It can at times be difficult to decide when a case is a safeguarding concern, acknowledged the AOP’s head of clinical and regulatory, Henry Leonard, when speaking at the AOP’s Locum Clinical Skills Conference in Birmingham in March.
During Leonard’s Help! I’m a locum and… workshop, which covered a range of common clinical, ethical and regulatory scenarios that are encountered by locum optometrists, including how to manage them effectively in practice, the optometrist delved into the example of a child who is not brought back to practice for a cycloplegic refraction.
The example detailed a case in which a child had a sight test during which the practitioner discovered long sight in one eye, as well as amblyopia. Afterwards, the child did not return to practice on either of the two required occasions for a cycloplegic refraction. What should a practitioner be worried about, Leonard asked?
If practitioners find themselves in this scenario, Leonard advised firstly explaining the purpose of the test and the possible consequences to the parent.
“It’s important to try to explain why the test is important – some parents may not appreciate that you are concerned about their child’s welfare,” he said.
He expanded: “They may not understand that if the child doesn’t have their vision corrected properly, they could end up with permanently reduced vision, amblyopia. So once you’ve explained that, most parents will realise why you’re giving that advice and what they need to do.”
Leonard noted that practitioners may find themselves is a situation where the parent fails to take the advice on board and they are required to raise concerns more formally in the best interests of the child.
“Your duty as a professional is towards your patient, which is the child in this case,” he said.
However, Leonard noted, optometrists will only have access to part of the picture.
“You may want to contact the patient’s GP to see if they have similar concerns. It may be a case of contacting the local safeguarding team to raise a formal concern,” he said.
“The safeguarding team may have received other concerns from healthcare professionals and others involved in their child’s care, so they are in a better place sometimes to assess whether there’s an issue that needs to be looked at,” he added.
He asked delegates to consider what could happen to a practitioner if they do not do anything, with delegates agreeing they could be criticised regarding safeguarding.
Leonard noted that while he has not seen a case arise, there could be potential in the future for the practitioner to be criticised by the child themselves. “If they get to 17 and they want to drive and maybe their vision is not good enough, or there’s a job they want to do, I’ve never seen it, but a child could try to bring a claim against you as a healthcare professional for not safeguarding them.”
Leonard reassured practitioners not to be too concerned about raising a concern with a safeguarding team. “You’re not saying there’s definitely something going wrong, you are just saying ‘this is what I’ve experienced in my capacity as an optometrist,’ and it may be part of a bigger picture.”
He highlighted: “Optometrists aren’t expected to know everything about how to safeguard children in the same way that safeguarding team would, but just raising that concern is usually enough.”
He emphasised that it can be difficult to decide when something is genuinely a safeguarding concern, adding that it is important for practitioners to take advice.
“If any practitioner is not sure what to do, do contact the AOP’s clinical and regulatory team for advice. We are very happy to talk through these sorts of scenarios on a case-by-case basis,” he added.
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