Just recently a report was published showing the highly alarming increase in type 2 diabetes in children. Currently more than 600 children are being treated for the condition with 110 more cases being found among the under 19s in 2015-16 compared to two years previously. The youngest affected are aged between five and nine. These results were described as a ‘hugely disturbing trend’ and council leaders said that urgent action on childhood obesity was required.
So what has any of that got to do with optometry? The simple fact is that diabetes long term is one of the leading causes for loss of functional vision and the earlier diabetes starts the greater the risk to eyesight for that individual. As optometrists we should therefore be at the forefront in preventing that vision failure onset. But does our job start at the point when a patient is diagnosed with diabetes? The clear answer is no. We have a duty of care to all our patients and that duty extends beyond just making sure they can read our letter chart clearly.
Within the NHS Constitution it states that our patients should expect to be given information that allows them to make fully informed lifestyle choices. This means that our role must extend to giving out information on the risk factors our patients are exposed to. Most people reading this will know of at least one child they have seen, and most probably many more than just the one, who are somewhere on the obese spectrum. These children are at increased risk of many health problems and clearly one of those is type 2 diabetes. But when was the last time that you sat down with that child’s parents and discussed the eye-related risk factors that obesity presents?
I can already hear people jumping up and down and shouting that it is not their responsibility to do this and that we should not ‘nanny’ these people, or that we are not paid properly enough to sit and spend time talking about this sort of thing. The simple fact is, however, that we should spend that time. The fact that we are not paid enough is irrelevant. That is our problem to take up with our professional bodies and should not influence the level of care we give to our patients.
Many may say that they are not allowed enough time by their employer to give time to talk to patients and parents about these things. Again that is not the fault of the patient but rather the employer. If employers are not allowing enough time for these discussions to take place they are abrogating their responsibility to the duty of care for the patient and should seriously review their stance on this.
We all accept that eyesight is one of the most precious senses, if not the most precious. Therefore we should be at the very forefront of preserving that precious sense. For years we have not tackled the smoking issue even though we knew the increased risks to eyesight that smoking brings. In that time how many of our patients have lost useful sight through premature onset AMD? How many times could we as optometrists usefully intervene to give patients the necessary information to assist them in informed lifestyle choices? It is little short of a travesty that we did not step up to the plate on that issue. Are we going to do the same thing again when it comes to children and their vision risks?
It is on these duty of care issues that our regulator should be taking the lead. The GOC really must become more pro-active in its approach to the level of care that is delivered to people in this country. It is pointless having a regulator that is not prepared to take a proactive stance on healthcare matters.
To date the GOC has a history of reacting to situations rather than proactively influencing the levels of care delivered. At the end of the day the GOC is there to protect the public. I can see no better way to do this than to ensure the clinicians it has sway over deliver standards of care that are in line with the basic concepts of the NHS Constitution.
While we wait for the GOC to do this what will you be doing as individual optometrists? Do you believe in preserving the vision of the next generation? It may not always be easy but it is what we trained to do.