2.2.2: Is able to work within a multi-disciplinary team

Question 1

What are some roles in a multi-disciplinary team?

Answer 1

• Working in MDT – OA/DO/Optoms/IP/CC/management/LAB
• My role in-store – test under supervision: investigate, diagnose, and manage conditions & other roles
• What other primary care roles do we work with - GP, pharmacy

Question 2

What is shared care?

Answer 2

• Responsibilities of managing a patient is shared between various primary care providers i.e. us, GP, pharmacy, and ophthalmology; this allows us to ease the burden on the HES and also increases px satisfaction
• Optoms 1st port of call
• We need shared care because of the ageing population, inadequate number of ophthalmologists to meet demands and is cost-effective healthcare

Question 3

What jobs do the different roles do:

Answer 3

• Clinical Manager – manages all clinics, advises OAs for 3 way handovers. Keeps things running smoothly.
• Optical Assistant – booking in pxs and also dispensing pxs.
• Optometrist – completes sight test for px with the best possible care, also handover to OA for whats to come next and any advise on glasses/CLs or repeat photos/fields
• Dispensing Optician – dispenses pxs, more expertise so can dispense under 16s. usually have their own clinics for pxs who would benefit from an dispensing optician

Question 4

National shared schemes:

Answer 4

• Minor Eye Conditions Service (MECS): Allows community optometrists to better manage patients presentive with a range eye conditions, including dry eyes, red eyes, painful/sore eyes, lid problems, suspect foreign bodies, flashes and floaters etc.
• Learning disability scheme:
  These patients would have been registered and would have a card which you would use to book them in with.
  You would get the relevant information you require about the patient before they arrive for their appointment which allows you to tailor the appointment for that individual.
  Example: If a patient does not like people coming close to them, ophthalmoscopy would be avoided.

Other schemes include: cataract/glaucoma/PEARS (primary eyecare acute referral scheme), flashes and floaters.

Question 5

LOCAL SCHEMES : Find out

Question 5

What can a dispensing optician do that an optical assistant can’t?

Answer 5

• DO can give instill eyedrops on behalf of an optometrist, at the optometrist’s request
• DO can sign off a child’s dispense & collection of glasses by ensuring they fit right & that the measurements are suitable
• DO can dispense low vision aids to visually impaired
• DO can change power of lenses supplied against a Rx e.g. change in power due to change in vertex distance or change in dispensed addition due to change in working distance
  
  • DO can sell any optical appliance without even needing a valid Rx if need be, although an out of date Rx should not be given unless clinically necessary

Question 6

What a CLO can do that a DO can’t?

Answer 6

• Fit contact lenses
• Selling plano CLs

Question 7

Delegation

Answer 7

This is important in practise as protected functions such as putting drops in eyes, or fitting CLs etc can only be done by the qualified practitioner. Therefore, these tasks can be delegated to those individuals. Also, under supervision, anyone can dispense anything & so the child’s dispense may be delegated to an optical assistant whilst the DO or optician may quickly check everything over at the end. It makes things more efficient.

Question 8

FIND OUT LOCAL SCHEMES

Question 9

Referral

Answer 9

• NICE (national institute for health & care excellence) – evidence-based recommendations for health and care in England
• SIGN (Scottish intercollegiate guidelines network) – glaucoma
• Emergencies – generally still seen same day, phone call to ARC
• Urgent – usually within the week, now 2-3 weeks
• Routine – 3-6 months
• GGC used to have fast track referral service for wet AMD – now its an option on SCI gateway
  PGD – protocol certain meds to certain group which meet criteria (pharmacy first)
  PSD – individual person who meets specific criteria/protocol – example, IP given steroids of uveitis (individual written rx)