Dear Profession,

I am an optometrist. I am a GOC registrant. I am a foundation fellow of the College of Optometrists. I am a practice owner. I am an independent optometrist. I am an LOC committee member. I have been a visiting lecturer at City University. I have been an examiner for the College of Optometrists. I have been a council member for the GOC. I have been a council member for the College of Optometrists. I also have had the honour of serving as President of the College of Optometrists.

Our profession is one of care, understanding and self-management. To be a professional you must adhere to the code of conduct and be rigorous with your ethical obligations. Our obligations are to develop and be the best we can be. We must, also, always put our patients' needs before our own.

As a professional optometrist we must always strive to be better, do better, improve our knowledge and improve our skills.

Our profession has a problem. That problem is locum optometrists. Locum optometrists undermine our profession with their apathy.

As a current expert witness (and having served on the GOC fitness to practice committees), the majority of fitness to practice hearings are for the deficient practice of locum optometrists. It is known by the GOC that a locum optometrist is 30 times more likely to have a fitness to practice hearing than an employed optometrist. That is an astonishing statistic.

The AOP are considering greatly increasing the insurance premiums for locum optometrists due to the increased risk of litigation. Boots Optician are considering implementing a defence clause with all locum optometrists (where the locum optometrist will be liable for an 'excess' charge against any complaint).

As an LOC committee we endeavour to always raise the standard of optometrists in our geographic area. We work tirelessly to secure enhanced service contracts for practices. Consistently the Eye departments and the CCG hold up or cancel proposed contracts due to the inconsistent standard of care in a specific area. When we examine the cause of the poor care, it is because the practices rely on locum optometrists. The actions of a few harm the chances of the many. The enhanced service is then not commissioned due to the actions of a 'test and go' locum.

To raise the standard of care we run events and peer review, but the practitioners that we want to reach never ever (ever) attend. By raising knowledge, skills and ability to manage patients we will improve the standard of care. Standard of care is the key for the profession. Once we improve the standard of care, everything else will follow.

'Test and go' does not make an optometrist. 'Test and go' means that you do not care. 'Test and go' means that you are doing your patients, your profession and yourself a disservice.

Making a referral is not a management plan.

You must devote some of yourself to your profession. You must develop yourself. You must improve your knowledge.

Optometry has a huge opportunity with enhanced services. We will never take advantage of this opportunity if the standard of care does not improve. We are missing out on opportunities (real contracts) due to the bad practice of a few. CCGs and Ophthalmology do not respect us. Until we tackle the locum optometrist epidemic, none of this will ever happen.

We need our professional bodies, the AOP and the chain opticians to work closely together on this matter. The GOC needs to:

  • Have a separate registration list for locum optometrists.

The College of Optometrists needs to:

  • Develop an advanced qualification in locum optometry. To be made up from all the current advanced certificates.

The AOP needs to:

  • Develop more robust indemnity insurance for locum optometrists.

Be included on the GOC list of locums:

  • The optometrist must be qualified for 5 years.
  • Has completed the College advanced qualification in locum optometry.
  • *Have the locum optometrist indemnity insurance.

All optometrists must have a continual development plan. As locum optometrists refuse to develop themselves, then the development must be done before they become a locum. Locum optometrists should be at the peak of our profession, with the most skill and knowledge. We must get away from the current mercenaries.

A cohesive, competent optometrist workforce will enable the profession to flourish. We will become a more respected profession, manage patients appropriately and take advantage of the enhanced services available. Standards of care can be raised, we must start with improving the group of optometrists that are holding back the profession, due to their continued apathy.

Thank you for your time.

The AOP replies: AOP rebuttal of ‘mystery letter’

November 3, 2016

I am writing in response to the letter published on Optician online on 2/11/2016 ‘Mystery letter deplores locum apathy’.

The AOP has never discussed, nor is considering, increasing the premiums of our locum optometrist members. In addition, if a member works less than 100 days a year they are able to apply for our Concessionary membership grade which gives them the same cover at a reduced fee. Our 2017 membership fees have been frozen for the seventh year in a row.

The AOP’s indemnity insurance is the most robust in the market and we treat all members equally in respect of their cover, no matter how or where they practise.

Looking back over the last 12 months, the AOP has no evidence to support the allegations that locums are more likely to have a Fitness to Practise hearing than an employed optometrist. All optometrists are trained to the same standard at university and have to adhere to the same CET requirements and Standards of Practice set by the GOC.

With an ever increasing number of optometrists choosing to locum, there is a stronger need than ever to work together to ensure locums are treated as a valued part of any practice team.

Yours sincerely,

Henrietta Alderman

Chief Executive