We were interested to read the debate in the letters on the Opinion pages about independent prescribing and higher qualifications.
When we set up Wopec at Cardiff University, six years ago, we created a website to have a capacity for 1,000 learners. At the time we thought that was ambitious. Today we were astounded to welcome our 10,000th learner.
Optometrists from Wales, England and Northern Ireland, funded by Locsu, LOCs, governments, health boards, CCGs or companies have done distance e-learning courses, on glaucoma, pre and post-operative cataract management, minor/acute eye conditions, low vision and eye care for people with learning disabilities. In addition, we have accredited more than 4,000 optometrists in clinical station assessments; more than 2,000 in the past year alone. Postgraduate taught courses have also been very popular, especially those accredited for higher professional qualifications in glaucoma, low vision, medical retina, paediatrics and independent prescribing and many are over-subscribed each semester.
We wonder how many other health care professions could boast something similar. We are constantly impressed by the willingness of optometrists to prove their competence to practice evidence-based health care at the top of their licence and learn new and advanced skills.
So why are optometrists coming forward in such large numbers? One reason is patient safety, but we would argue the evidence is that the risk is currently in the hospital eye service and not in optometry practice. The president of the College of Ophthalmologists recently outlined the patient safety concerns that have resulted from the mismatch in capacity and demand.1 In 2009 a Rapid Response Report by the National Patient Safety Agency outlined the growing number of reports of concerns about patient safety due to delays in follow-up appointments for glaucoma patients in ophthalmology departments.2 The Care Quality Commission also reported that ‘pressure on the outpatients department meant long delays for some specialities and not all patients being followed up appropriately, particularly in ophthalmology and dermatology’ in a report on Addenbrooke’s and Rosie Hospitals in 2015.3
The mismatch in capacity and demand is not always just caused by a lack of professional time in hospitals, it can also be a lack of rooms and equipment in hospitals. In Wales, to try to balance capacity and demand, one health board is not only discharging OHTs and glaucoma suspect patients to community optometry practices with a management plan, it has also contracted six optometry practices to monitor low risk glaucoma patients.
As optometrists we are really proud of our profession and the way it is rising to the challenges to help deliver high quality safe eye care across all parts of the pathway in Wales and the UK.
There is no doubt change is here and we think all the indications are there will be an increasing role for optometrists in primary eye care in future. We suspect it is impossible to predict exactly what the future holds for optometry. However, we do not think there is a need to put restrictions on the profession in terms of what they should or should not be able to do. Instead it is our hope optometrists continue to put their patients first and work with ophthalmologists, GPs, ophthalmic nurses and orthoptists to try to ensure that together we deliver safe, sustainable high quality eye care for everyone that needs it now and in the future. We expect, and hope, that would be the aspiration of all leaders in the profession.
Drs Barbara Ryan and Nik Sheen, directors, Wopec, Cardiff University
1 Prof Carrie MacEwen, president, Royal College of Ophthalmologists. Eye risk from ‘overstretched NHS’. bbc.co.uk/news/health-35743550, accessed October 12, 2016.
2 March 16, 2016 National Patient Safety Agency (2009) Rapid Response Report NPSA/2009/RRR004: Preventing delay to follow up for patients with glaucoma.
3 Care Quality Commission (2015). Quality Report: Cambridge University Hospitals NHS Foundation Trust, Addenbrooke’s and the Rosie Hospitals. Supported by independent reports.
