A s the optical industry evolves following the pandemic and heightened demand due to the NHS backlog, Optician talks to the professionals on the ground. Eye hospitals and clinics discuss workplace challenges, understand workplace challenges, professional opportunities and differences from high street optical practices, including working relationships across primary and secondary care.
Ongoing pandemic impacts
Practitioners highlight that the main pandemic workplace challenges revolved around needing to develop alternative solutions to support patients, such as introducing remote consultations, adapting communication with face masks through increased verbal affirmations, as well as improved flexibility overall.
Dr Clare O’Donnell, head of optometry and eye sciences at Optegra Eye Health Care, says: ‘This included our virtual clinics, which were very popular with patients, so much so that we have carried on with these in parts of our service delivery. Naturally, with social distancing measures and temperature testing/screening, there were changes to diaries and workflow in order to keep everyone safe, and, of course, the impact on resourcing when colleagues were unable to work posed additional challenges.’
The change in procedures highlights the importance of communicating effectively with the patient’s family as well as the patient. The pandemic caused barriers to clinical decision-making with patients’ families. This also meant patients required more mental health support, says Optegra optometrist Dr Nabila Jones.
Moorfields Eye Hospital redeployed 250 medical and nursing staff to support wider London facilities during the peak of Covid-19, so optometrists covered additional duties. This included providing advice and guidance to patients on the helpline, triaging referrals and developing training and protocols for virtual reviews, while also working weekends to assess and list patients for cataract surgery.
Sarah Canning, head of optometry at Moorfields Eye Hospital, adds: ‘Moving activity to virtual platforms, such as Attend Anywhere, ensured we were able to maintain contact with patients in a safe way. We performed a massive risk stratification exercise, which allowed us to identify lower risk patients who could be reviewed via a diagnostic and virtual review pathway. This ensured that we kept our backlog to a minimum for patients requiring face-to-face outpatient appointments. Optometrists also supported our initiatives to recover surgical activity by working over weekends to assess and list patients for cataract surgery.’
Hospital vs high street
Canning says eye hospital workplaces differentiate from high street optical practices as they are very multi-professional. ‘You work closely with ophthalmologists, nurses, orthoptists, pharmacists and specialist teams, such as healthcare scientists who perform electro-diagnostics and ocular prosthetics,’ she explains. ‘When you start in a hospital role, you will largely work in seeing patients for diagnostic refractions pre- and post-surgery, low vision assessments and medical contact lens fitting and aftercare.
‘Most optometrists will transition to see patients in other sub-specialty clinics after two to three years and can go on to develop advanced skills, such as delivering laser, minor operations and independently managing and treating patients with a variety of ophthalmic conditions. There are also senior roles for leadership and management of optometry-led services, education and research and strategic development across integrated care systems (ICSs).’
Optometrist Dr Nabila Jones notes that the working dynamics impacts relationships positively: ‘I feel we have a closer relationship with the ophthalmologists we work with. At a hospital level, optometrists are trained to diagnose, treat and manage patients more independently than they would be if working in a high street setting.’
She adds that hospitals allow wider prospects for career progression, saying: ‘Continual professional development is ongoing, but there are also excellent opportunities, including support to become independent prescribers and upskilling to perform higher clinical skills, such as performing YAG laser capsulotomy.’
Canning emphasises that the variety of work and breadth of experts at Moorfields Eye Hospital is one of the professional perks of the workplace, and often results from how most patients have complex visual needs. She says: ‘Working in a hospital optometry role provides many chances to develop extended knowledge and skills in assessing and managing patients across sub-specialty services, such as glaucoma, medical retina, cornea, A&E and oculoplastics.’