The article Visus writes has come to my attention and I feel it would be useful to respond.
Firstly, orthoptists have been referred to as non-autonomous practitioners. This is now not the case with orthoptists managing their own clinics and caseloads in addition to working as part of MDTs. The question of ‘selling’ applies to orthoptists that are working for private companies and therefore the use of medicines is not covered by NHS practice. This is the terminology applied to all professions using exemptions.
Secondly, the question of why orthoptists need access to cyclopentolate is raised. The ability for orthoptists to instil drops prior to a patient seeing an ophthalmologist would have considerable benefit for patient flow throughout a paediatric clinic. In addition, if an orthoptist identifies a patient who needs refracting at their next appointment they could supply cyclopentolate to the parent to instil an hour before the refraction thereby reducing waiting times in clinic. This is especially important for darker eyed patients who take longer to dilate.
In answer to the question of antibiotic use: many paediatric patients attending for orthoptic clinics present with sticky eye and the number of orthoptists involved in red eye clinics is increasing. Orthoptists supplying antibiotics would need to comply with ARHAI guidelines and local governance policies.
The next question raised was whether atropine as a treatment option was elucidated to as part of the consultation. Yes. The use of evidence based practice (in line with PEDIG studies) is at the core of our argument. We need to ensure that children have first line access to all proven treatment modalities.
Lastly, it was stated that there is little detail to the proposed training. I point readers in the direction of the Outline Curriculum Framework, a supporting document to the consultation, which describes the basis for post-graduate training. Any HEI wishing to train orthoptists to use exemptions would need approval from our regulators, the Health and Care Professions Council, who would also design standards of proficiency for the use of exemptions by orthoptists.
I hope this answers some of the queries. We are concerned that misrepresentation of the current case would influence optometrists’ responses to the public consultation. Please do not hesitate to contact me if you or your readers have any more queries.
Claire Saha BIOS Medicines Project Lead, King’s College Hospital