Optical assistants (OA) and other non-registered staff can flourish in any practice environment, but few employers make it as easy as Specsavers. With more than 20,000 OAs in its business, the majority of whom are performing delegated functions, director of professional development, Grant Duncan, (pictured right) says the company wants the level of expertise among them to be as high as possible.
Learning begins in earnest for new OAs. There are two levels of training OAs are expected to have completed within the first six months of employment: OA1 and OA2. OA1 begins to build the essential practice skills, including an introduction to dispensing and customer service, along with mandatory internal compliance training.
It is at this point the OAs also become familiar with equipment used to perform delegated functions, including auto-refraction, non-contact tonometry, visual fields, and optical coherence tomography (OCT).
The diagnostic component of the training is delivered online and in practice by existing clinicians that help OAs through this stage of the programme and sign off on the OA’s competency at the end.
For those clinicians, there are teaching elements on the company’s internal learning platform. OA2 then builds on some of the subjects in OA1 and gets the OA ready for Specsavers’ Cert 3 BTEC courses.
Build your own BTEC
The BTEC course is accredited to Level 3 by Pearson and has recently been redeveloped by the company. Duncan says the new courses, dubbed ‘build your own BTEC,’ are more job specific and more focused than previous syllabuses, which comprised a main course topic alongside a secondary subject. There are now dispensing, contact lens dispensing, clinical technician, and lab technician courses under the Level 3 accreditation which allow OAs to fine tune their own career progression path.
In order to standardise the training involved for delegated functions across the business, Specsavers introduced an internally awarded clinical technician training programme and certificate in 2022.
Much like the OA1 and OA2 courses, the new training includes hands-on learning experience with the equipment, but training is delivered and observed by a General Optical Council registrant and includes sign offs across five practical skill assessments and four online workbooks.
Additional e-learning elements cover anatomy, physiology, pathology, OCT and fundus imaging. OAs will also learn practical skills, including recognising signal strength indexes for OCT scans, and how and when to use different viewing modes.
Throughout the courses, OAs are guided through what to say to patients during tests and, more importantly, what not to say. OAs are trained on how to explain what each piece of equipment is and what is being looked for. On an OCT, for example, the OA will tell the patient: ‘This test will give the optometrist a more detailed view of layers of the retina and, therefore, help them better determine your eye health.’
Duncan adds: ‘The OA will also explain that they’re unable to interpret or comment on the findings of any tests and that it’s for the optometrist to determine the findings of the test.’
After explaining the purpose of the tests, dialogue between the patient and the OA will consist of guiding them through positioning on each device and maintaining fixation.
Progression
Maintaining a high level of training for OAs and other non-registered staff, along with offering clear career progression, is something Duncan says is incredibly important for Specsavers in ensuring the business is future-proofed from any sector workforce changes.
‘The ambition is to really drive our expertise and to improve it, because knowledge and expertise across the Specsavers estate is something that ensures patients come back time and again,’ he says.
Offering potential new staff clear progression opportunities is a great recruitment tool, says Duncan: ‘We’ll train you as an OA, we’ll get you through a BTEC Level 3 qualification and then give you the option to progress to level four and onwards to diploma or degree level. All of this is possible when you come and work for us because it’s the expertise we want to build in the workforce.’
The poise to perform
OAs all over the UK use Topcon Medical’s equipment while performing delegated functions and it is the responsibility of UK and Ireland clinical affairs manager Dani Lee to make sure they are au fait with each device. 
Lee says her own career background puts her in a similar position to many OAs, as she joined the sector with very little knowledge of eye health.
A degree in medical biochemistry landed her a job in an NHS and transplant laboratory, but her interest was piqued by an opening for OCT technician at Bristol Eye Hospital.
She quickly found herself using a range of imaging equipment and was soon promoted to the position of hospital photographer.
Lee says she was a ‘bit of a test’ case in the role while the hospital worked out what it wanted from its photographers, as she was trained to assist in intravitreal injections and run clinical trials.
‘I don’t think I could go on the same journey now if I had to start again. I don’t think they’d let me do all the things that I was allowed to do back then,’ she jokes.
With an eclectic mix of experience, Lee joined Topcon as a clinical affairs specialist in 2020 and has since been promoted to her current role.
The first part of Topcon’s training comes when a device, usually an OCT or Myah, is delivered and installed in practice after purchase. Lee explains that the first piece of education comes from the practice’s sales representative, who will be present when the equipment is delivered and set up.
The sales representative will offer some familiarisation training on image capture to any member of staff in the practice who is likely to be using the device.
Lee’s team then take the reins and subsequent training will be tailored to each member of staff that will be using the equipment.
Staff can utilise both remote learning platforms as well as in-practice training. ‘Online software training is generally more tailored to optometrists, but modules, such as introduction to anatomy, are available for OAs,’ says Lee.
Confidence
In-practice training from Topcon’s clinical team tends to be more focused on OAs and front of house members of staff, says Lee. ‘Training for front of house staff aims to get them talking confidently about OCT and potentially engaging the patient before they’ve even seen the optometrist.’
Staff will also be trained in scenarios where the patient declines an OCT or objects because they believe they have had the test elsewhere, which Lee says often happens with diabetic patients, who believe screening programmes will have provided sufficient information on the progress of diabetic retinopathy.
This confidence building approach has recently been expanded to include the Myah device used to support myopia management, explains Lee: ‘It’s a newer area of clinical care, but we’re seeing a definite shift in terms of myopia management and how practices are communicating with patients.’
Lee notes that the capture side of the Myah device is relatively simple and suitable for OAs, but being a relatively new addition, many practices are still working out where to put their devices, with some opting for the consulting room with the optometrists, while others are keeping it as part of the pre-screening process.
Patients and parents are becoming increasingly aware of myopia in children and are starting to make a different level of enquiry with practices, adds Lee. ‘I have spoken with practices that have had patients ask if they’re able to measure axial length,’ she says.
While this shows the leaps made by the eye care sector in recent years, it underlines the importance of making sure everyone in practice is confident talking about clinical services and instruments to a certain level.
For OAs, the training focuses on ensuring they are capturing good quality images that can be analysed and that they have the confidence to recognise good and bad images, and whether a scan needs to be repeated or additional images captured.