The General Optical Council (GOC) has released the findings of a report it commissioned to investigate optometrist therapeutic prescribing (OTP) and the factors that could affect the uptake of associated qualifications within the industry.
Optometrists in the UK can undertake training with the GOC that, following a successful clinical placement and final assessment, enables them to prescribe a range of medicines for patients with eye conditions. However, the GOC’s report found that progress in upskilling optometrists had been hampered by a range of factors that the regulator said it would consider when reviewing the education and training requirements for its independent prescribing qualifications.
In its conclusion, the report’s authors said: ‘A lack of joined up thinking appears to have hampered advancement in relation to many aspects of the preparation, education and use of the prescribing role by OTPs. Future development of OTP would benefit from greater strategic oversight and alignment with educational and governance procedures in place for other non-medical prescribers.’
The timeliness of the report was also highlighted by the GOC, which added that ‘non-medical prescribing (NMP) is likely to be increasingly important for services to overcome predicted workforce deficits and inadequacies.’
The GOC explained that it commissioned the review of the literature on OTP to ‘identify known barriers and facilitators to implementing NMP that impact on OTP, related to additional
supply, independent and supplementary prescribing.’ Major barriers identified by the report included levels of organisational and practitioner readiness, training and professional development.
Organisational readiness
It was identified by the report’s researchers that optimal organisational readiness at the national and GOC level would be key to supporting the implementation of NMP. Local policy and infrastructure to support prescribing and leadership backing were the contingent aspects of this, with up-to-date NMP policies and ‘clarity regarding NMP roles’ highlighted as particularly important.
In its discussion segment, the report said: ‘Concerns about role erosion and examples of resistance to NMP, in particular from the medical profession, have long been noted as a barrier to the acceptance and implementation of NMP. Indications from this review are that similar resistance exists with regards to OTP.’
However, the report added: ‘Negative views and concerns about NMP are known to dissipate once colleagues gain experience of working alongside NMPs, understand the benefits and have an opportunity to develop a trusting relationship.’
Practitioner readiness
The report also identified the preparedness of clinicians as a key factor in the uptake of OTP across the profession. Lack of remuneration, funding and time allocated to complete training were highlighted as the key barriers in this area while the expectations and motivations of practitioners were also
discussed.
A positive attitude towards upskilling was identified by the researchers, who described ‘an increased sense of autonomy, the desire to make use of professional skills and expertise’ and professional development alongside increased clinical competence as the most common reasons practitioners decided to undertake training in NMP.
However, major deterrents were identified as ‘added responsibility that came with prescribing together with a lack of financial remuneration.’
Training and development
Satisfaction ratings for OTP training were generally high, with three-quarters believing training was relevant and helpful to practice. However, the report found 25% had indicated they were not adequately exposed to relevant clinical conditions or a sufficient number of patients during training. Additionally, difficulties finding a required hospital-based clinical placement were identified as a key barrier to the growth of OTP.
The report mentioned the strategy employed by the Scottish and Welsh governments to invest in OTP and highlighted their decisions to allocate funds for training courses and placements as generally positive, but explained that issues remain around ‘spread and availability of OTPs who tend to be concentrated in urban rather than rural locations.’
Mixed views on the necessity for two years of post-registration experience in optics prior to beginning training as an OTP were also noted by the report, which highlighted a ‘lack of consensus within other regulators who have adopted different approaches to supporting uptake of the IP role.’ There was also recognition of a ‘lack of alignment between prescribing standards set out by the GOC and those in the Royal Pharmaceutical Society Competency Framework for all Prescribers, adopted by all the other professional groups who undertake NMP training.’
- Read the GOC’s full report at https://bit.ly/35VLwK2