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AOP Council: “The sector is going to be transformed”

Councillors discussed how optometry’s overarching legal framework could be reimagined at the latest AOP Council meeting

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A planned overhaul of legislation that underpins optometry practice in the UK was discussed at the latest AOP Council meeting (8 June, Crown Plaza Hotel King’s Cross).

AOP policy director, Carolyn Ruston, provided a brief update on the Eyes Have It partnership.

The AOP and the Royal College of Ophthalmologists have joined Fight for Sight, the Macular Society and Roche Products in supporting the initiative, which aims to raise awareness of eye health and drive change within government.

Ruston noted that the first national clinical director for eye care has recently been appointed, with the chief medical director of Moorfields Eye Hospital, Louisa Wickham, taking on the role.

AOP chief executive, Adam Sampson, provided an update to council on the Association’s upcoming five-year strategy.

He noted that as well as changes within the organisation, with a new chair and new chief executive, the strategy comes amid a state of broader flux.

Advances within technology, the challenges of the NHS backlog and planned changes to the Opticians Act all contribute to a shifting professional landscape.

“All of these things mean that the sector is going to be transformed in the next 10 years,” Sampson highlighted.

“We need to get ahead of the change, shape the change and prepare members for it,” he added.

Sampson described the AOP Strategy for 2022-2026 as a roadmap to securing the present and shaping the future of optometry.

He discussed the evolving membership needs of the organisation, noting that while the role of the AOP is to defend its members, they work in a healthcare system that serves patients.

Sampson outlined the values of the AOP. He noted that in order to be influential, the AOP needs to be more outward looking than it has been in the past.

“The audience we’re talking to isn’t just our members. We have to talk to people beyond the optical world – that’s a skill we need to develop if we are going to influence change,” he emphasised.

We have an incredibly dedicated and competent profession – let’s honour that

AOP chief executive Adam Sampson

Sampson highlighted that the next value within the AOP’s strategy is dedication.

“We have an incredibly dedicated and competent profession – let’s honour that and celebrate that,” he shared.

Turning to the value of expertise, he shared that within the room of AOP Councillors there was an immense depth of knowledge.

The final value that Sampson discussed is the AOP as a principled organisation.

“This is a place where people believe in doing the right thing – people aren’t just acting out of self-interest,” he noted.

Sampson outlined the four main pillars of the AOP strategy – legislation and regulation; external influence and policy making; the role of optometrists in the future of healthcare, and economics within the optical sector.

Sampson noted that while it is unlikely that the Opticians Act will be changed in the next two to three years, the General Optical Council’s(GOC) call for evidence can be seen as “the firing of the starting gun” for the AOP to develop its own vision on how the profession should evolve.

“We have to come up with our view on what the regulations and legislation should look like. We then need to convey that to Government,” he noted.

AOP Councillors had the opportunity to discuss key areas of the GOC call for evidence in small groups.

Sharing his group’s views on delegation of refraction, AOP Councillor, Ali Yasen, highlighted that many tasks can be delegated, noting that there are now computer systems capable of completing certain activities.

“It is about those tasks being overseen by the optometrist,” he emphasised.

Yasen noted that the role of providing advice, guidance and recommendations should remain with the optometrist and not be delegated.

He discussed the benefits and disadvantages of separating the sight test into refraction and eye health elements.

The possible advantages include that it may be cheaper for the patient and may result in financial gain for the large optical companies.

Separation could provide an opportunity for the development of dispensing opticians and could free up time for optometrists.

However, turning to the disadvantages, Yasen highlighted the potential for the breakdown of communication between those responsible for different elements of the sight test.

He also noted that the approach to refraction is often informed by knowledge of the patient’s eye health.

As spokesperson for his group, AOP Councillor Vijay Anand emphasised that the supervisor of delegated tasks should be on site and there should be a limit to the number of staff who can be delegated to.

He added that for certain vulnerable patient groups, delegation should not be allowed.

Summarising the points raised by her group, AOP Councillor Josie Evans highlighted that the ultimate decision about clinical management of the patient should remain with the optometrist.

She added that optometrists should be responsible for determining which tasks are delegated.

In making this decision, the optometrist could evaluate the value created by delegating the task compared with the potential risks associated with delegation.

Group spokesperson, AOP Councillor Paul Chapman-Hatchett, emphasised the importance of locum optometrists attending practices understanding what the processes for delegation are.

They also need to be confident in the skills, training and associated audit trail of the individuals who are undertaking delegated tasks.

Discussing the potential for separation of elements of the eye examination, Chapman-Hatchett noted that the enhanced potential for online sight tests could result in better access in rural areas but there was also the risk that pathology could be missed.

Presenting for his group, AOP Councillor, Kevin Wallace, noted that delegation may be suitable for procedural elements of the sight test but not for interpretation or management.

He emphasised the importance of having a clear chain of command within practices.

The Councillors turned to issues of new technology, safeguarding vulnerable patient groups, and the growth of online sales.

Wallace highlighted that certain groups should have special protection, including patients under the age of 16 and those being fitted with myopia control products or extended wear contact lenses.

Speaking about the benefits of new technology, Yasen noted its potential to be quicker, more accurate and free up clinician time for patient management.

However, there may be risks in a lack of consistency across different platforms and the cost of new equipment may be prohibitive.

Speaking for his group, AOP Councillor Tushar Majithia highlighted that when supplying contact lenses, there should be an obligation for the supplier to check that the prescription is in date.

He added that there could be a QR code on contact lens packaging linking to online information on contact lens care.

On the subject of technology and remote care, Majithia noted that remote appointments may be more convenient for some patients and free up capacity for other patients to be seen face-to-face.

However, he highlighted the data security issues associated with some new forms of technology.

Majithia also noted that there may be barriers to those with limited financial resources or digital literacy in accessing new online platforms.

Following a ballot at the meeting, AOP Councillors, Francesca Marchetti and Dr Rachel Hiscox, were elected to the AOP Board.