BIOS has written to the new Secretary of State for Health and Social Care, Wes Streeting, highlighting the importance of Orthoptists in supporting eye care services, and calling on the new government to take steps to support Orthoptists to deliver to their full potential.
Dear Secretary of State
Orthoptists’ role in supporting eye care services
I am writing to you on behalf of the British and Irish Orthoptic Society (BIOS), the professional body and trade union for more than 1400 practicing and training orthoptists in the UK, to highlight the essential role of our members in ensuring equitable access to high quality eye care.
Orthoptists are experts in how the eyes move and work together. We assess, diagnose, treat and monitor a variety of eye disorders and specialise in the assessment of visual function, particularly in children and those with communication difficulties. We are experts in understanding why and how neurological defects affect how we see, which can have a significant impact on wellbeing and life outcomes. Orthoptics is a cost-effective and outcomes-focused profession.
Our members are employed overwhelmingly by the NHS in hospitals or community eye services, primarily diagnosing and treating defects in eye movement and problems with binocular vision. However, they are increasingly working in advanced and extended roles across Ophthalmology, such as paediatric ophthalmology, neuro ophthalmology, oculoplastics, cataract, glaucoma, emergency, medical retina and vitreo-retinal, and low vision.
Ophthalmology is the busiest outpatient specialty, with over 645,000 patients waiting for an appointment. Orthoptists are ideally placed to address this, as they already have the skills and knowledge to work within extended practice in this area. We also have a significant impact in public health and prevention through early diagnosis and treatment in areas such as stroke care and falls patients, as well as through childhood vision screening programmes.
It is therefore vital that the new government recognises the importance of orthoptists to improve the eye health of the population. In particular, there are a number of specific actions that could be taken to support orthoptists:
- Extend prescribing responsibilities to orthoptists. The role of orthoptists in ophthalmology is limited by not having independent prescribing responsibilities, prolonging the patient journey and adding pressure to the ophthalmologists and GPs required to prescribe the necessary medicines.
Orthoptists are currently the only profession in the eye care workforce not to have independent prescribing responsibilities. These responsibilities could be extended using a similar framework to that used by optometrists and nurses, accessing the same training provided by higher education institutions for these professions. This is a simple reform through the powers you have under the Medicine and Medical Devices Act (2021), and one which could have many benefits for patients, the healthcare professionals working with them and the wider health and care system.
- Make orthoptic-led vision screening mandatory across England. Screening at 4-5 years old detects amblyopia (commonly known as “lazy eye”), where the vision in one or both eyes doesn’t develop properly. It is estimated that 1 in 50 children will develop this condition and if left untreated, can result in lifelong and irreversible reduced vision. Identification and correction of reduced vision at school entry also reduces the impact on the vital early years of education for the child.
Currently, while orthoptic-led child vision screening is recommended by the UK National Screening Committee, Commissioning in England is optional, with an increasing number of local authorities declining to provide programmes. A mandatory national screening programme would ensure that all children receive the same care when they need it, regardless of where they live.
- Support and expand the orthoptic profession. Orthoptists play a vital role across the NHS, diagnosing and treating visual defects in a wide range of patients. The government should ensure access to orthoptic expertise in all appropriate settings. For example, all stroke rehabilitation teams should have an orthoptist to assess vision and support patients to manage their vision defects.
The British and Irish Orthoptic Society would be very happy to work with you in order to ensure the delivery of these proposals. We would be glad to meet with you to discuss this further.
Yours sincerely
Craig Murray
Chair, British and Irish Orthoptic Society
