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Opchat Magazine Professional Matters PagesProfessional Matters News, January to March 2020

Optometry/Dispensing

For Ophthalmology Section Page Click Here.

COVID-19 - Patient Care at Growing Risk as NHS ENGLAND ignores Optics
Promised further information and important links for help in finance in Covid Pandemic
News is just arriving on help for self-employed which will assist locums
OFNC updated guidance on opening arrangements for optical practices
AOP calls on Government to act faster for locums
OPTICAL PRACTICES – ESSENTIAL OPENING ARRANGEMENTS clarified this morning (24 March 2020)
Routine Eyecare to cease by order in Scotland
COVID-19 – SUPPORT FOR GOS CONTRACTORS IN ENGLAND
RCO and College publish joint Covid Statement
GOC response to the COVID-19 (coronavirus) emergency
GOC erases 2 student dispensing opticians
Dr David Parkins reappointed as member of GOC Council
GOC sets out position on lissamine green
GOC makes statement on Cataract Referrals
Hard Sell for Private Cataract Surgery claims Inside Health non BBC Radio 4
Richard Whittington appointed Chief Executive of LOCSU
Optometry Scotland calls on government to rethink GOS budget
Join the Locum Optometrists Reference Group
News from The General Optical Council
New College President and Council members welcomed at AGM
GOC publishes guidance on disclosing confidential information
AOP opens nominations for 2020 Council elections
ABDO makes calls on Governments against Postcode Lottery
Eye health sector continues to respond to glaucoma investigation
Public Health England has issued a guide about eye care and treatment for eye problems for people with learning disabilities.
Two New Committee members for ABDO NCC
AOP calls for halt to optometry degree apprenticeships
Eye health experts call for urgent action on hospital eyecare to reduce delays and improve patient safety
New ABDO Vice President announced
AOP Voice of Optometry survey opens with new charity incentive
GOC erases Manchester based student dispensing optician
College AGM date announced, have your say.
PSA reports on GOC improving triage process
Scotland 2020 GOS Mandatory Training for Optometrists/OMPs
Domiciliary Providers asked to provide answers to anomymous questionaire
RCOphth published new strategic plan for 2020 to 2022
GOC erases Cambridgeshire based dispensing optician
Scottish Opticians underusing code?
Workforce survey for Scottish optometrists
GOC position on proposed apprenticeship standard, a further statement issued during consultation period.
Archived News from October to December 2019

COVID-19 - Patient Care at Growing Risk as NHS ENGLAND ignores Optics

March 2020

NHS England’s failure to act is forcing hundreds of optical practices to close, with a direct and dangerous impact on the eye healthcare of patients in England during the COVID-19 crisis, the OFNC warned today.

Optical practices in other parts of the UK, as well as pharmacists and dentists across the UK, have already been offered emergency NHS funding to enable them to continue providing urgent and essential care during the COVID-19 crisis. But NHS England has given no guidance to practices in England on their role during the crisis, despite constant pressure from the OFNC.

The OFNC and its member bodies, along with others in the optical sector across the UK, have stepped in to fill the gap where we can, issuing guidance on what services practices should provide during the crisis. However, we cannot fill the void the NHS has left on the problem of funding.

Optical practices have had to stop routine sight testing in line with public health guidance. That means the vast majority of their income has vanished overnight. Like other NHS providers, they need a financial lifeline to help patients and the public – who will otherwise be forced down higher-risk pathways to A&E.

The NHS in all parts of the UK except England has recognised the vital role optical practices can play in providing urgent and essential eye care to patients during this crisis, and keeping patients away from overstretched GPs and hospitals. This is even more vital now that the Royal College of Ophthalmologists has recommended hospital eye departments reduce their clinical activity by 80-90%.

With no certainty of NHS funding during the crisis, hundreds of optical practices have already closed their doors and many more will follow in the next few days. On Wednesday OFNC wrote to Ministers and NHS England warning that “many optical practices in England are now in complete despair”. We have published the letter here.

Today OFNC Chair Paul Carroll said “Eye care patients are now at serious risk because of blockages somewhere in the NHS England system. We are now asking Ministers to intervene urgently to sort this out, so we can help the public with eye and vision problems during this national crisis.”

Promised further information and important links for help in finance in Covid Pandemic


March 2020

The Chancellor, last night announced a new Self-employment Income Support Scheme to support self-employed people who have been adversely affected by COVID-19.

GOV‌.UK has further details about who is eligible for the scheme and how it will work

Self-employed people do not need to get in touch with HMRC as the scheme isn’t yet open for applications.

HMRC will contact eligible customers by the beginning of June, inviting them to apply.

Unfortunately, we are aware of an increase in scam emails, calls and texts. If someone gets in touch claiming to be from HMRC, saying that financial help can be claimed or that a tax refund is owed, and asks you to click on a link or to give information such as your name, credit card or bank details, please do not respond.

HMRC will never contact you out of the blue to ask for these details.

The government has also introduced the following help for the self-employed:


We will continue to share the most up to date information as it is sent to us from HMRC and other legitimate governmental organisations with you as it becomes available.

News is just arriving (5pm 26 march) on help for self-employed which will assist locums

March 2020


Rishi Sunak Chancellor
Self-employed workers will be able to apply for a grant of up to £2,500 a month to help them cope with the financial impact of coronavirus, the chancellor has announced.

The money will be paid in a single lump sum, but will not begin to arrive until the start of June at the earliest.



Rishi Sunak
told the self-employed: "You have not been forgotten."

The total number of people in the UK to die with Covid-19, the disease caused by coronavirus, reached 475.

What help will the self-employed get?

Mr Sunak said the steps taken so far were "already making a difference" but it was right to go further "in the economic fight against the coronavirus".

Self-employed people will be able to apply for a grant worth 80% of their average monthly profits over the last three years, up to £2,500 a month.

It is acceptable to provide only 1 or 2 years average monthly profits if your are recent to the marketplace but 3 years is also possible in case you have suffered a downturn in any one year.

Mr Sunak said the grants would be available to people across the UK for at least three months, and longer if necessary.

In all, 95% of people who earn most of their income as self-employed would be covered, the chancellor added.

We will bring you more precise information and links as we receive further news

OFNC updated guidance on opening arrangements for optical practices

March 2020


Joint statement from the Optometric Fees Negotiating Committee (OFNC), Optometry Scotland, Optometry Wales and Optometry Northern Ireland

The UK Government has now published further guidance clarifying that opticians are exempt from the general requirement for retail businesses and premises to close.

Optical practices may therefore continue to provide urgent and essential eye care to the extent that they can, including remote care, while managing COVID-19 risk to keep patients, staff and the public as safe as possible.

This is a key health service to meet urgent eye care needs during the crisis, especially for isolating elderly people and key workers, and to divert patients from GPs, A&E and hospital emergency eye departments.

Optical staff involved in offering urgent and essential eye care meet the Government definition of a key worker for the purpose of access to transport and schools.

ABDO has published an ‘essential workers’ template letter for optical practices to help their staff demonstrate this to schools, and the sector is working on further resources covering transport etc. Key workers should only place children in school where absolutely necessary because they cannot safely be cared for at home.

Meaning of ‘urgent’ and ‘essential’ care

The Welsh, Scottish and Northern Ireland governments have all issued advice on the care that optical practices should continue to provide during the COVID-19 crisis. NHS England has yet to provide guidance but is expected to do so very soon.

On 23 March the College of Optometrists, OFNC and the UK optical bodies all issued statements advising optical practices to stop providing routine sight tests and care in the current circumstances. Optical practices should only remain open to provide urgent and essential care.

Our current view is that:

Urgent or emergency care would include urgent clinical advice or intervention eg for red eye, contact lens discomfort, foreign object, sudden change in vision, flashes and floaters which might suggest detachment etc.

Scottish Government guidance for practices in Scotland states that as is already the case, it is up to the professional judgement of an optometrist or ophthalmic medical practitioner to determine whether or not the circumstances in which a patient presents constitutes an emergency. Professional guidance already exists to help practitioners in this regard, such as the College of Optometrists Guidance for Professional Practice

Essential eye care would include appointments for patients who would not normally be considered to be emergencies, but where, in the practitioner’s professional judgement, a delay in an examination may be detrimental to a patient’s sight or wellbeing.

This definition is from the Scottish Government guidance for practices in Scotland. Optometry Scotland takes the view that a sight test is highly unlikely to meet the definition of essential care. In other parts of the UK, practices may consider a sight test as essential care if for instance a key worker needs a sight test and new spectacle prescription in order to continue to work. Other examples of essential care could include a visually impaired person or child who needs eye care where a delay in care may be detrimental.

