BIOS believes that full independent prescribing responsibilities are needed to maximise the impact of orthoptists working in advanced roles throughout ophthalmology. This has the potential to provide more timely care for patients as well as enabling orthoptists to better support overstretched eye heath services.
We are currently working alongside other professional bodies to call on the government to extend independent prescribing.
Why is it important?
Orthoptists are currently able to supply and administer certain medicines under exemptions. This is approved for all undergraduate and post graduate courses to enable qualified orthoptists to be annotated on the HCPC register.
Orthoptists are currently the only regulated professionals in the ophthalmology workforce unable to independently prescribe. IP would help to address the capacity and demand issues in ophthalmology and provide benefit to patients.
Orthoptists are already working in advanced and extended role practice and have done so for many years, they have contributed significantly to the development of the Ophthalmology Common Competency Curriculum and framework (OCCCF) and are training as both clinical and educational supervisors for other professionals gaining certificates through the OCCCF programme.
Orthoptists assess, diagnose and manage a wide range of patients in many of the ophthalmology sub-specialities, such as paediatric ophthalmology, neuro ophthalmology, oculoplastics, cataract, glaucoma, emergency, medical retina and vitreo- retinal, and low vision. Orthoptists are heavily involved in assessing and managing the visual complications that arise from medical patients as part of the stroke pathway, those with neurological or endocrine impairment or patients who are frail or at risk from falls.
We believe that there are both benefits to patients and to the profession if Orthoptists were Independent Prescribers and we have case studies and evidence to support the case and some are listed below.
Benefits to patients
- Reduce risk of sight loss and visual progression in the disease process (IIH, corneal exposure in stroke or Thyroid patients)
- Increase recovery of visual symptoms in neuro conditions (MS)
- Early detection of subtle visual changes and early management is more effective (glaucoma)
- Early treatment following detection of advancement of disease (glaucoma, IIH, Pituitary tumour)
- Flexibility and responsive management for those with LD and in Special schools to adapt to required diagnostic and management pathways.
- Reduce the heavy reliance on asking the GP to prescribe which occurs in some ocular pathways to address the lack of prescribing rights for orthoptists
- Increase the available workforce in ophthalmology pressure areas (EED, glaucoma, neuro ophthalmology, paed ophthalmology)
- Orthoptists already provide some aspects of counselling and psychological support and signposting in patients with active disease – IP would enable the medical management without need for additional appointments for vulnerable patients
- Orthoptists can act as both diagnostic / monitoring and therapeutic practitioners – IP would enable the patient pathway to be delivered in a consistent and co ordinated manner building relationships with patients and trust in practitioner
- Improved patient experience as both new and FU wait times would be reduced in a risk stratified group of patients
- Waiting time during clinic would be reduced (orthoptists would not have to find a prescriber to change treatment)
- Reduced follow up appointments required to book into a prescriber led clinic
- Increased capacity as more patients could be seen per clinic
- Increased choice of access to clinics (evening and weekends)
Benefits to the orthoptic profession
- Provide equity in career framework and progression with other eye health professionals
- Improved clinician experience in ability to run extended clinics more independently
- Reduced bias when recruiting non-medical practitioners for extended roles in ophthalmology (nursing and optometry professions can become IPs)
- Increase recruitment into the profession
- Further contributions possible to the OCCCF, GIRFT, LTP