Updated NICE Guideline on Stroke Rehabilitation in Adults

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The updated guidelines highlight the massive strides made towards cementing the place of orthoptists within the stroke care team.

The guidance is now that people in hospital following a stroke should be offered a specialist orthoptist assessment as soon as possible. If this is not possible before discharge, the person should be offered an urgent outpatient appointment.

This represents a real step forward, in addition to the recommendations in the National Clinical Guideline for Stroke in May, which recommended that vision screening should be completed within 72 hours, but does not specifically mention orthoptists.

Problems with vision and eye movement are common following a stroke or brain injury, affecting about 73% of people. This can have a significant impact on a person’s rehabilitation, as well as negatively affecting their quality of life.

Currently, as highlighted in the evidence review for the new Guidelines, the provision of eye care on stroke units is non-standardised and ad hoc, leading to vision problems being missed. NICE state as the basis for their recommendation that eyesight problems are more likely to be identified during an orthoptist assessment when compared to other forms of assessment.

We are hopeful that the new guidelines will encourage more consistent access to specialist orthoptist assessments, supporting earlier diagnosis of vision and eye movement problems in people who have had a stroke.

Dr Lauren Hepworth, Co-Lead of our Stroke and Neuro Rehabilitation Clinical Advisory Group said “This update of the NICE guidelines on stroke rehabilitation in adults is a positive step forward towards better system of identification and management of visual impairment post-stroke. Implementation of these guidelines will also release other members of the multi-disciplinary team from vision screening to focus on other areas of rehabilitation. There are services which already meet this new recommendation, demonstrating it is possible!”

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If you are interested in finding out more:

Read the Revised guideline here

Stroke & Neuro Rehab CAG page

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BIOS launch Orthoptic Support Workforce Hub

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We’re delighted to launch our new Orthoptic Support Workforce Hub today, bringing together all our information and resources for clinical assistants in one place.

As the culmination of one of the strands of the Health Education England-funded Workforce Development Project, the hub already features an FAQ, case studies, and example job descriptions and person specifications for managers. Later today, we’ll be celebrating our support workforce at an Orthoptic and Ophthalmology Support Workforce Webinar, where we’ll be launching our Roles and Responsibilities Guidance covering levels of practice and recommended standardised titles.

You can access the hub here 

Our vision is for all orthoptic staff wherever they work to feel valued, integrated into teams, able to work fully to their potential; with access to lifelong learning including relevant formal qualifications.

We wish employment in the clinical support workforce to be seen as a career that is valued and valuable. Moreover, whether staff wish to pursue their careers in the clinical support workforce or progress onto registered grades we want to ensure they have rewarding careers and are clear how they can develop, accessing the support they need.

The support workforce is an integral part of the orthoptic clinical team.

You can read our full vision statement here.

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GIRFT Ophthalmology report published

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The latest report from the Getting It Right First Time (GIRFT) programme highlights how eye care services could be rethought to make better use of available resources.

Demand for Ophthalmology services has risen significantly – with referrals from primary care up 12% since 2013/14 – and repeated studies suggests it will continue to rise, particularly in light of an ageing population. The report was written in response to the impact of this on ophthalmology departments, that are often struggling to keep pace.

The approach of the report is to draw on best practice to identify ways to optimise provision and increase capacity, reducing pressure on consultants and empowering the wider team while offering patients a more flexible service and better experience.

In the foreword, Mike Burdon, President of Royal College of Ophthalmology welcomes the publication, ‘It reflects a huge commitment by the GIRFT team to analyse the ophthalmology services being delivered at the 120 trusts in England, and to identify innovative models of eye care which, if adopted nationally, would greatly impact on our ability to keep pace with rising demand and ensure patients benefit from high quality care.

The principle value of this GIRFT report is that it provides an in-depth assessment of what is good practice and what could be improved. The clinicians and managers working in ophthalmology services, and those that commission these services, have a duty to reflect on its recommendations. It is vital that we adopt efficient models of care, and the reporting and auditing of that care, to ensure we are able to deliver the quality of services that all patients have a right to expect.’

