20 May 2021
The pandemic has brought independent prescribing (IP) optometrists to the fore by showcasing the unique skillset of this group of professionals.
Altered working lives during COVID-19 have also prompted some professionals to consider further education, with several IP courses reporting an increased demand over the past year.
Speaking at a General Optical Council (GOC) meeting in July last year, council member Helen Tilley described a “tsunami of applications” for the WOPEC IP course in July 2020.
She expressed concern that there would not be enough hospital placements to keep up with the demand, while fellow council member Roshni Samra shared her personal experience of her IP qualification timing out after she was unable to secure a clinical placement.
A recent development could help to address concern about a bottleneck in IP clinical placements, with the GOC set to permit up to 55% of clinical sessions to be completed remotely as part of independent prescribing training.
IP optometrist and managing director of Cameron Optometry, Ian Cameron, shared with OT that any measure that increases access to IP training is “very welcome.”
“For a lot of busy practitioners the difficulty of securing a clinical placement is off-putting so it’s great to see the learnings we’ve all gained about virtual care throughout 2020 being adapted so quickly into IP training,” he emphasised.
He believes that the GOC has got the balance right by requiring some in-person examinations, but at the same time lowering the barriers to signing up for IP by enabling a significant portion of the training to be completed virtually.
Virtual consultations have not always been embraced wholeheartedly. A letter from NHS England requiring GP practices to offer face-to-face appointments as social distancing restrictions ease was described as “tone deaf” by the British Medical Association this week.
“As COVID-19 becomes less of a threat, phone and online consultations will continue to play an important role for many,” Dr Richard Vautrey emphasised.
He added that while most GPs do not want to become ‘call centre clinicians’, and would like to see some patients face-to-face, this cannot happen overnight.
“Even as restrictions ease, COVID-19 is still circulating and new variants remain a concern, so to continue protecting patients, we have to limit how many can be in the surgery at any one time,” Vautrey highlighted.
Few optometrists would want to offer all care virtually – and the picture of a patient’s eye health when solely gathered through remote measures would be incomplete.
However, virtual consultations have benefits both for clinically vulnerable patients – who might go without care in the absence of a digital solution – and for clinicians, who are able to manage care more efficiently.
A study published by Moorfields Eye Hospital in March found that the safety of virtual consultations was comparable to those offered in person.
OT is keen to hear your experiences of offering virtual consultations. Please get in touch.
OT asks...
Would you consider IP training?
Comments (5)
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Anonymous22 June 2021
I find it very frustrating to having an OD degree with over 10 years of independent prescribing in the USA only to have to then take another course here then to find there is no placement for me. Nearly 2 years since my course ended and still no placement around me available. There are other American ODs in this country eager to work as an IP optometrist (and adequately qualified) but the path to IP is too expensive, too confusing and often unattainable when having to depend on hospitals to take us on. Seems like the solution would be to educate all optometrists as IP on graduation. Think of all the people in the country that would benefit from better access to primary eyecare with more IP optometrists available.
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Anonymous21 May 2021
As an IP Optom working in HES I feel that the face-to-face experience of the clinical placement is absolutely vital, especially in the acute eye care are of prescribings. There is a need for regular and repeated exposure to cases alongside experienced prescribers to build up both the clinical experience in accurate diagnosis but also the confidence in safe and cautious prescribing. Having noted discussions on some forums and IP peer review sessions there is a risk of stepping beyond the level of experience that some clinicians have. Just because you can prescribe doesn't mean you should.
There also needs to be robust frameworks between community optometrists and the local HES so ensure that clinical support is working well, that local protocols are considered. I would prefer consideration of funding and support to be able to increase the availability of HES clinical placements as this would also serve as a way to improve the communication and links between HES and Community Optometry in shared knowledge, education and appreciation of experience.
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Anonymous20 May 2021
Before universities accept large numbers of students to pay for the IP course, should they not ensure enough placements are available? Or else they are doing their students a disservice. The College of Optometrists, AOP, NHS England and the Royal College of Ophthalmologists should be working closely together to ascertain the value and benefit of this qualification and support the much needed placements.
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Anonymous20 May 2021
Before universities accept large numbers of students to pay for the IP course, should they not ensure enough placements are available? Or else they are doing their students a disservice. The College of Optometrists, AOP, NHS England and the Royal College of Ophthalmologists should be working closely together to ascertain the value and benefit of this qualification and support the much needed placements.
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Anonymous20 May 2021
Whilst I welcome this development, I do feel relaxation of the 2 year timeframe from completing the academic portion to starting the placement is needed. Failing that, a "refresher course" being offered to "reset the timer" on the timeframe.
I've struggled to find a placement (even before starting the university course) and I am on a waiting list that may or may not be able to accommodate me within the timescale because of the pandemic. Many are still not offering placements because of social distancing and many eye departments simply don't offer placements.
I was one of 80+ on my particular course and there are many institutions offering the course. There are clearly not enough placements to accommodate, meaning a lot of us would have spent considerable amounts of time and money on a course we cannot convert, through no fault of our own.
It's disappointing that many of those that have paid out and studied hard on top of the extra demands raised by working through the pandemic, will be forced to abandon training when the country needs IP-qualified optometrists more than ever before.
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