“We need to protect the next generation of optometrists now”

While there appears to be light at the end of the tunnel for exiting lockdown following the UK Government’s roadmap, routine optometric practice will certainly look very different. Strict infection control, the use of PPE and social distancing are likely to be crucial in the practice environment to ensure the safety of both patients and staff. Also, there will, understandably, be a change to the optical workforce as recovery begins.

A new kind of patient interaction

This summer, hundreds of final year students are due to enrol on the College of Optometrists’ Scheme for Registration. At the same time, hundreds of existing pre-registration optometrists have been furloughed while the College has ceased assessments. But as we return to some form of normality, what will this mean for pre-registration optometrists who face unique challenges?

We might see time restrictions imposed on testing times, or how long each patient is allowed on the premises for. How will this impact upon pre-registration optometrists, who have a very different need for patient interaction to experienced optometrists?

The first consideration is that pre-registration optometrists will have a very different patient interaction to a qualified practitioner. While qualified optometrists will typically spend around 30 minutes with each patient, a pre-registration optometrist’s testing time can be initially anywhere up to one and a half hours, decreasing to around one hour with experience. As well as this, pre-registration optometrists will commonly dispense spectacles for their own patients. This is a requirement of the College Scheme for Registration, further increasing contact with each patient.

When you factor in that supervisors will also routinely check the clinical findings for the patient, which increases the number of staff members that the patient comes into contact with, you can see the potential implications of the traditional patient interaction for pre-registration optometrists. The risk of significant exposure to the virus is increased and in a new environment where efficiency, reduced patient contact and social distancing will be key, this is an important consideration. In a post-COVID-19 practice environment, employers will be considering these changes, but they still need to be profitable. So, we might see time restrictions imposed on testing times, or how long each patient is allowed on the premises for. How will this impact upon pre-registration optometrists, who have a very different need for patient interaction to experienced optometrists?

One potential solution for practices is remote consultation. Take for example Specsavers launch of RemoteCare, its new online platform for remote consultations. The GOC has recently relaxed rules on remote dispensing and contact lens assessments. While these changes are currently intended to be temporary to allow for provision of services during lockdown, they have been effective in many cases. As a result, could continued remote consultation for select situations become the new normal? It has potential to reduce the number of patients in the practice at any one time and reduce contact – these are two key factors that employers will need to achieve. If this is the case, how will remote consultation work with pre-registration optometrists? Will these count as patient episodes and, if so, how will the supervision element be conducted? If these aren’t permitted, will we see a reduction in the number of episodes required?

Resourcing needs

Considering the workforce, as thousands of optical employees begin to return from the furlough scheme, optical practices will be in a very different financial situation than at the start of the year. Lockdown has paused many parts of the economy and with the suspension of routine eye examinations, this is also true for optometry. Therefore, practices will face a number of difficult months and, during this period of recovery, may be faced with reduced patient numbers. Practices will also have existing employees that they will want to protect. How will this affect the employment of incoming pre-registration optometrists and even existing pre-registration optometrists? Potentially, this may not be an issue for the multiples, but independent opticians and smaller practices may struggle to accommodate a new trainee.

Pre-registration optometrists face unforeseen challenges and a drastically different practice experience, which, due to the new normal, may threaten the viability of their training

A final consideration is that of clinical experience. The College has already said that there will likely be a delay for incoming trainees to enrol on the Scheme and with clinical teaching suspended for most final year students in mid-March, this creates a long period of time without clinical experience. Many final year students will also have to carry over undergraduate episode requirements and competencies into their pre-registration. Extensive support will be initially required as existing pre-registration students will have spent months out of practice. With a backlog of College assessments, how will this support be ensured to safeguard the next generation of optometrists?

Pre-registration optometrists face unforeseen challenges and a drastically different practice experience, which, due to the new normal, may threaten the viability of their training. At the moment, details from the Government are limited with regard to the reopening of practices and while the AOP is working very hard to develop guidance, there is still a lot of uncertainty in what is an evolving situation.

One thing is for sure: pre-registration optometrists will need to be considered in any plan for moving forward. We need to protect the next generation of optometrists and I call on employers to agree.