2.2.3: Is able to work within the law and within the codes and guidance set by regulator and profession

Question 1

GOC

Answer 1

• Governing body and UK regulator for the optical professions with statutory responsibility for setting standards of performance and education
• GOC standards of practice define the standards of behavior and performance expected of all optometrists
• Protects public
• 4 main roles: set standards, approve qualifications, maintain a register, and investigate and act when a registrant’s ability to practice/train/carry on business is impaired
• Set comps & CET guidelines – dictates which comps need to be met, guidelines

Question 2

GOC standards

Answer 2

1. Listen to patients and ensure that they are at the heart of the decisions made about their case
2. Communicate effectively with your patients
3. Obtain valid consent
4. Show care and compassion for your patients
5. Keep your knowledge and skills up to date
6. Recognize, and work within, your limits of competence
7. Conduct appropriate assessments, examinations, treatments and referrals
8. Maintain adequate patient records
9. Ensure that supervision is undertaken appropriately and complies with a law
10. Work collaboratively with colleagues in the interest of patients
11. Protect and safeguard patients, colleagues and others from harm
12. Ensure a safe environment for your patients
13. Show respect and fairness to others and do not discriminate
14. Maintain confidentiality and respect your patients’ privacy
15. Maintain appropriate boundaries with others
16. Be honest and trustworthy
17. Do not damage the reputation of your profession through your conduct
18. Respond to complaints effectively
19. Be candid when things have gone wrong

Question 3

College of optometrists:

Answer 3

• registered charity; professional examining body for optometrists (optional to be member); set guidelines i.e. CMGs
• Supporting its Members in all aspects of professional development, the College provides Pre-Registration training and assessment, continuous professional development opportunities, and advice and guidance on professional conduct and standards, enabling our Members to serve their patients well and contribute to the wellbeing of local communities.

Question 4

Association of optometrists:

Answer 4

provide indemnity insurance, do not write the laws/legislation

• Protect - medical malpractice insurance & legal defense
• Support - services & benefits for members to fulfill professional roles
• Represent - shaping the sector & positively influencing members’ working lives
• Provide professional indemnity insurance

Question 5

Medicines Act 1968

Answer 5

• Act of parliament which governs the control of medicines for human use and veterinary use, which includes the manufacture and supply of medications
• Regulates use & supply of drugs/what diagnostic drugs are available, PoM/P/GSL, IP vs Entry

Question 6

Categories of Drugs:

Answer 6

• GSL General sales list medicine - ‘Off-the-shelf’ - safe enough without any supervision
• P Pharmacy medicine (OTC) - ‘Behind-the-counter’ - pharmacist supervision e.g. advice on suitability, specific warnings depeding on px such as pregnancy
• PoM Prescription-only medicine - In the dispensary’ - given at pharmacies but given by appropriate practitioner
• CD Controlled Drugs - Strict legal control - prevents harm, misuse & illegal use

Question 7

Medicines Act 1968: Sell/supply?…

Answer 7

Pharmacists may sell or supply certain POMs against an order signed by a registered optometrist.

Optometrists may sell or supply specific POMs
- in response to an emergency situation
- or in the course of their professional practice

Provided it is in the course of their professional practice, registered optometrists may sell or supply:
- all GSL medicines
- all P medicines
- only certain specified POMs (i.e. not all POMs that an optometrist can use are allowed to be supplied to, or prescribed for, the patient e.g. anaesthetic.)

Question 8

Medicines Act 1968:Signed Order:

Answer 8

Given to the patient by an optometrist. Written on headed practice paper.

State:
- Patients name, address and d.o.b.
- Drug
- Concentration
- Directions, e.g. QDS for 3 days (QDS = 4 times daily)
- Purpose

Signed
- Optometrist’s name and address
- GOC number
Noted in patient record (keep a copy for at least 2 years).

