Competency 2.2.3 Flashcards
What Bodies Offer Advice on How I should Practise?
- Optometry Scotland
- The AOP
- The GOC
- The College of Optometrists
What is Optometry Scotland?
- Lobbying body for Scottish optometry
- Formed of optometric practitioners through all health boards in Scotland
- Provides advice and CPD information to practitioners to keep Scotland at the forefront of eye care
- Advice includes when pre-reg should register to practise in a specific health board before qualifying (2 months before due to sit OSCEs)
- Source Eyes.scot for clinical decision making
What is The AOP?
- Representative body for optometry in the UK
- Membership is not mandatory but 82% do pay membership
- Provides legal, commercial and administrative advice to members
What is the vision of The AOP?
- Assist members to prosper in all modes of practise
- For public recognition of eye health and AOP members
- To be unrivalled provider of support, promotion and protection of the member
What are the pillars of The AOP?
- Membership services
- Policy and promotion
- Sustainability
What is the College of Optometrists?
- Professional and examining body for optometrists in the UK
- Provides training and CPD
- Runs the scheme for registration
- Membership is not mandatory but is given free to students.
- Membership is mandatory for lead supervision and apply for research grants
- Further training such as IP training or glaucoma cert is provided by the college
What is the Purpose of the College?
- Promoting lifelong learning and career advancement
- Effectively amplifying the expert voice of optometrists
- Defining and supporting good clinical practise
College Guidelines of Practise Catergories
College provides guidelines to support a practitioner when they are practising. It falls into 4 categories:
1. Knowledge, skills and performance
2. Safety and quality
3. Communication, partnership and teamwork
4. Maintaining trust
Examples of College of Optometrist Guidance
A233 Consider the following when prescribing spectacles for an under 7:
- is refractive error normal for this Childs age?
- will this refractive error emmetropise?
- Will this refractive error disrupt normal visual development or functional vision
- will prescribing improve functional vision
- will prescribing interfere with normal emmetropisation
A255 Even in absence of signs or symptoms the following patients are at greater risk of POAG
- Certain ethnic groups (e.g. afro-caribbean)
- with first degree relatives with glaucoma
- over age of 40
- with a thinner cornea
- with myopia (especially over 6DS)
- with diabetes
- with systemic hypertension
- taking systemic or topical steroids
What is the GOC?
- Established in 1958 by the opticians act where it was given control over optometry as a profession/industry
- Any OO/DO/CLO needs to be registered to legally practise in the UK
- Regulates profession through maintaining list of professionals
4 Core Functions of the GOC
- Setting standards for performance and conduct of registrants
- Approving qualifications leading to registation
- Maintaining register of professionals, trainees and businesses
- Investigating and acting in fitness to practise disputes
GOC Standards for Practitioners
Organised into 19 categories, including:
3. Obtain valid consent
11 Protect and safeguard individuals
Example of GOC Standards
3.1 Obtain valid consent before examining a patient, providing treatment or involving patients in teaching or research activities. For consent to be valid it must be
- 3.1.1 Voluntary
- 3.1.2 By patient or someone authorise to act on their behalf
- 3.1.3 By a person with capacity to consent
- 3.1.4 By an informed person
10.1 Work collaboratively with colleagues within optical profession or other healthcare professionals with the best interests of patients at heart, ensuring clear communication.
What is The Opticians Act 1989?
- Current governing legislature in the sector
- Did not create GOC but did reinstate its importance
Opticians Act 1989 Breakdown
- General Optical Council
- Registration and training of opticians
2.a Fitness to practise
3.a Proceedings and appeals
4 Restrictions
5 Miscellaneous
Opticans Act Section 1
General Optical Council
- Stated that there should continue to be a GOC which should continue to promote and regulate the sector
- Overall aim of GOC is to protect the public
- Recommended a structure in the form of committees, five of which are statutory
GOC Statutory Committees
- Companies Committee
- Advises council on matters related to business registrants - Education Committee
- Advises council on educational and training matters - Investigation Committee
- Investigates whether an allegation against a registrant, trainee or business should be elevated to a fitness to practise committee - Registration Committee
- Advises council on issues such as rules governing registration and publication of register - Standards Committee
- Advises council on standards of both conduct and performance
Opticians Act Section 2
Law states individual can have their name on the register if the fulfil 3 criteria:
- Holds a qualification (as a DO or OO) from an approved institution at the time
- Has had adequate practical experience
- Is a fit person to practise
Opticians Act Section 2.a
- Fitness to Practise Committee has power to dish out financial penalty as well as suspension or erasure from register
- An individual may reapply to be re-registered:
- after 2 years from punishment
- after 1 year from previous application
What Standards Are Different from Student to Supervisor?