Managing COVID-19 risk

Practices that remain open to provide urgent and essential care must have in place appropriate measures to manage COVID-19 risk. These should include:

• Displaying the College of Optometrists or equivalent poster at the entrance of the practice
• Using remote consultations wherever possible, closing for routine sight testing, and only admitting patients on appointment for essential and urgent eye care which cannot be provided by phone, video or email
• Keeping up to date with and following Public Health England guidance on limiting the spread of COVID-19 in workplaces, including:
• maintaining a distance of at least 2 metres from others where possible
• regular hand-washing and cleaning - ABDO has published an FAQ on the cleaning of practices, equipment and spectacles to manage COVID-19 risks.

Personal Protective Equipment (PPE)

The optical sector bodies are in constant contact with government, public health and NHS authorities about PPE. The situation is fast-moving and we recommend that you check the College of Optometrists website for regular updates using the link below.

The College has provided the following guidance (as of midday on 25 March) for optometrists providing urgent and essential care:

“We understand the growing concern about the potential for tears to lead to COVID-19 infection and are waiting for more information on this. In the meantime, optometrists should not put themselves at unnecessary risk and we are asking the UK governments to provide appropriate PPE for optometrists who are providing essential services. If you need to use personal protective equipment, it is important that you use the correct type and are trained in how to use it.

“Current guidance is that face masks are only needed for those who are dealing with patients with confirmed or suspected cases of COVID-19. The Royal College of Ophthalmologists advises that patients with no known risk, should be seen as normal - with the ophthalmologist using scrupulous standard infection control as for any patient (e.g. hand hygiene, clean instruments). They recommend that there is no known need for using face masks or gloves for every patient but that discretion is to be used. Ophthalmologists should use normal surgical masks for specific situations or patients, especially prolonged slit lamp exposure time or patients with watery, discharging eyes. They should balance mask use with the possibility of supplies running low if the pandemic is prolonged.

“We have guidance on how to adapt your practice to minimise prolonged close contact in our FAQ 'Should I continue with business as normal?”

If a practitioner has concerns about any procedure (especially aerosol effects) when carrying out urgent or essential care on an asymptomatic patient, they should apply their professional judgement when deciding whether to perform it. If they decide not to, they should inform the patient and note the reason in the patient record (annotating COVID-19) and where necessary rearranging care. In recent statements, the GOC has acknowledged that “registrants may be called upon to …vary their practice …. in challenging circumstances (and that) registrants should act in good conscience, for the public benefit, exercising professional judgement in all of the circumstances that apply”.

AOP calls on Government to act faster for locums

March 2020

The Association of Optometrists (AOP) is calling on the Government to redouble its efforts to provide essential support for self-employed people, such as locum optometrists.

Within the last week, the Government has announced the Coronavirus Job Retention Scheme for the employed, guaranteeing 80% of their monthly earnings, up to £2,500, alongside a package of supportive measures for public services and businesses.

The Treasury is currently working on income support measures for self-employed people, but today said these are likely to take time to introduce because of the complexities involved in delivering a brand new service.

In response, the AOP is highlighting the need for the Government to drive this forward more quickly, because thousands of our locum optometrist members, like other self-employed people, are now in a desperate financial situation through no fault of their own.

AOP Councillor and locum optometrist, Alison McClune said: “We understand the Government faces huge challenges in supporting people during this unprecedented disruption. But the self-employed workforce, who play a key role in supporting our healthcare system, must be given the same help as others, and at the same time. Locums make up a massive part of the UK’s optical workforce, providing essential eye care in the community. They are rightly angry and deeply worried that the Government can’t yet assure them they will be given the same level of help as others.”

The AOP today issued specific guidance for locum optometrists.

OPTICAL PRACTICES – ESSENTIAL OPENING ARRANGEMENTS clarified this morning (24 March 2020)

March 2020

Following the initial statement posted yesterday evening and published by us (see news story) we now have further clarification that Optical Practices following strict rules can and are expected to stay open for key workers as well as those with ongoing essential and emergency care.

In a Joint statement from the Optometric Fees Negotiating Committee (OFNC), Optometry Scotland, Optometry Wales and Optometry Northern Ireland

On 23 March the UK Government published a revised list of business and premises required to close. This included retail premises, with exceptions for a range of premises including pharmacies and health shops. The list does not mention optical practices.

Our understanding is that the four UK governments intend optical practices providing NHS services to continue to provide essential and urgent eye healthcare services during the COVID-19 crisis, subject to suitable risk management measures both to meet essential health needs, especially for isolating elderly people and key workers, and to keep pressure off GPs, A&E and hospital emergency eye departments.

The OFNC in consultation with the other UK optical bodies has confirmed that optical practices in the UK providing urgent and essential eye healthcare are key health services and should continue to function where possible during the COVID-19 crisis. This means that NHS primary care premises are exempt from general closure requirements for retail premises.

The condition is that those which are able to open have in place appropriate measures to manage COVID-19 risk. These should include remote consultations wherever possible, closing for routine sight testing and only admitting patients on appointment for essential and urgent eye care which cannot be provided by phone, video or email.

The Welsh, Scottish and Northern Ireland governments have all issued advice on this as has OFNC for England. NHS England has yet to provide guidance on this but is expected to do so very soon.

On 23 March the College of Optometrists, OFNC and the UK optical bodies all issued statements advising optical practices to stop providing routine sight tests and care in the current circumstances. Optical practices should only remain open to provide essential and urgent services.

Currently:

• Essential eye care would for be instance where a key worker or elderly person needed a sight and new spectacle prescription, had broken their glasses, where a contact lens wearer needed more lenses, or where a visually impaired person or child needed eye care.
• Urgent care would include urgent clinical advice or intervention e.g. for red eye, contact lens discomfort, foreign object, sudden change in vision, flashes and floaters which might suggest detachment etc.
Scottish Government guidance for practices in Scotland on these issues is:

Emergency care

As is already the case, it is up to the professional judgement of an optometrist or ophthalmic medical practitioner to determine whether or not the circumstances in which a patient presents constitutes an emergency. Professional guidance already exists to help practitioners in this regard, such as the College of Optometrists Guidance for Professional Practice

Essential care

As these measures will likely be in place for some month, essential care is to be interpreted as meaning appointments for patients who would not normally be considered to be emergencies, but where, in the practitioner’s professional judgement, a delay in an examination may be detrimental to a patient’s sight or wellbeing.

Statement made by OFNC, Optometry Scotland, Optometry Wales, Optometry Northern Ireland

Routine Eyecare to cease by order in Scotland from March 23rd

March 2020

CORONAVIRUS/COVID-19: GOS and EYE CARE Continuity in Scotland

A Memorandum providing an important update to all community optometry practices and staff regarding the provision of community eye care services during the COVID-19 pandemic is available in full here as a pdf . Read full memo here


A summary of the memoranda includes:


Instruction to all General Ophthalmic Services (GOS) providers to cease providing routine eye care and to move to providing only essential and emergency eye care in Scotland from Monday 23 March 2020

A package of financial measures to help support community optometry practices in Scotland during the COVID-19 pandemic - all practices will receive a monthly payment equating to their average monthly item of service income across the 2019/20 financial year

Information about emergency eye care pathways within NHS Board areas
infection control measures

Revised Health Protection Scotland guidance for optometrists and opticians

Details of the temporary suspension of the requirement for patient or patient representative signatures on GOS(S)1 ‘cheque book’ slip and GOS(S)3, GOS(S)4, HES(S)1, HES(S)3 and HES(S)4 forms
information about notifying Health Boards of changes in permanent practice opening hours or of practice closures as a result of COVID-19.
and other information.

1. This Memorandum provides an important update to all community optometry practices and staff regarding the provision of community eye care services during the COVID-19 pandemic.

It includes:

 an instruction to all General Ophthalmic Services (GOS) providers to cease the provision of routine eye care services in Scotland from Monday 23 March 2020,

and move to providing only emergency and essential eye care;

 details of a package of financial measures to help support community optometry practices in Scotland during the COVID-19 pandemic;

 information about the development of emergency eye care pathways within NHS Board areas;

 infection control measures;

 information about revised Health Protection Scotland guidance for optometrists and opticians;

 information about new General Optical Council guidance for COVID-19;

 details of the temporary suspension of the requirement for patient or patient representative signatures on GOS(S)1 ‘cheque book’ slip and GOS(S)3, GOS(S)4, HES(S)1, HES(S)3 and HES(S)4 forms;

 information about notifying Health Boards of changes in practice opening hours or of practice closures as a result of COVID-19.

