision practitioner, & Low Vision lead for LOCSU.
   • Update from LOCSU regional meeting – note of increased ICB pressure on contracts in other areas including a cap on the number of episodes that can be completed for CUEs for example in Leeds & withdrawal of post cataract services in Durham.
     • There was a review of declarations of interest.
     • A repeated request for if any referrals are being rejected to please flag to Katherine (Chair) who will pass on to Stephanie who is our regional representative for the region.
     • LOCSU continues to work with IV in other areas which doesn’t affect us directly.
     • LOCSU lead assessor training. There is a number of new LOCSU lead assessors who have had funding from LOCSU in order to provide WOPEC assessment work.
     • A reminder that their are various LOCSU meeting that can be attended.
     • A response to the NHS 10 year plan notes of which will be shared.
     • Special schools regional update – Melanie sits on this test group. No changes or real updates about the new contract being rolled out. Melanie would like to know when the date the pilot contract will get noticed & new contracts issued.
     • Deborah responded to advise Melanie that there is still debate within the ICB over which contracting team will have responsibility for the new special schools contract. It is highly likely to sit within Deborah’s team. At the moment Deborah’s team are looking at the procurement & hopefully being able to link in with North East & Cumbria with a view to going out for procurement with contracts up & running for Sept 2026. Deborah not sure how achievable this is but this is aim.
     • Katherine raised point that as Special educational school contractors do not pay an LOC levy this isn’t technically core work does the LOC want to continue to support Melanie & the other special schools contractors in continuing this work through LOCSU. Firsted Katherine, Seconded Charlotte. Agreed by LOC.
8. NHS local update
   • Welcome & introduction from Debra Leadbetter – lead within primary care for GOS contracting. ICB colleague but not always working within other contract areas but can help sign post relevant people.
   • Enquiry from contractor about continued low rate of GOS remuneration, realise is OFNC question rather than NY & Humber question but wanted noted.
   • Also delays on CPD grant with no updates.
   • Deborah wants to thank contractors for completion of annual GOS complaints survey as very good take up rate. They will reach out to any non-completing contractors in a supportive manner.
   • Note from Deborah for Melanie regarding Special educational schools provision, high interest from school & positive feedback for Melanie.
   • Deborah explained about the workforce training budget; this is still live & Deborah would like to continue to promote this to enhance local skillsets. Also using this funding to sponsor CPD events with local guest speakers.
   • Deborah explained ICB has cloud hanging over with government announcements of 50% reduction in staffing, budget & finances which is driver behind decisions being made & delays that may be experienced. Increased over-sight panels prior to agreement of any monies being spent.
9. Hypertension Service Funding
   • Thanks to Philip, Charlotte, Deborah & wider ICB team for work behind scenes on funding of hypertension service.
   • Hasn’t been as much take up as envisioned for this service which has meant large surplus of funds which is currently been held by the LOC as per agreement with the ICB when the pilot first came out. These funds have generated interest.
   • LOC want to understand what is exactly surplus hypertension funding which has been clarified, next is to understand what bank interest is solely hypertension funding related & what is true LOC fund interest.
   • Next step is movement of funds going forward. LOC have requested initially any funds relating to Pharmacy are no longer held by NY LOC.
   • Deborah is currently working on all funds being managed not by the LOC going forward rather the ICB. This would mean Optometry practices would no longer come via the NY LOC for that funding.
   • All surplus funds would be returned to ICB to manage this service appropriately for this purpose.
   • Any interest gained on hypertensive funds would also need to be returned other than a proportion which will be required from HMRC for corporation tax purposes. The LOC is fairly certain we will be required to make this tax payment & LOCSU have supported with understanding this.
   • Charlotte queried due to the complexity of accounting required to determine interest split would the ICB also be happy to pay for the accounting invoice from this. Deborah felt this was a fair ask & would be happy to support either full or part payment of this invoice.
   • Charlotte proposal is to use Locum Kit a LOCSU approved accounting firm to review & calculate the relevant interest split. Katherine seconded the motion. Agreed by all LOC members present.
   • Charlotte asked for further clarification from Deborah prior to the move of monies from the LOC to pharmacy. Initially advised monies had been GOS surplus from covid & that was reason given for pharmacist non-management of funds. In hypertension service majority of money is actually paid to pharmacists, Charlotte queried why this service is not more supportive of Optometrist practices. Deborah explained over time there has been new income stream coming into this project some of which has been for digital funding – pharmaoutcomes. All this funding came to LOC but should on reflection have gone to LPC. Not all money is GOS surplus.
   • When this money is returned to ICB will they work with the LOC to ensure money from GOS surplus is protected for GOS providers & a suitable ophthalmic project? Deborah explained that there is a risk this money is lost into the ICB however she will try her best to protect these funds.
   • Katherine queried if it would be worthwhile for the LOC in the future to put forward an application or proposal to the ICB for how this money could be spent. Deborah agreed this would be worthwhile.
   • Sid offered support with putting together a proposal in the future. He has experience of providing business cases for low vision.
   • Deborah mentioned a potential option to use the surplus funding to support current schemes if required.
   • Deborah confirmed that the £25 monthly fee for managing the accounts will be retained.
   • The LOC has been working with the LOCSU CVD project which aims to ensure best practice with similar projects across the country & encourage engagement. For this the LOC has claimed a £500 grant. They have requested a case report from the LON area if anyone has one, please email northyorkshireloc@gmail.com.
10. Constitution 
    • There is a delay in the supporting documents from LOCSU hoping these will be available early 2026 which should provide time to complete the work in advance of the AGM.
11. Payroll, renumeration & expenses
    • Charlotte proposed (seconded by Katherine) that the LOC move to a PAYE system for all committee members from April 2026 with LocumKit the current approved LOCSU provider. There is currently no charge to the LOC for using LocumKit this is covered by LOCSU. Reasoning behind is to ensure clarity for HMRC especially around NI contributions. All office holders, chair, secretary & treasurer are viewed as fixed job roles rather than ad hoc contracting. Unanimously agreed.
    • Proposed changes to how time is renumerated (firsted by Katherine and seconded by Charlotte). Maintaining £1000 honorarium for office holders but split over 12 months via PAYE. Also to change the hourly rate to a standard rate during office hours or outside of office hours to £60ph up to max. Day rate of £400. Unanimously agreed
    • Proposed changes to expense policy will be reflective of the new policy LOCSU are yet to publish so will be revisited when this work is completed. With immediate effect all milage to be set at 45p/mile as per HMRC requirements.
12. LOC member development day 24^th November deadline to book 5^th
13. CPD day following day- thanks to Sarah Smith for taking lead on arranging.
14. Proposal for communications role to manage website, provide monthly LOC email with updates including CPD offerings locally all with aim to increase local engagement. Committee agreed good to investigate this role & members will reflect on this prior to the next meeting.
15. Review of financial report. Premium account is predominantly holding ICB funds, community account predominantly made up of LOC levy will soon see debited the CPD day funding including venue hire fees.
16. Next meeting will be 15^th January 2026 7pm at The Crown Hotel Boroughbridge. Observers welcome, please contact northyorkshireloc@gmail.com to arrange attendance.

Meeting Closed.