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Joint working

A specialist role

OT  finds out how joint working takes place at Manchester Royal Eye Hospital’s NHS community eye clinics

22 Aug 2019 by Andrew McClean

Manchester Royal Eye Hospital’s NHS community eye clinics were set up to expand the capacity for patients living with macular disease and delivering intravitreal injections. At the clinic, patients have their sight tested, their macular scanned and assessed to determine a treatment plan. This is carried out by a doctor and an optometrist working together. Consultant ophthalmologist and clinical lead for macular services, Sajjad Mahmood (SM), and optometrist, Jez Parkes (JP), tell OT  how the multi-disciplinary team works together.

Who makes up the team at the eye clinics?

SM: The vision check is done by a clinical support officer. The imaging is done by an ophthalmic science practitioner. The key part is the assessment, which is a review of the patient’s treatment and making a treatment plan. That’s done in one room with a doctor and in another room with an optometrist. If a treatment decision is made and a patient needs an injection, that’s done by a specialist nurse.

How does the role of the optometrist fit into the pathway?

JP: If it’s a patient who I feel comfortable managing then I’ll see them and sort out their treatment care plan. If it’s a patient with an unusual presentation then I will go and discuss the case with Sajjad, for example.

SM: The optometrists have autonomy to do an assessment and make a treatment decision. They will have been through a training programme at our central hospital site and after that process they can do the assessment independently, but the doctor is there as a backup to discuss difficult scenarios and treatment decisions.

“Without this approach we would not have the capacity to deal with the number of patients presenting”

Optometrist at Manchester Royal Eye Hospital’s NHS community eye clinics, Jez Parkes

How important is joint working to deliver the highest level of patient care?

SM: We couldn’t manage without it. In macular treatment, the demand has grown hugely. We do around 1600 injections a month versus about 10 a month 10 years ago. We can’t deliver that with one staff group. That’s why we had the idea to involve other staff groups.

Optometrists have all the background knowledge and skills as part of their training to be able to take on this more specialist role. In Manchester, where we have a central site and multiple sites around the city, each of those sites need staffing and that can’t just be run by doctors. Joint working has been crucial for us.

JP: It’s made the services possible. Without this approach we would not have the capacity to deal with the number of patients presenting.

Pictured from left to right is Mr Mahmood and Mr Parkes

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