Suspension of all routine eye examinations, and arrangements for continuation of emergency and essential eye care

3. In line with wider guidance on social distancing to reduce the transmission of COVID-19, all providers of GOS in Scotland are instructed to cease the provision of routine eye care services from Monday 23 March 2020 until further notice. Routine existing appointments on or after this date should therefore be postponed with immediate effect.

4. From Monday 23 March 2020, community eye care services provision will change to supporting only patients who need emergency or essential eye care.

As set out in paragraphs 8 to 25, financial support measures are being put in place to complement the continuation of this care.

5. Practitioners and practice staff are reminded that, where applicable, they are required to follow the advice issued in relation to self-isolating and social
Read full memo here

COVID-19 – SUPPORT FOR GOS CONTRACTORS IN ENGLAND

March 2020

OFNC

 

The Optometric Fees Negotiating Committee (OFNC) and its members (ABDO, AOP, BMA and FODO) are working closely with NHS England on supporting GOS contractors in England through the coronavirus crisis. NHS England has confirmed that eye care is an essential part of the NHS and primary care service, both of itself and in keeping pressure off other NHS services such as GPs and A&E. NHS England’s aim is to keep essential eye care operating as far as possible to ensure essential and urgent eye health needs are met whist protecting patients, staff and the public. 

Issues that the OFNC and NHS England are urgently working on with the aim of supporting optical practices in England, include:

  • The financial implications for practices of a downturn in GOS fee income because of the crisis 
  • More flexibility around GOS contractual requirements, to help practices and domiciliary providers give patients the care they need as quickly and safely as possible, and to support practices who may not have the staff available to provide services, due to illness or self-isolation 
  • Guidance to help patients, optical practices and other parts of the NHS understand the GOS services that optical practices in England will continue to provide during the crisis and to direct patients to them 
  • How the whole sector can work together to mobilise new services in optical practices as quickly as possible, to meet essential and urgent eye care needs during the crisis and reduce demand on GP and hospital services. 
OFNC and its member bodies are working very closely with LOCSU, which is co-ordinating the sector-wide work on new services, and with the General Optical Council, College of Optometrists, Optometry Wales, Optometry Scotland and Optometry Northern Ireland and government to streamline communications and provide evidence-based advice to the front-line throughout this crisis.

We and the NHS in all countries thank you for your support to the population at this difficult time. We will share more information about these measures as soon as we can. 

RCO and College publish joint Covid Statement

March 2020

Viral conjunctivitis and COVID-19 – a joint statement from The Royal College of Ophthalmologists and The College of Optometrists

Recent reports have suggested that COVID-19 may cause conjunctivitis, and it is known that viral particles can be found in tears, which has caused some concern amongst eye health professionals. It is recognised that any upper respiratory tract infection may result in viral conjunctivitis as a secondary complication, and this is also the case with COVID-19. However, it is unlikely that a person would present with viral conjunctivitis secondary to COVID-19 without other symptoms of fever or a continuous cough as conjunctivitis seems to be a late feature where is has occurred.

Viral conjunctivitis is not currently listed in the national case definition for COVID-19. As such practitioners should treat viral conjunctivitis in the absence of other symptoms as they would usually treat any presentation of viral conjunctivitis, including normal scrupulous levels of infection control, as we do for adenovirus which is very contagious. The optometric management of viral conjunctivitis can be found in the Clinical Management Guideline, it is a self-limiting condition and should not be referred to secondary care.

During the pandemic, we recommend that, for all patients, scrupulous infection control and hand hygiene measures are employed and that, where possible, time spent on slit lamp and other close examinations is kept to a minimum safe level.

GOC response to the COVID-19 (coronavirus) emergency

March 2020

The General Optical Council (GOC) understands that many of its registrants and stakeholders will have questions about the impact of COVID-19 and wants to ensure that everyone in the optical professions is aware of the steps the GOC has taken in light of the emergency.

Support for registrants

The GOC has established a dedicated COVID-19 page on its public website where it is directing registrants to the latest Government guidance.

Along with all other healthcare regulators, the GOC has signed a joint regulatory statement which acknowledges that registrants will need to act differently and deliver care in different ways during the COVID-19 emergency in line with Government and public health guidance.

The GOC will take account of this in fulfilling its regulatory functions and will also be publishing a series of optical sector specific statements to reassure registrants that when they act in good conscience and exercise professional judgement for the public benefit, the GOC will support them.

Today, the GOC has published a new statement on the supply of spectacles and contact lenses, which allows registrants to use their professional judgement to decide whether it is necessary for a patient to attend for a sight test or contact lens fitting/check in order to supply spectacles and contact lenses. This follows the publication of a statement for education providers yesterday on the ability to adapt education delivery approaches during this time.

The GOC has also signed a joint regulatory statement on remote consultation and prescribing which is particularly relevant during this period of social distancing.

Further statements to support optometrists, dispensing opticians, optical students, optical businesses, the education sector and other stakeholders will be published over the coming days and weeks.

GOC office

In line with Government advice, GOC staff are now working remotely instead of in the office, which is now closed to visitors. The GOC will no longer take telephone calls and all enquiries should be made by email.

You can visit theContact Us page on the GOC website for a full list of email addresses within the organisation.

Homeworkers will not always have secure environments in order to have potentially sensitive and confidential telephone calls or take personal information and so this approach ensures that people’s personal data is protected. In some instances, where it is essential and where a confidential environment can be guaranteed, the GOC may make calls.

The GOC urges those wishing to communicate with them to send communications electronically in order to minimise post and ensure it is dealt with as effectively and quickly as possible. This includes supplier invoices, which the GOC will endeavour to pay as quickly as possible.

GOC Fitness to practise (FTP) hearings

To ensure the safety and wellbeing of everyone concerned, the GOC will no longer be conducting office-based hearings. The GOC is exploring options to support remote hearings and will issue a statement on this shortly.

A message from GOC Chief Executive and Registrar, Lesley Longstone. “In these extraordinary times, we are fortunate that in all four countries of the United Kingdom we have a group of exceptionally well qualified eye care professionals on whom the general public and fellow healthcare professionals can rely. Uncertain times mean that our registrants may be called upon to work at the limits of their scope of practice and vary their practice for protracted periods of time and in challenging circumstances.
With our COVID-19 statements we hope to reassure practitioners, academics and students that when they act in good conscience, for the public benefit, exercising professional judgement in all of the circumstances that apply, the GOC will support them. We will also continue to closely monitor and follow Government guidance and act accordingly. We want to thank everyone for their cooperation.”

Latest Government statements and links can be found here on Opchat's Covid-19 page

GOC erases 2 student dispensing opticians.

March 2020

The General Optical Council (GOC), the UK regulator for optometrists and dispensing opticians, has decided to erase Taseer Kazi, a student dispensing optician based in Staffordshire, from its register. He will now be unable to undertake training as a student dispensing optician in the UK.

A GOC Fitness to Practise Committee found his fitness to practise impaired by reason of conviction. This is related to his convictions of possession of a bladed article, an offensive weapon and illegal drugs, in addition to causing grievous bodily harm with intent.

Mr Kazi has until 19 March 2020 to appeal his erasure, during which time he is suspended from the register under an immediate suspension order.

The GOC has also erased from the register Shamir Kazi, a student dispensing optician based in Leicester. He will now be unable to undertake training as a student dispensing optician in the UK.

A GOC Fitness to Practise Committee found his fitness to practise impaired by reason of conviction. This is related to his conviction of causing grievous bodily harm with intent.
Mr Kazi has until 18 March 2020 to appeal his erasure, during which time he is suspended from the register under an immediate suspension order.

Dr David Parkins reappointed as member of GOC Council

March 2020

The General Optical Council (GOC) has reappointed registrant Council member Dr David Parkins for another four years, commencing 15 March 2020.

Gareth Hadley, GOC Chair, said: “We are delighted that David has been reappointed for a second four-year term. His knowledge and critical thinking skills will continue to be put to good use and thereby help the world of optics rise to the challenges of maximising its contribution to the protection of people's sight.”

David is also a member of the GOC Audit, Risk and Finance Committee, which advises and gives assistance to the Council on matters relating to budgeting and financial performance, risk management and internal and external audit.

David works in a hospital practice in South East London and is Chair of the London Eye Health Network (NHS England).

GOC sets out position on lissamine green

March 2020

The General Optical Council (GOC) has published a statement on the use of CE-marked lissamine green ophthalmic strips to assist registrants in ensuring they act in the interests of the public.

Lissamine green is used when assessing the ocular surface and is available as a CE-marked product (a medical device) for use as a ‘diagnostic agent when superficial corneal or conjunctival change is suspected’.