More information, including the full report, can be found on the GIRFT website.

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If you are interested in finding out more:

Read the full GIRFT Report here.

The CCEHC’s Systems and Assurance Framework for Eye Health (SAFE) aims to help commissioners develop a more strategic and consistent approach to service planning.

Read BIOS’s position on Advanced and Extended roles here.

More information about the advanced and extended roles taken on by orthoptists is available on our CAG pages.

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Clinical leadership – a framework

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NHS Improvement’s Clinical leadership – a framework for action promotes the importance of more professionally diverse leadership teams. It highlights some of the barriers to clinicians, such as Orthoptists, reaching the most senior levels. This is hugely positive and we would like to see it act as a spur for more of our members to progress to leadership positions.

This guide reflects one of the priorities of the recent NHS Long Term Plan, which highlights the importance of visible senior clinical leadership in enabling and assuring the delivery of high quality care. It has been recognised that professionally diverse teams are better equipped to adapt to the complex challenges facing the NHS. The new publication seeks to encourage this through providing leaders with new perspectives on what might be standing in the way of progress, while also providing questions to consider and some possible ways of tackling common barriers.

It is encouraging to see recognition of some of the major barriers to Orthoptists progressing to leadership positions and that steps being taken to tackle this. The framework has been developed through discussions with clinicians exploring some of the barriers and enablers they identify when moving into senior leadership positions, such as unhelpful career structures and lower expectations of clinicians making this step.

The framework is also accompanied by a number of case studies showing how clinicians, including Allied Health Professionals (AHPs), are making valuable contributions in senior leadership roles.  There are valuable lessons to be learned from their journeys but it is also pleasing to see these achievements recognised, particularly as the barriers to progress include a lack of role models for clinicians and the failure to prioritise the value of having clinicians in these role.

This is timely for BIOS as we will soon be launching our new My Eyes My Orthoptist campaign, which includes a call for the removal of arbitrary barriers to promotion for Orthoptists. We would therefore encourage our members to share this resource and consider some of the lessons in the case studies.

The Clinical leadership report has also been endorsed by the Allied Health Professions Federation (AHPF), of which BIOS is an active member.

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If you are interested in finding out more:

Visit our pages on Education & Professional Development and our Leads Of the Orthoptic Profession (LOOP) group.

Keep a look out for our upcoming campaign, My Eyes My Orthoptist

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Professional Bodies and Unions launch a set of CPD and lifelong learning principles for health and social care.

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Professional Bodies and Unions launch a set of CPD and lifelong learning principles for health and social care.

A working group comprising organisations from across a range of health and social care sectors has today launched a set of principles for continuing professional development (CPD) and lifelong learning.

The principles are designed to guide individuals, employers and wider systems to create a culture of continuous improvement, workforce development and improve outcomes for service users. People working in the health and social care workforce operate in a changing, challenging and complex environment. Practising safely and effectively, now and in the future is essential.

The five principles are that CPD and Lifelong Learning should;

  1. be each person’s responsibility and be made possible and supported by your employer
  2. benefit the service users
  3. improve the quality of service delivery
  4. be balanced and relevant to each person’s area of practice or employment
  5. be recorded and show the effect on each person’s area of practice

Will Broughton, Director of Professional Standards for the College of Paramedics and Chair of the working group, said:

“We believe that the health and social care workforce should have the opportunity to undertake CPD activity and these five principles clearly illustrate how developing new knowledge, skills and evidence-based working will produce an effective workforce, who are well-equipped and prepared to deliver high quality services.

It is our intention to evaluate the impact of the principles next year ahead of a review in January 2021. We welcome feedback from people working across the health and social care workforce that will contribute to further versions of this document.

Thank you to all members of the working group, the organisations who hosted our meetings and for the behind the scene support that got this to finished project.”

 

Please follow this link to access the publication:

https://www.orthoptics.org.uk/wp-content/uploads/2019/01/CPD-Principles-Jan-2019.pdf

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