- CPD is a standard in fully qualified standards that is not present in student standards
What is the Medicines Act?
- Recognised that an optometrist could be involved in use of medication use
- It established the categories of medications
- GSL
- Pharmacy
- PoM
Categories of Medications under Medicines Act
General Sales List
- can be bought without prescription and without pharmacist supervision
- can be sold in any retail outlet with proper licensing
- limited concentration
- pre-packaged
Pharmacy
- Prescription not required
- Must be sold under pharmacist supervision
- Sale can be refused
- higher concentration than GSL
Prescription Only Medication
- Only accessed via prescription from e.g. doctor or dentist
Updates to Medicines Act
Updated to state that all optometrists can, if is in the course of their practise:
- Administer, supply or sell any GSL or P medication
- Supply from a list of exempted PoMs
Also updated later to allow any optometrist with required accreditation to prescribe any medication that is licensed for use in conditions affecting the eye and surrounding tissues. (IP Course)
Exempted List of PoMs for Sale and Supply
- Drops containing no more than 0.5% chloramphenicol
- Ointment containing no more than 1.0% chloramphenicol
- Cyclopentolate hydrochloride
- Tropicamide
- Fusidic acid
Exempted List of PoMs for Supply ONLY
- Tetracaine
- Lidocaine
- Oxybuprocaine
- Proxymetacaine
Mental Capacity Act 2005
- Only applies in England and Wales
- Applies to those over 16 who are unable to make some decisions themselves
- Professionals should work on premise that every adult has capacity i.e. don’t assume they can’t based on appearance
- Same premise applies in Scotland through Adults with Incapacity Act 2000
Adults with Incapacity Act 2000 Principles
- Benefit
- Actions or decisions must benefit the adult and when that benefit cannot be achieved without it - Least Restrictive Option
- Take Account of Adult’s Wishes
- As far as can be ascertained - Consult with Relevant Others
- Take account of the views of anybody whom the sheriff has directed should be consulted - Encourage the Adult to Engage
- May result in development
What is Gillick Competence?
- Idea that children under 16 can be competent enough to make decisions on their own health
- It is upto practitioner to decide if patient is Gillick Competent
What is the Duty of Candour?
Must be open and honest if there is an error. We must:
- Tell the patient
- Apologise (not admission of guilt)
- Offer remedy or support
- Explain short- and long-term effects
- Be open with relevant others
What Needs to be Conducted for a Primary GOS Exam in Scotland?
- H&S
- Assessment of visual function
- External eye examination
- Internal eye examination
Should carry out all procedures unless clinical reason not to or patient refuses.
Minimum Interval Between Primary Eye Exams
Patients under 16
- One year
Patients 16-59
- Two years
Patients over 60
- One year
Patients with DM/Sight impaired
- One year
Exemptions to Minimum Intervals for a Primary Eye Exam
Code 7
- Patient is new to practise and no access to previous records
Code 8
- Patient was under 16 at time and put on 1 year recall
GOS Eye Exam Costs
Under 60 Primary Eye Exam
- £42.21
Over 60 Primary Eye Exam w/ Photo
- £51.35
Supplementary Exam
- £27.96
Tint Supplement on a Voucher
- Can only be on a prescription lens
- Can only prescribe is tint is clinically necessary
Voucher Values
A Voucher
- £42.40
E Voucher
- £ 73.30
Voucher Entitlement Reasons
For young people:
- Under 16
- FT student aged 16,17, or 18
For others:
- Income support
- Income-based jobseekers allowance
- Universal credit
- Pension credit
- Income related employment support allowance
- My partner is entitled to