The Medicines and Healthcare products Regulatory Agency (MHRA), an executive agency of the Department of Health with responsibility for regulating all medicines and medical devices in the UK, considers lissamine green should be regulated as a medicine, however there is no marketing authorisation in place. Its status has therefore caused confusion.

The statement clarifies that there will be circumstances where it is necessary, in the patient’s best interests, for optometrists and contact lens opticians to use CE-marked lissamine green ophthalmic strips (the marketing and supply of which is not currently opposed by the MHRA) within the scope of their practice.

It also outlines registrants’ responsibility in acting in the best interests of their patients at all times and determining the most appropriate clinical care in accordance with the GOC’s Standards of Practice for Optometrists and Dispensing Opticians.

It was developed as a result of a clinical consensus panel of experienced practitioners and academics, formulated by the professional bodies within the optical sector including the Association of British Dispensing Opticians (ABDO), the Association of Optometrists (AOP), the British Contact Lens Association (BCLA), the College of Optometrists and the Federation of Ophthalmic and Dispensing Opticians (FODO). The MHRA has also contributed to the statement, setting out its position in respect of lissamine green.

GOC Chief Executive and Registrar Lesley Longstone said “This is a complex issue and we have worked closely with a number of stakeholders in developing this statement.
Our role is to protect, promote and maintain the health and safety of members of the public and we hope it will give registrants clarity and reassurance about using CE-marked lissamine green ophthalmic strips within the scope of their clinical practice.”

The full statement can be found on the GOC Standards website

GOC makes statement on Cataract Referrals

March 2020

The GOC outlines the standards expected of its registrants in the Standards for Optometrists and Dispensing Opticians and Standards for Optical Businesses.

The GOC takes seriously any allegation of inappropriate clinical referral or where patients think they have been coerced into undergoing unnecessary treatment or treatment that they do not want.

The following standards for optometrists and dispensing opticians may be relevant in this type of circumstance:

Standard 1. Listen to patients and ensure they are at the heart of the decisions made about their care.

1.2 Listen to patients and take account of their views, preferences and concerns, responding honestly and appropriately to their questions.
1.3 Assist patients in exercising their rights and making informed decisions about their care. Respect the choices they make.

Standard 2. Communicate effectively with your patient

2.2 Patients should know in advance what to expect from the consultation and have the opportunity to ask questions or change their mind before proceeding.

Standard 7. Conduct appropriate assessments, examinations, treatments and referrals

7.6 Only provide or recommend examinations, treatments, drugs or optical devices if these are clinically justified and in the best interests of the patient.

Standard 10. Work collaboratively with colleagues in the interests of patients

10.2 Refer a patient only where this is clinically justified, done in the interests of the patient and does not compromise patient care or safety. When making or accepting a referral it must be clear to both parties involved who has responsibility for the patient’s care.

Standard 16. Be honest and trustworthy

16.2 Avoid or manage any conflicts of interest which might affect your professional judgement. If appropriate, declare an interest, withdraw yourself from the conflict and decline gifts and hospitality.
16.3 Ensure that incentives, targets and similar factors do not affect your professional judgement. Do not allow personal or commercial interests and gains to compromise patient safety.

The following standards for optical businesses may be relevant in this type of circumstance:

Standard 1.1 Patients can expect to be safe in your care

1.1.10 Your business ensures that any operational or commercial targets do not have an adverse effect on patient care.

Standard 2.1 The services that you provide are open and transparent

2.1.9 Your business encourages staff to declare any conflicts of interest, where they arise, and withdraw themselves from such conflicts. The joint regulatory conflicts of interest statement sets out what is expected.

Standard 3.1 Your staff are able to exercise their professional judgement

3.1.3 Your business makes sure that operational and commercial pressures do not unreasonably inhibit the exercise of professional judgement.

Standard 3.4 Staff collaborate with others, where appropriate

3.4.1 Your business supports its staff in making referrals and ensures that they only make referrals when appropriate and clinically justified.

The GOC will consider any concerns that our standards have not been met. For full details of our complaints process, please refer to our website: How to make a complaint

The GOC is unable to comment on the detail of individual complaints.

Hard Sell for Private Cataract Surgery claims Inside Health non BBC Radio 4

March 2020

Inside Health broadcast by BBC Radio 4 hears from two people who believe they were subject to hard sell for cataract surgery by the UK's biggest private provider, Optical Express

You can listen to the podcast here

Optical Express Clinical Services Director, Stephen Hannan, in response to PHN's reaching out to Optical Express said:

“Optical Express Ophthalmic Surgeons and Specialist Refractive Optometrists are amongst the most experienced experts in the field of Cataract and Refractive Surgery. Our clinicians have access to the very latest diagnostic technologies, surgical equipment and work with the utmost precision to give expert clinical care and advice, leading to patients achieving exceptional high-quality outcomes.

“We are totally committed to giving our patients excellent care and advice, leading to the best possible outcomes. Therefore, it is extremely disappointing that the BBC have chosen to interview only two patients who claim to be unhappy with their experience, out of over 1 million patients our surgeons have treated. It is worth noting that our clinicians have refused to treat over 1 million patients, based on our extremely conservative clinical parameters and their clinical suitability, after attending a Cataract or Refractive surgery consultation.

“There were numerous factual inaccuracies in the programme broadcast by the BBC, and we were deeply disappointed by the approach taken by the programme-makers. Particularly as we informed them ahead of the programme being broadcast that their information was inaccurate.

“Putting patient satisfaction into perspective, 99% of patients treated would recommend Optical Express to friends and family.

“We completely refute the suggestion that our Optometrists have encouraged patients to have unnecessary surgery. Cataracts get worse over time, and the impact they have on a patient’s quality of life increases with age. The point at which a cataract is causing a patient’s vision to deteriorate to such a degree that it affects their quality of life, will be different for every patient. Both patients featured in the programme attended surgery consultations and were recommended to have surgery as they had been diagnosed with cataracts. One of the patients went ahead with surgery, but now believes it may not have been necessary. We absolutely refute this. The other patient chose not to go ahead with any treatment at Optical Express, based on the price of private cataract surgery.

“I have reviewed the case histories of these patients and I have full confidence in the clinical colleagues who examined, advised and decided on a recommendation for treatment for them and we welcome an unbiased opinion on this rather than a sensationalising “fake news” story by the BBC.

“At Optical Express our clinical governance procedures are robust and are approved by an international medical advisory board. All Optical Express patients are seen by a multi-disciplinary team of expert Ophthalmic Surgeons and Specialist Refractive Optometrists. Every patient goes through a detailed and comprehensive informed consent process, which includes information and discussion about potential risks, benefits and alternative treatments. Some patients make an informed choice to proceed with surgery, others choose not to. We respect all our patients' decisions. The consent process enables each patient to have multiple consultations, to include those with their optometrist and with their treating surgeon prior to their procedure.

“Optical Express compare outcome data of patients we perform cataract surgery on, against published NHS reports. In this regard, surgery at Optical Express is evidenced to be both safer and more effective in its outcome delivery across a wide range of important categories than that identical procedure performed under the NHS.”

Richard Whittington appointed Chief Executive of LOCSU

March 2020

Mike Fegan, Chairman of LOCSU said “I am pleased to announce that Richard Whittington, who was Chief Operating Officer of LOCSU, has been promoted to Chief Executive”.

“Richard joined LOCSU in 2016 and has been its senior executive for the past 2 years. This promotion recognises the strong leadership which Richard has provided and the hard work and commitment he has shown in delivering LOCSU objectives.
" Richard will now take LOCSU forward with the aim of building on the progress of the last few years, within the context of major reorganisation of the NHS in England. His focus will be to ensure
" LOCSU provides the support that LOCs, regional networks of LOCs and PECs need to deliver the aims and ambitions of the sector.
"The LOCSU Board and I wish Richard every success in his new role”.

Richard Whittington said “I am very pleased to take on this enhanced role within LOCSU. There is much to do. The NHS is proposing significant structural reform and the new Outpatient
Transformation Programme is focusing first on ophthalmology. All LOCs and PECs will have to be supported to help deliver significantly expanded capacity to deliver primary care led services closer to home. With a proposed IT connectivity solution upcoming and together with the LOCSU pathways, this is something we be should be able to do. The NOC 2019 has given us clear insights as to the support LOCs wish to access alongside guidance as to where the gaps are; LOCSU will play its role in partnership with national bodies to ensure we can deliver”.

Optometry Scotland calls on government to rethink GOS budget

March 2020

Optometry Scotland (OS) says its sector is the only one in the Scottish Government’s health budget to face a real-term cut.

Overall spending on health rose 5.2% after inflation but for General Ophthalmic Services (GOS) there was a 0.8% decrease says OS.

