The General Optical Council’s call for evidence on the Opticians Act is a great opportunity for the optical sector to think about the future. It also allows us to explore how the regulatory framework should evolve to continue protecting the public by enabling dispensing opticians and optometrists to develop their roles and work together as part of a multi-disciplinary team for the benefit of patients.
The issue that has dominated the public debate so far has been refraction and this debate has generated a lot of heat, but not an awful lot of light.
The Association of British Dispensing Opticians (ABDO) is seeking a limited change to the GOC’s 2013 statement on sight-testing to allow dispensing opticians to refract as part of the sight test under the oversight of an optometrist or medical practitioner. To carry out this role, a dispensing optician would, of course, need to be competent to do so and have appropriate professional indemnity insurance. From our perspective, this change should not be controversial.
Existing roles
The optometrist or medical practitioner will still be responsible for the sight test, meaning that patients will continue to benefit from an eye health examination at the same time as a refraction. This is a major strength of the UK’s system of eye care and enables eye and other health issues to be identified and addressed at an early stage in line with the wider health policy focus on prevention.
Enabling dispensing opticians to support optometrists and medical practitioners in carrying out sight tests would simply enable patient care to be provided in a more flexible way, while upholding the principle that a sight test should involve both a refraction and an eye health examination.
There should also be no reason for concern about dispensing opticians’ ability to carry out refraction accurately and safely, including their ability to flag up any concerns about pathology. Dispensing opticians already learn to refract as part of their education and it is often overlooked that the GOC’s 2013 statement already allows dispensing opticians to refract outside of the sight test to, for example, verify a prescription.
The quality of the education that dispensing opticians receive is reflected in the fact that I, along with several of my colleagues, went on to pass a practical refraction examination. Also, as an ABDO examiner I have been examining overseas students on refraction for many years.
A multi-disciplinary approach
If the GOC allow dispensing opticians to refract as part of the sight test – under the oversight of an optometrist or medical practitioner – ABDO will provide training to enable members who wish to do this to check their skills and knowledge are up-to-date and gain accreditation to this effect.
For the next generation of dispensing opticians, the GOC’s new outcomes for registration will require them to learn how to carry out refraction and there will be a practical examination to test their skills and knowledge.
It is just not the case, therefore, that enabling dispensing opticians to carry out refraction as part of the sight test would present a risk to patients or the wider public. Dispensing opticians undertaking this task will have proven their ability to do so and will be more than capable of identifying any concerns about pathology that arise during the refraction.
Enabling dispensing opticians to refract as part of the sight test is part of the wider and positive trend towards a multi-disciplinary approach to delivering primary eye care. As an independent practice owner, I value all the members of my team and want them to be developing their skills and knowledge as much as possible. In this way, we can relieve the huge strain on hospital eye departments and improve the quality of eye care that we provide to the public.
Added value
Observing the current debate, anyone would think that the sight test does not already involve a range of staff, such as optical assistants measuring visual fields or operating an auto-refractor. It seems perverse for an optometrist to rely on the results of an auto-refraction but not a refraction carried out by a dispensing optician. A dispensing optician can save time for an optometrist by carrying out the re-check needed if a patient returns to the practice following a sight test, saying that their new spectacles have not corrected their vision as intended.
I hope that in responding to the GOC’s call for evidence, colleagues across the sector will set aside any pre-conceived ideas about the expertise that dispensing opticians have in relation to refraction and recognise the value they can add, certainly compared to the auto-refractors that many optometrists currently use.
- The GOC’s call for evidence closes on July 18.