Question 9

Opticians Act

Answer 9

• 1958 and 1989 (didn’t introduce anything new/consolidation bill) based on the crook report
• 2005 amendment changed ophthalmic optician to optometrist; and added mandatory amount of CET points; added implications for impaired fitness to practice
• Legislation compiled by parliament which gives the GOC the powers to make orders, rules and regulations in relevant areas
• The sections include: GOC, registration and training of opticians, fitness to practice, proceedings and appears, restrictions
• We have do heath check as well as refraction

Question 10

GOS

Answer 10

GOS 1 – application for NHS eye exam
GOS 2 – Px’s optical prescription
GOS 3 – NHS voucher
GOS4 – NHS optical repair/replacement <16s

Question 11

Recalls:One year recall acceptable if:

Answer 11

Under 16
60 or over
Diabetic
Sight impaired/severely sight impaired – code 9

Question 12

Recalls: Two years

Answer 12

• 16-59
• Diabetic on DRS
• Family history glaucoma – was prev 1yr, now can only claim a sup if 1yr recall
• OHT (used to be 1 yr)2wq

Question 13

Early re-exam

Answer 13

Code 7 – new to practice/no previous details – not suitable if LEE prev specsavers
Code 8 – if px was put on 1yr recall at 15, and is now 16

Question 14

PEE includes:

Answer 14

history, eye health assessment, refraction and visual function, communication of findings, capture and record digital image for over 60s, opticians act ‘to perform such exams of the eye for the purpose of detecting injury, disease or abnormality in the eye or elsewhere’

Question 15

Most common Supplementary

Answer 15

• Codes 2.5, 2.8, 4.5, 4.8 can be claimed on same day as a primary – where the sup eye exam is an emergency

Most common codes to use:
- 2.0 cyclo refraction
- 2.5 anterior eye problem (can’t claim sup’s for CL red eyes)
- 2.8 unscheduled appointment – i.e. feels change
- 4s = enhanced (dilation)

Question 16

Entry lvl optoms, sell/supply the following

Answer 16

• All GSL/P meds provided it is the course of professional practice
• Eye drops that contain 0.5% chloramphenicol
• Eye ointment that contains 1% chloramphenicol
• P med for bacterial conjunctivitis AND less than 5ml prep
• Exempt PoM if 10ml prep/another other use
• Fusidic acid 1%
• Sodium cromoglicate 2% (<10ml)
• Antazoline sulfate
• Contain: cyclo, tropicamide, phenylephrine

Question 17

MHRA – medicines and healthcare products regulatory agency

Answer 17

• Executive agency which ensures medicines/medical devised meet appropriate standards of safety/quality/efficacy
• UK system for collecting and monitoring information on safety concerns involving medicines
• Yellow card scheme: health professionals can report suspected ADRs; provides an early warning that the safety of a product may require further investigation
• Especially important for new medications, inverted black triangle on BNF
• Covid yellow card reporting sight for side effects of vaccine

Question 18

Mental capacity act: adults within capacity

Answer 18

• Any action must benefit the px and be necessary
• Wishes of person considered
• Options should be least restrictive
• Other relevant people must be consulted before decision is made
• Person must be encouraged to use skills and develop new skills where possible

Question 19

Gillick competency

Answer 19

• Used to decide if a child (under 16) is able to consent to their own medical treatment, without the need for parental permission or knowledge

Px under 16 can consent if they’re believed to have enough intelligence/competence and understanding to appreciate what’s involved in treatment i.e. be Gillick competent

If px is Gillick competent it is not appropriate to ask for parents consent
E.g. if parent asks for details of exam on child <16 who is Gillick competent, you should ask for the child’s permission before sharing such things

Question 20

Disability/Equality Act

Answer 20

Most not discriminate under any circumstances
E.g. 1 year old comes to store for ST – not allowed to turn them way based on age, may speak to px about availability of tests, may be best suited to go at elsewhere

Question 21

When qualified

Answer 21

Must have an ophthalmic list number & GOC number

PVG – for doing regulated work with children / vulnerable adults

Must be registered to practice under which health board you work in: 2 types of registration, 1 type if you work under 1 health board, 2nd type for locums etc