David Quigley, chair of OS, said: “It is concerning that despite a rise in health spending there is a decrease for GOS, meaning inflationary pressures are simply not being recognised.” He added that the approach was “simply unfair and unsustainable”.

OS is now calling for a real term GOS budget increase of 3.3%, which would take the GOS budget to an estimated £109.5m per year.

Join the Locum Optometrists Reference Group

February 2020

The group will act as a proxy for the locum population, and provide a sounding board for the College to refer to on specific documents, or specific matters for discussion, where the views of locum optometrists should be incorporated into the College’s work.

This group of volunteers will:

actively promote the College to other locum optometrists and to inform, inspire, engage and influence other hospital optometrists to follow College activity

assist with the College’s support for locum optometrists by commenting on new ideas and work

help to promote College events.

The College will ask members of the group for their input and comments via email, with an opportunity for participants to meet once a year or to join a working group on a particular issue.

Members of the group will be paid travel and subsistence expenses when attending meetings, in line with College Standing Orders in force at the time.

The term of office is two years, renewable for a maximum of six years.

If you are interested in joining this group, please complete the form here by 5 March 2020.

News from The General Optical Council

February 2020

Strategic plan 2020-25

The GOC is launching a new strategic plan in April 2020 which sets out the organisation’s vision over the next five years.

A draft plan was consulted on from December 2019 to January 2020, receiving 50 responses from individuals and organisations across the optical, regulatory and healthcare sector.

A revised plan was presented to Council which was approved, subject to drafting changes arising from the meeting.

Council welcomed the support from respondents for the mission, vision and values and the Equality, Diversity and Inclusion (EDI) strategy, as well as the three strategic objectives:

• delivering world-class regulatory practice;
• transforming customer service; and
• building a process of continuous improvement.

They also discussed feedback in relation to issues raised which will be considered in the final development of the plan.

The main changes include:

• reduced length of the plan from a six year plan to five years to bring it in line with the next CET cycle ending in 2025;
• merging of the EDI strategy into the main strategy for clarity and cohesion;
• ‘we are agile and responsive to change’ added as a value; and
• inclusion of work programmes and timescales under each of the objectives to provide clarity on how the objectives will be achieved.

Council also approved the business plan and budget for 2020-21.

The final version of the strategic plan will be published by in March, ahead of its launch in April.

Council Chair appointment

Council have agreed the recommendations from the Nominations Committee regarding the appointment process for a new Council Chair following Gareth Hadley’s term of office ending in February 2021.

The recommendations agreed were:

• the role profile
• the competences to be sought
• the selection panel membership
• involvement of CEO and Council members
• timetable for campaign

Recruitment will begin in July 2020 and the new Chair will be announced in December 2020.

Fitness to Practise

It was reported that open case volumes are down by 30 per cent compared to this time last year, largely due to the GOC’s Fitness to Practise (FTP) improvement programme. An enhanced triage process concluded its pilot in December 2019.

An audit on FTP decisions during 2018-2019 was conducted to ensure they are compliant with legislation, rules and decision-maker guidance, and that they meet the overarching objective of protecting the public.

Overall, the findings demonstrate that the GOC continues to meet the high quality standards and is compliant with the Council’s statutory obligations.
Optical Consumer Complaints Service (OCCS)

Following a competitive procurement exercise, Nockolds Solicitors has been reappointed as the Optical Consumer Complaints Service provider, on a three-year contract commencing 1 April 2020. The service is funded by the General Optical Council.

Last year, Nockolds enabled the OCCS to successfully resolve 88 per cent of consumer complaints via mediation.

The firm has provided the free mediation service to resolve consumer complaints in the optical sector since 2014.

New College President and Council members welcomed at AGM

February 2020

The College of Optometrists welcomed a new President and six new Council members at its AGM, held during the College’s clinical conference, Optometry Tomorrow 2020 in Telford on 24 February.

New College President Colin Davidson
The incoming College President is existing Board member and former Vice-President, Colin Davidson FCOptom, Programme Lead at the University of Hertfordshire.

He said; “I am very proud to be taking over as President of the College. I feel honoured and privileged to represent our members and very much look forward to meeting as many members as possible over the next two years. I am looking forward to building on the great work of the Immediate Past President, Professor Mallen at this critical time in terms of the Education Strategic Review and the proposed optometry degree apprenticeship and would like to welcome our new Council members to our team.”




The new Council members are; Clare Pearce MCOptom (Wales), Dr Grant Robinson MCOptom (Wales), Hassnain Safdar MCOptom (East Midlands), Meera Shah MCOptom (London), Professor Robert Harper FCOptom (North West) and Professor Kathryn Saunders FCOptom (Northern Ireland).

Speaking about his election to Council, Dr Grant Robinson MCOptom said; 'I am very excited to be starting my role as the new College Councillor for Wales. I feel privileged to represent the views of the optometrists of Wales to the College and look forward to contributing to the continued development of the profession.”

Following the election process, six Council members retained their seats, they are; Tony Gibson MCOptom (North East), Laura E Sweeney MCOptom (Scotland), Lucy Blown MCOptom (South East), Eddie Pigott MCOptom (South East), Shamina Asif MCOptom (West Midlands) and Barbara Watson FCOptom (Yorkshire and Humber).

Five members of Council stepped down at the AGM and were acknowledged for their service and commitment to the College; Geraint Griffiths MCOptom (East Midlands), Russell Dawkins MCOptom (London), Ian White MCOptom (North West), Mary-Ann Sherratt MCOptom (Wales) and Angharad Hobby MCOptom (Wales).

Members can contact their regional Council member via the College website at: www.college-optometrists.org/council-member.

Several other appointments were also announced at the AGM; Professor Leon Davies FCOptom was elected as Vice President, Prab Boparai MCOptom was elected as a Trustee, Mark Redhead was elected as the Lay Trustee; and Dr Gillian Ruddock MCOptom was re-elected as Chair of the Education & Standards Committee. Dr Mary-Ann Sherratt MCOptom, Dr Rob Hogan MCOptom and Andrew Kitchen were co-opted to the Board of Trustees for one year until the 2021 AGM.

GOC publishes guidance on disclosing confidential information

February 2020


The General Optical Council (GOC) has today published new guidance on disclosing confidential information about patients, including where patients may not be fit to drive.

The guidance is designed to provide clarity for optical professionals in situations where they need to consider whether to disclose confidential information to ensure the protection of patients and the public.

It does not create new requirements or give legal advice and should be read alongside the Standards of Practice for Optometrists and Dispensing Opticians or the Standards for Optical Students.

It comes as a result of research, commissioned by the GOC, which showed that registrants found confidentiality to be a complex and confusing area, especially in relation to what to do if a patient’s eyesight is no longer adequate to drive.

The Vision and Driving research showed that 72 per cent of registrants would not feel comfortable informing the Driver and Vehicle Licensing Agency (DVLA) or the Driver and Vehicle Agency (DVA) if the patient could not or would not do it themselves. More than half (56 per cent) said it was difficult to balance patient confidentiality with their duty to protect the public from harm.

In response, the GOC drafted guidance on disclosing confidential information about patients which was consulted on from March to June 2019.

There was a positive response from registrants, with 84 per cent of individual registrants stating that it would help them to understand when and how to apply their professional judgement to override patient confidentiality to protect the public from risk of harm.

Marcus Dye, Director of Strategy, said: “We’ve listened to registrants’ feedback from both the research and consultation in order to develop new guidance which more clearly sets out our expectations of registrants’ responsibilities for disclosing confidential information in the public interest. "
"We know the area of vision and safe driving is a particularly difficult one for registrants, so we’ve included a flowchart in the guidance to provide them with more clarity on what to do if a patient’s vision is no longer adequate to drive. We hope the guidance will give registrants the confidence to decide when to override confidentiality to ensure public protection.”

To read and download the guidance, visit here

AOP opens nominations for 2020 Council elections

February 2020

The Association of Optometrists is inviting practitioners and students to put themselves forward to become AOP Councillors, with nominations opening on Monday 24 February.

AOP Councillors ensure that views from around the UK and within the profession are represented in the AOP’s policy-making. The Association is encouraging eligible members of all grades to put themselves forward before the nomination period closes on 20 March.

Speaking about her position, AOP Councillor for Scotland, Eilidh Martin said: “A highlight has been working for the optical community to make a difference to the future of the profession. It’s rewarding to work on behalf of my peers to represent their interests and any concerns they have. Optometrists of all backgrounds and experience should consider standing.”

Valerie Jerome explains how becoming an AOP Councillor for South East England changed the way she felt about her career: “Had I not become active in the profession outside the consulting room, I would be a “clock in, clock out” optometrist. Since joining the AOP Council, I have met so many optometrists from all over the country, learned about optometry in other places besides my small town, and learned so much more about the behind the scenes events shaping our profession.”

