Opinion

HSOC: “The collegiality of the NHS community was evident”

Australian optometrist, Lynne Allard, believes that the skills of practitioners are “largely under-utilised” in the hospital system she practises in. She travelled to the UK to compare approaches at the AOP’s HSOC event, which took place in Manchester last month

4 min read

Lynne Allard

16 October 2024

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I work as a lead optometrist at Sir Charles Gairdner Hospital (SCGH), a large public teaching hospital in Perth, Western Australia. Optometrists are largely under-utilised in our hospital system, in my opinion, and many patients continue to wait a long time for eye care.

I saw the Hospital and Specialty Optometrists Conference (HSOC) advertised on the AOP’s Facebook page in July this year and immediately contacted the organisers to see if virtual attendance was an option. It was not, and in hindsight this was a good thing, as I gained so much more by attending in person.

In Western Australia, fewer than 40 registered optometrists are hospital-based, and our scope varies widely from one hospital to another

Travelling for education

My goal from attending HSOC was to learn more about the advanced scope of practice in hospital optometry that exists in the UK, and to better understand how this has evolved. I hoped that by doing so I would be able to apply some of the strategies I learned to our advocacy for the expansion of the role of optometry in the Western Australian hospital system.

Sitting in lectures and networking with peers at the conference, it was really encouraging to hear that our current experience in Western Australia is exactly where the UK used to be. It allowed me to feel hopeful that my fellow optometrists and I could soon contribute more to public health eye care in Australia.

Arriving at the conference’s Head of Department meeting early on the Friday (20 September), I was immediately welcomed by Jonathon from Belfast, and Cora from Inverness, who launched straight into answering all my questions about where and how they worked.

I sat next to Rachel from Moorfields Eye Hospital, who kindly shared some of her learnings from the hospital’s effective referral management project. I reciprocated with an offer for her to visit our beaches to discuss this further.

The conference was even more valuable than I had expected, with outstanding content, workshops and posters. Its location and the friendliness of my fellow delegates was wonderful too.

Those who delivered lectures succeeded in compressing a lot of information into short, succinct sessions, creating a content-rich agenda.

Poster sessions were interesting, and I was happy to see one co-authored by a former colleague from Utrecht, Will Holmes, alongside Catherine Porter, and Mirjam van Tilborg: The potential for using entrustable professional activities in assessing optometric clinical competence.

A highlight from the poster sessions was Sunil Mamotra’s work at the Bristol Eye Hospital on a pilot trial on remote imaging – How are advances in telemedicine going to enable community eye care? This programme is highly relevant to the hospital where I work, where patients may travel significant distances to attend appointments. Bringing these resources into the communities where people live has so many personal, environmental, and economic benefits.

I also attended the glaucoma and red eye peer review session, and enjoyed discussing diagnosis and management strategies with colleagues from across the UK.

It was really encouraging to hear that our current experience in Western Australia is exactly where the UK used to be

Similarities and differences

By far, the highlight of the weekend was meeting many wonderful colleagues with similar interests and shared experiences. The collegiality of the NHS community was evident in the constant chatter and laughter at break times, and the lively Friday night pre-conference gathering in the Sports Bar.

Australian optometrists who are endorsed for therapeutic prescribing can currently prescribe topical, but not oral medications. Core optometry and the management of many eye diseases are adequately provided by community optometrists, and community eye care is subsidised by Medicare.

However, based on the UK’s experience, I now understand that there are benefits to a more decentralised and advanced scope in the community. In Western Australia, fewer than 100 registered optometrists are hospital-based, and our scope varies widely from one hospital to another. In some locations, optometrists participate fully in patient care and management, while in most we are just beginning to fully contribute.

At SCGH consultant specialties include retinal, corneal, cataract, uveitisand oculoplastics. There is provision for three full-time optometrists, and these roles are covered by a group of part-time optometrists, all of whom also practice privately in community optometry in order to maintain their core skills.

Our association, Optometry Australia, recently created a Community of Practice and Education (COPE) group for hospital-based optometrists – we meet online every six weeks. There are 22 members of the group from across the country, spanning a two-hour time zone difference. We have had several meetings so far, chaired by Michael Yapp and Maliha Shorab, and it has been great to connect with others facing similar challenges.

There are many more similarities than differences between hospital optometry in Australia and the UK, and I hope there will be plenty of future opportunities to share experiences and learn from each other.