We’ve published our review of evidence to support the legislative change to allow orthoptists to prescribe glasses in the hospital setting in accordance with the Opticians Act 1989.
Hospital ophthalmology services are coping with the longest waiting times experienced in ophthalmology for a decade. A particular problem is that children are waiting too long for routine refraction (glasses test) appointments, so delaying further treatment. Limited changes to the legislation controlling the prescribing of spectacles to include orthoptists in this setting will be consistent with meeting the NHS workforce aims to offer care in the right place, at right time by “improving productivity by working and training in different ways, building broader teams with flexible skills, changing education and training to deliver more staff in roles and services where they are needed most, and ensuring staff have the right skills”.
Recommendations and key findings:
BIOS would welcome review of regulations governed by the GOC regarding sight testing, that would allow the profession of orthoptics to be named within the Opticians Act (1989) Part IV thus enabling orthoptists to conduct refractions and prescribe glasses within the hospital / NHS setting in addition to optometrists and medical practitioners.
This is based on the following:
- Graduate orthoptists already have the skills and knowledge to carry out and make decisions on glasses prescriptions and eye health checks but these can be lost post-graduation if not maintained, due to the inability to sign prescriptions. Additional training would ensure the same competency standard as their ophthalmology colleagues as already evidenced in some HES clinics
- This would be safe and highly beneficial for patients and would align with strategic reforms in workforce development that allow more efficient eye care to be delivered.
- It would enhance patient care by making simpler care pathways with more streamlined clinical decision making.
- It would provide financial and cost savings for patients and hospital eye services.
- BIOS would not be seeking this right outside of the hospital-based services. This amendment would not undermine the law, or be a threat to the optometry profession. It is a unique proposal to allow a highly skilled registered eye care profession to provide more efficient care benefiting patients within a specialised area of eye care within the NHS/HES setting.
- Regulation and education are embedded within the profession and the Health and Care Professions Council (HCPC) has mechanisms to ensure that regulators will be competent to assess those on the Orthoptics Register who refract and prescribe glasses.
- The proposal is that in order that an orthoptist could sign prescriptions there would be an annotation to the register after completion of appropriate post registration training. This would be limited to the Hospital Eye Service. There is broad support from within ophthalmology and from the HCPC who are willing to discuss proposals going forward.
- There is currently no legislation that prevents orthoptists carrying out eye health checks, and assessment of eye health forms a large part of undergraduate training and current orthoptic practice, but training to qualify for annotation to the HCPC register would include enhanced eye health training