Alongside the 12 elected posts being contested across the UK in 2020, three designated positions representing undergraduate students, pre-registration optometrists and newly-qualified optometrists are open for application.

Describing the vital role of Councillors, Henrietta Alderman, AOP Chief Executive, said: “It’s never been a more important time for our members to be involved in the policy direction of the AOP, and indeed the profession. This year, we’ve made ‘influence through change’ our theme – all our AOP Councillors have a role to play in ensuring we determine the future of optics.”

Voting for elected positions will be open from 1 April until 23 April, and all eligible AOP members will be invited to vote. The appointed candidates for designated positions will be chosen by the AOP Appointments Committee. The results will be announced in May.

For more information, including the role of Councillors and the election timeline, visit the AOP website

ABDO makes calls on Governments against Postcode Lottery

February 2020

Governments in Wales, England, and Northern Ireland (NI) need to act now on the eyecare postcode lottery and have the same routine and emergency eye health care for people across the UK according to the Association of British Dispensing Opticians (ABDO). ABDO is calling for action on the 21st anniversary of the launch of Vision 2020, a World Health Organisation (WHO) global initiative to eliminate the cause of preventable and treatable blindness as a public health issue by the year 2020.

The Scottish Government prioritised eye health in 2006 and since then has revolutionised care to enable prevention and early intervention in the fight to eliminate avoidable blindness. Clive Marchant FBDO, President of ABDO says, “On the anniversary of the Vision 2020 initiative it is disappointing that England, Wales and Northern Ireland are failing to follow Scotland and offer a universally NHS funded comprehensive service to catch treatable eye conditions at an early stage. Action now could not only save people’s sight but also save the NHS and Social Care significant amounts of money.”

He continues, “We are calling for further investment in General Ophthalmic Services (GOS) so it and our optical workforce can be used to their full potential to prevent avoidable sight loss throughout the rest of the UK. Getting the right eye care at the right time from the right clinician is important from the cradle to the grave. We would like to see everyone have access to /NHS funded regular eye examinations from pre-school onwards to give everyone the best start in life. The risk of eye disease grows as you get older, and it is vital for eye disease and the need for spectacles to be detected as early as possible which can only be done by regular eye health checks. Scotland is leading the way here.”

Attendance at A&E costs the NHS more to deliver eye care than it does if it is delivered locally by optical practices. If a national eye care service, like Scotland has, was rolled out across the UK it could save millions for the NHS and prevent avoidable sight loss in the UK.

Eye health sector continues to respond to glaucoma investigation

February 2020

The eye health sector has continued to respond to the Healthcare Safety Investigation Branch’s final report on its investigation into lack of timely monitoring of patients with glaucoma on 9 January, reporting that delays in access to care were resulting in avoidable sight loss.

ABDO, however, has called for a more inclusive and united approach.

FODO responded to the national safety report by issuing a call to action on 10 January to address the root cause of these longstanding system issues and for the NHS to offer more care in primary and community care settings to liberate capacity in secondary care and ensure prompt access to care.

The story has since also been reported on extensively in the Health Service Journal and by the Royal College of Ophthalmologists.

This week, the College of Optometrists, AOP and ABDO issued statements following the joint statement published on the Royal College of Ophthalmologists website in January.

College of Optometrist's statement:

Premise

Up to 22 patients a month across the UK might be losing vision because of delayed treatment and follow-up appointments.

The January 2020 Healthcare Safety Investigation Branch (HSIB) report on Lack of Timely Monitoring of Patients with Glaucomaiii centres on the serious risks to patients’ sight caused by delays in glaucoma appointments. This and the Getting It Right First Time (GIRFT) Ophthalmologyiv report both highlight that urgent changes are needed in eye healthcare.

The College calls on NHS England leaders to work with professional and patient eye care organisations to improve the models and funding of eye care services to protect patients.

In the absence of enhanced services and funding, commissioners can still work to improve integration of services, and care providers can collaborate to improve the way we use existing resources.

For example, ensuring that only patients whose conditions need secondary care input are seen in hospital will improve capacity for patients with serious and sight-threatening conditions.

This is likely to have a positive impact on patient waiting times and reduce unnecessary healthcare expenditure.

The Royal College of Ophthalmologists, The College of Optometrists and the Association of Optometrists are committed to working together to promote cooperation and best practice. Our joint statement sets out the ways that commissioners, hospital eye departments, individual ophthalmologists and optometrists can already contribute to improving eye care service capacity.

NHS England leaders and commissioners

Commissioners and NHS leaders can make the most significant contribution to reducing avoidable referrals. Scotland and Wales have led the way in developing national schemes to ensure that more care takes place in the community and fewer avoidable referrals take place.
The College calls on Integrated Care Systems in England and their constituent CCGs to commission services as defined by the Clinical Council for Eye Health Commissioning Primary Eye Care Framework for first contact carev, from primary care optical practices including:

Minor Eye Conditions (MECs)

Integrated Cataract Care (Pre and Post Op)

Glaucoma Referral Filtering and Monitoring (as outlined in NICE Glaucoma Guidance NG81)

Commissioners and national NHS bodies should also support the development of IT links between hospitals and community optometry so that quality structured referrals can be made quickly and securely, and feedback on and support for referral decision-making can be more easily provided.

Ophthalmologists and optometrists:

Individual ophthalmologists and optometrists can contribute to improving referrals through communication and collaboration:

Develop and work to joint local care guidelines and referral criteria within the context of national pathway and guidance recommendations (College of Optometrists guidance and advice services)

Build relationships between local primary and secondary care, including optometrist visits to the hospital eye clinic where possible

Implement good practice identified in national studiesix such as combining active local education and good referral practice

Ophthalmologists:

Provide clinical feedback to all referring practitioners

Be actively involved in education and development of local optometrists as primary eye care providers

Optometrists:

Send clear, concise and legible structured referrals which contain sufficient information to enable safe triage, including a timescale within which it is recommended the patient is seen

Take care not to give patients unrealistic expectations of how quickly they will be seen

Use feedback received from the local Hospital Eye Services (HES) for improving future referrals

Hospital Eye Services

Although HES are operating under great pressure, executives, managers and clinical leads with responsibility for HES can work with primary care optometrists to facilitate appropriate referrals:

Promote ophthalmologists and optometrists working together to establish referral guidelines, supported by opportunities for education for primary care optometrists including shadowing clinicsx

Provide advice to primary care optometrists on their preferred format of structured referral

Develop pathways to support referral decision making (telemedicine/support phone lines and advice and guidance)

Ensure feedback on referrals

Welcoming the joint statement ABDO president Clive Marchant called for a united approach by the sector in order to avoid being ignored.

Grafton Optical make a timely announcement that bookings for the ‘Glaucoma care: the next generation’ sessions at Optrafair 2020 are now open and highlighted on Opchat News Optrafair Preview Pages. The sessions allow practitioners to gain hands on, practical insights into why the Corneal Hysteresis (CH) and IOPcc parameters represent the future of Glaucoma diagnosis and care.

These metrics, which are exclusive to the Ocular Response Analyser® G3 and the 7CR Auto Tonometer, have been covered in over 700 clinical papers to date.

Click here and read how you can expand your knowledge and book a glaucoma clinic appointment and read increasing info on other exhibiters at Optrafair 20/20

Public Health England has issued a guide about eye care and treatment for eye problems for people with learning disabilities.

February 2020

People with learning disabilities are more likely to have serious sight problems but less likely to be able to successfully access eye care services than the general population. Good eye care helps people to live healthier, more active and independent lives.

There is a legal obligation for eye care services to make reasonable adjustments to ensure that people with learning disabilities can access services in the same way as other people.

This might include making practical adjustments to the environment or changes in the process. This guidance gives examples of reasonable adjustments and signposts resources that can be used to support people with learning disabilities with their eye care.

There are also examples of changes that can be made to systems or pathways to improve the eye care of people with learning disabilities.

Important eye care messages:

Adults with learning disabilities are 10 times more likely to have serious sight problems than other adults and children are 28 times more likely
people with very high support needs are most likely to have sight problems. They may not know they have a sight problem, and may not be able to tell people - supporters, carers and teachers often think that people can see very well

6 in 10 people with learning disabilities need glasses and often need support to feel comfortable to wear them

Adults should have an eye test every 2 years, sometimes more often, children should have an eye test every year
everyone can have a sight test, with the right support

The biggest single cause of avoidable sight loss across the world is those with very poor eye sight not having glasses

It is a common misconception that sight tests are just about glasses. In fact, the sight test is also about eye health and identifying sight threatening conditions which can often be treated.

Some types of sight loss have no obvious signs or symptoms and it is important that such sight problems are detected early through eye tests, to maximise the opportunity for treatment.

Two New Committee members for ABDO NCC

February 2020

ABDO Vice President Jo Holmes FBDO, chair of the National Clinical Committee, has welcomed two new members to the committee. Former ABDO board member Kevin Gutsell and local lead Joshua Smith will be adding their expertise to the clinical committee which oversees ABDO’s clinical direction.

Kevin Gutsell FBDO is a former ABDO Board member, a GOC educational visitor, former director of the FMO, a business owner, BSi Rep, and an ABDO College tutor. He says, “The NCC has already undertaken important work expanding the scope of practice for dispensing opticians and I am looking forward to being involved in and working with like-minded professionals to achieve more. I have been fortunate to have had fantastic opportunities and meet knowledgeable individuals during my time which has helped shape the person I am today, bringing passion and enthusiasm to improve our profession and its members, I hope to be a valuable contributor to the NCC.”

Joshua Smith FBDO currently practises at Sheffield Teaching Hospital NHS Foundation Trust. Before qualifying as a dispensing optician he worked as a registered dental nurse. He says, “My aspirations to join the NCC stem from my desire to help shape the future for current and upcoming dispensing opticians. As a dispensing optician who currently works within the ophthalmology department at a leading NHS hospital I bring a wealth of specialist knowledge to the committee, ranging from low vision and refractive surgery to medical contact lenses and complex dispensing. I am currently studying for the ABDO Contact Lens Certificate and a Doctorate in Healthcare Science, researching the dispensing managing of patients following intraocular lens implantation. Having recently also being appointed an ABDO local lead I am excited about getting involved with the NCC and the Association as a whole.”

Jo Holmes says, “I'm delighted to welcome both Kevin and Joshua. There was a very high standard of applicants making our choice tricky. I believe we have chosen two DOs who will bring the best skill set and complement the existing knowledge we already have on the team. Kevin Gutsell brings a wealth of experience and knowledge. He has been involved with optical manufacturing, runs his own business, and is on the BSi committee to name just some of his portfolio. Joshua Smith has experience in the hospital environment and brings energy and passion regarding the role of Dispensing Optician. I look forward to working with our newest recruits along with the rest of the team.”

AOP calls for halt to optometry degree apprenticeships

February 2020

The Association of Optometrists (AOP) is calling for a halt on the current proposal for optometry degree apprenticeships until the profession’s serious concerns are addressed.

Skills for Health recently released a Q&A document saying the trailblazer group would continue work on the proposal.

The AOP contacted the group, Skills for Health and the Institute for Apprenticeships in late January – arguing that development should stop until strong concerns over patient safety and confidence in the profession, raised by many in the sector, are fully addressed.

The AOP pointed out that a proposal for a degree apprenticeship in pharmacy has been halted twice to allow for proper stakeholder engagement, and that optometry deserved the same consideration.

We have received no response from the trailblazer group or the other organisations involved.

AOP Clinical Director, Dr Peter Hampson said: “We continue to be deeply concerned over the optometry apprenticeship proposal. We are even more concerned that those involved in its development seem to be ploughing on without properly addressing the issues that are being raised by many optometrists. There are a range of reasons to oppose the current proposal but above all the risk it poses to patient safety and confidence remains key – we’re very disappointed that these concerns have been met with silence.”

The AOP was the first major optical body to oppose the degree apprenticeship – drawing on member feedback to build a case against the proposal as part of its consultation response in December 2019.

Since then, the AOP has been working with other stakeholders including current education providers to explore the key issues around student supervision and quality assurance. It is clear that these are already challenges under the current education system, and that the difficulties would be amplified if a degree apprenticeship was introduced.

The AOP is asking members who have had problems with supervision in an optical practice under the current education system – whether as an undergraduate or pre-reg student, or as a registrant who’s been asked to supervise a student to share their experiences.

AOP members can email the AOP policy team, policy@aop.org.uk or discuss in the AOP community forum.

Links to previous statement stories and Opchat's Breaking News story on Optoms Petition in November 2019

Eye health experts call for urgent action on hospital eyecare to reduce delays and improve patient safety

February 2020


Joint statement to tackle pressures on hospital eye departments from The College of Optometrists and AOP.

The Association of Optometrists (AOP), The College of Optometrists and The Royal College of Ophthalmologists have joined forces to issue a statement outlining steps to tackle increasing pressure on hospital eye departments in England.

Calling on NHS England leaders, the optical bodies are urging that new models of eyecare with adequate funding, are introduced in a bid to protect patients from failings that pose a risk to sight.
The call follows recent findings from the Healthcare Safety Investigation Branch (HSIB) and the Getting It Right First Time (GIRFT) Ophthalmology report which highlighted serious inadequacies in eye healthcare and an urgent need for change.

Under existing services, as many as 22 patients a month across the UK suffer severe or permanent sight loss because their follow-up appointments and treatment in hospital do not take place quickly enough1.
Clinical Director for the AOP, Dr Peter Hampson said: “Under the current system, things are simply not working. We’re regularly hearing stories of patients that are suffering as they live with unnecessary sight loss. National recommendations were made on the referrals process for conditions like glaucoma over a decade ago and yet people continue to experience the same systemic failings. We believe it’s time to see a change. Making full use of the skills of other professionals, such as optometrists, could release time for ophthalmologists to manage cases where the patient has more complex needs.”

Consultant Ophthalmologist, Melanie Hingorani, Chair of the UK Ophthalmology Alliance said: “There is an enormous amount optometrists and ophthalmologists can do to reduce care delays for patients with eye conditions if we work together. However, we need NHS England and Improvement to enable greater collaboration by urgently addressing the many barriers in the current system limiting this.”

The College of Optometrists’ Director of Policy and Strategy, Dr Sarah Cant, said: “This joint statement is an acknowledgement of the root and branch reform that needs to happen across England to alleviate the pressure that hospital eye health services and patients are experiencing. We know that there are some areas where optometrists’ skills are utilised in enhanced services schemes, resulting in patients being seen quickly and their treatments managed locally. These need to be available across England if we are to tackle the systemic problems now being faced.”

In their joint statement, the organisations have set out immediate steps to improve patient eyecare referrals in hospitals in England. The document includes guidance for commissioners, hospital eye departments, individual ophthalmologists and optometrists to better integrate services and pool existing resources. For example, ensuring that only patients whose conditions need secondary care input are seen in hospital will improve capacity for patients with serious and sight-threatening conditions.

KEY INFORMATION

• Demand for hospital eyecare in the UK is unprecedented and growing – in 2018/19, ophthalmology was the largest outpatient speciality in England, with over 7.9 million appointments2

• As the UK’s population ages, with the number of people aged over 65 projected to rise by over 40% in the next two decades, more people will need treatment for serious eye diseases such as
cataracts, glaucoma and age-related macular degeneration (AMD)

• It’s estimated that glaucoma cases will increase by 44% over the next 20 years, and AMD cases by 60%

Further comments

ABDO President Clive Marchant today welcomed the joint statement issued by The Association of Optometrists (AOP), The College of Optometrists and The Royal College of Ophthalmologists calling for new action to take pressure off hospital eye departments.

He said, “The arguments put forward are compelling and we at ABDO fully support this initiative. Sadly however, the sector is not seen as fully united. ABDO has members working in the hospital eye service and we have members who as practice owners will be central to delivering enhanced services in the community. We all need to be seen to be on the same page and until the whole sector is both involved and united we are likely to remain ignored as we have been for so many years.”

New ABDO Vice President announced

February 2020

Daryl Newsome

Daryl Newsome has been elected as the next Vice President for the Association of British Dispensing Opticians (ABDO). Daryl will take over from Jo Holmes who becomes ABDO President. Both changeovers will take place at the ABDO Gala Dinner at Optrafair in April.

Daryl is a second generation Optician following in his father’s footsteps. Since qualifying in 1984, he has worked for multiples and independents in various roles including buying, middle management, training and teaching. Currently he is a partner in Newsome opticians in Devon, a practical and theory examiner for ABDO, and a practical tutor preparing undergraduate students for their professional examinations.

Daryl says, “I am very pleased to be elected by our board of directors to become Vice President as Jo Holmes becomes President. It is both an honour and a privilege. I have worked with Jo on ABDO’s National Clinical Committee since its creation and I know we can work harmoniously and synergistically. I look forward to supporting what looks to be a very exciting presidency.”

Jo Holmes, current ABDO Vice President and President-elect says, “I’d like to congratulate Daryl Newsome on his appointment as Vice President to the Board. We have an exciting and varied time ahead over the next two years, and I’m sure we will all work successfully together as a board to address the challenges ahead.”

AOP Voice of Optometry survey opens with new charity incentive

January 2020

The Association of Optometrists (AOP) is today launching the fourth Voice of Optometry survey – an annual questionnaire that raises the profile of optometry and eye health.

Optical professionals are given a unique opportunity to share their views and experiences of working in the sector. Results are then used by the AOP to promote positive stories in the media that increase the public’s understanding of optometry and good eye health habits.

As a thank you for taking part, the AOP is opting to make donations to three sight charities – Fight for Sight, Vision Aid Overseas and the AOP’s Optical Benevolent Fund. The amount given will be calculated based on the selections from members who will be asked to choose one at the end of the survey.

Chief Executive of the AOP, Henrietta Alderman, said: "The AOP is delighted to be introducing a charity donation as a thank you to members for taking part – an initiative based on member feedback.

With ‘creating visibility of optometry’ listed as one of members’ top three priorities for the AOP in our latest membership research – the Voice of Optometry survey continues to be a valuable tool in championing the profession.”

Open to UK practising optometrists, this year’s survey will ask participants on a range of subjects including vision standards for driving, children’s eye health and other topical eye health issues.

The survey, which takes no more than 10 minutes to complete, is open to practising AOP members, who will be sent a unique link from Survey Monkey on Tuesday 28 January.

Findings of the survey will be reported on a general, rather than individual, level and all views of panel members will remain anonymous.

The survey design and analysis will be managed by independent research company, Trueology.

GOC erases Manchester based student dispensing optician

January 2020

The General Optical Council (GOC), the UK regulator for optometrists and dispensing opticians, has decided to erase Sanna Aslam, a student dispensing optician based in Manchester, from its register.

She will now be unable to undertake training as a student dispensing optician in the UK.

A GOC Fitness to Practise Committee found her fitness to practise impaired by reason of misconduct. This related to her dishonestly obtaining a number of free trial daily contact lenses for someone she knew.

Ms Aslam has until 20 February 2020 to appeal her erasure.

College AGM date announced, have your say.

January 2020

The College's AGM will take place on Monday 24 February during Optometry Tomorrow 2020. You can download the annual report and annual accounts as well as agenda here.

The College extends a welcome to all its members to share our latest annual report, which focuses on our achievements during the last membership year.
These include:

• The launch of our member-only app, which provides instant access to our core clinical guidance.
• The development of myopia management resources for members, including a patient leaflet, an Optometry in Practice special issue and online learning.
• The launch of our new podcast series, bringing listeners the latest in eye health research and patient experiences.

These could not have been achieved without you, our members, and the annual report provides an opportunity to thank members for their continued support.

Members can share their thoughts on any of the achievements highlighted in the annual report via email or social media.

We hope you can join us for the AGM. If you want to raise matters under Any Other Business, email Cat Moloney, Clerk to the Board and Council, before the meeting.

PSA reports on GOC improving triage process

January 2020

The Professional Standards Authority (PSA) has produced a short report showing how its work contributes to protecting the public, and provides a narrative informed by the various statistics produced as part of the Authority’s processes.

The data used includes statistics arising from the PSA’s review of regulators (both their performance as part of annual reviews as well as scrutiny of their final fitness to practise decisions).

Included in the report is reference to the introduction by the General Optical Council (GOC) of a new triage process to filter out concerns that cannot be taken forward by the regulator. In an initial review the PSA found issues in nearly a third of the sample of triage cases it reviewed and had no reason to think the sample was not representative.

In response, the GOC made changes to its triage process as well as developing a new quality assurance measure. These included:

• Recruiting new staff (a triage officer and senior triage officer)
• Making changes to its triage process ‘case plan’
• Implementing acceptance criteria
• Amending its referral form to make it easier to understand.

The GOC also developed quality-assurance measures about when to and when not to open a case at the triage stage, including:

• A recommendation by the triage officer
• Decision by the senior triage officer
• Right to request a review (to be reviewed by the director of casework)
• Review by an investigations manager when opening a full investigation
• Sample control check of decisions not to open a case
• An independent audit of a sample of decisions.

Subsequently, the PSA carried out a targeted check to see what improvements had been made and examined 25 cases closed at this stage in the fitness to practise process and found that the concerns it had identified had been addressed.

The PSA also did not identify any cases closed where there was not a good reason to close them; or that significant issues of the complaint had not been considered. The GOC having made positive changes to the process then agreed to carry out an audit about how it is using its acceptance criteria which the PSA will look at as part of its next review.

Scotland 2020 GOS Mandatory Training for Optometrists/OMPs

January 2020

As part of The National Health Service (General Ophthalmic Services) (Scotland) Amendment Regulations 2018, there is an annual requirement for all Optometrists and OMPs working under GOS in Scotland to satisfactorily complete an element of mandatory training, provided by NES.

For the second year (running January 2020 to December 2020), this will take the form of an online TURAS Learn module on an Introduction to Consent and Capacity in Optometric Practice in Scotland.

The module is split into two sections (Consent/Capacity): you must complete both sections to complete your mandatory training. Two GOC CET points are available for completing both sections and passing the corresponding MCQs.

Reminder: Following a communication from the Scottish Government in PCA(O)2019(3), practitioners no longer need to submit their mandatory annual training completion certificate to the NHS Board(s) with whom they are listed to provide GOS. However, please ensure your primary host health board is correctly listed on Turas.

Domiciliary Providers asked to provide answers to anomymous questionaire

January 2020

Domiciliary Eye Care Committee safety questionnaire

The Domiciliary Eye Care Committee (DEC) on behalf of the Optical Confederation is keen to ascertain the nature and extent to which physical barriers and concerns about provider safety prevent or impede the provision of domiciliary eye care.

Could you assist DEC by completing a short questionnaire and sharing it with your colleagues? This anonymous questionnaire should only take five minutes to complete with the deadline being midnight on Friday 31 January.

RCOphth published new strategic plan for 2020 to 2022

January 2020

The Royal College of Ophthalmologists believes that everyone should have access to high quality eye care.

The new RCOphth Strategic Plan 2020-2022 directs and prioritises key policy and campaign activities over the next three years. The way NHS care is provided and the treatments available to improve patients’ lives have changed almost beyond recognition since our charter first set out our obligations as a medical royal college in 1988. Read the full plan here

GOC erases Cambridgeshire based dispensing optician

January 2020

The General Optical Council (GOC), the UK regulator for optometrists and dispensing opticians, has decided to erase Barry Church, a dispensing optician based in Cambridgeshire, from its register. He will be unable to practise as a dispensing optician.

A GOC Fitness to Practise Committee found his fitness to practise impaired by reason of misconduct relating to his conviction of theft and failing to engage with a GOC investigation.
Mr Church had until 9 January 2020 to appeal his erasure.

Scottish Opticians underusing code?

January 2020

A recent Scottish Payment Verification meeting has highlighted that new codes 2.9 and 3.0 are most likely being underused.

Code 2.9 is for cataract counselling and can be used following a primary examination to give advice about cataract surgery when referring a patient. Code 3.0 is the complex needs code and is used when bringing a patient back for a consultation, if the primary examination could not be conducted in full on the day or if extra time was taken to complete a primary eye examination on that day.

Find out more on the OS website

Workforce survey for Scottish optometrists

January 2020

Optometry Scotland has developed a survey to provide the Scottish government and other stakeholders with information on the status of the current optometry workforce.

It takes about three minutes to complete and as an incentive to do so, participants will be entered into a prize draw to win one of four Amazon vouchers worth £50.

The survey can be completed here or on the OS website and will be open until 31 January 2020.

GOC position on proposed apprenticeship standard, a further statement issued during consultation period.

January 2020

The GOC has issued a statement in response to concerns that have been raised about the proposed apprenticeship standard.

The GOC emphasises that it is responsible for protecting the public by setting the standards for all optometry programmes in the UK and for approving and quality assuring these programmes. It goes on to state:

“Any programme of education and training designed to meet the optometry apprenticeship standard would require our approval in the usual way for students undertaking the programme to be able to join our register and practise as an optometrist.

“Through our involvement with the Trailblazer Group involved in developing the proposed optometry apprenticeship standard, we have ensured that the Group is aware that the standard must be consistent with our requirements and that any programme of education and training designed to meet the standard would then require our approval.

“We hope that this clarifies our role and provides assurance that any new programmes designed to meet the proposed optometry apprenticeship standard would be subject to the same scrutiny as any other new route to registration.”

Responses to the optometrist degree apprenticeship standard consultation close on 10 January.

Readers can remind themselves of our breaking story in our November pages here

 

 
 
 
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