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Optometry

Vision for Optometry development in HEIW

Health Education and Improvement Wales (HEIW) vision is to support optometrists and other eye care professionals through a programme of high quality education and skills improvement aligned to continued professional development, reflective practice, and mentoring.

 

Outline

The future for eye care services in Wales requires a multifaceted approach with the involvement of all healthcare roles to solve current problems. There are key roles for optometrists in reducing the number of referrals into the hospital eye service, the management of more patients in primary care, including patients currently under the hospital eye service. Orthoptists and nursing are also crucial to support ophthalmology services in secondary care. Underpinning these new roles and changes in service are learning and training.

To achieve these aims Health Care Professionals need to be upskilled with further postgraduate education and continued professional development. Aligned to this is a requirement for optometrists to be supported when they take on extra clinical roles and, crucially, enable them to become more adept at managing and accepting clinical risk. Optometry in Wales does not have a significant presence in hospital eye care and this also needs to be supported and developed, allied to developing our future clinical leaders. All this needs to be within the context of the framework of education at all levels so that optometrists of the future arrive as professionals ready to clinically manage patients within primary care on day one with their continued journey supported and developed.

There are 4 elements that need to be addressed:

  1. Continued Professional Development (CPD) and higher qualifications commissioning
  2. placements and education and training structure
  3. mentorship and support
  4. leadership

 

CPD and Higher Qualifications Commissioning:

 

To deliver new services, certain skills and learning elements are compulsory, with selective CPD allied to the 3-year regulator standards. CPD will be for the whole profession but will also be tailored to the services and work that an optometrist, dispensing optician and contact lens optician undertakes. Reflective portfolios will facilitate teaching, attitudes and professionalism. The focus will be on scope of practice, reflection and mentoring aligned with other health care professions, such as dentistry, pharmacy and medicine.

To ensure we are agile in the delivery of CPD to facilitate a variety of learning styles, we offer CPD in the form of online presentations, peer review sessions, and workshops.  This is organised through our online learning platform Y Ty Dysgu (Welcome! - Ytydysgu Heiw).

HEIW commission qualifications that are designed to help optometrists and dispensing opticians in primary care practice. Specifically, qualifications that can facilitate management of:

  1. patients with glaucoma and ocular hypertension
  2. patients with Age related Macular Degeneration (AMD), especially neovascular AMD and other medical retina conditions
  3. acute eye care presentations, through the prescribing of medication for conditions affecting the eye.
  4. patients who are eligible for additional low vision support

By targeting these qualifications and ensuring they can be offered to optometrists and dispensing opticians working in every cluster in Wales, we will achieve national coverage, targeting a reduction in demand for secondary care across Wales.

The aim is to ensure that in each cluster area in Wales, there are practitioners with qualifications in independent prescribing; glaucoma; medical retina; low vision

The long term goal is to decrease the pressures on secondary care eye care services and ensure more patients are treated and managed closer to home whilst reducing the number of patients being sent to secondary care from optometrists in Wales.

 

Placements and education and training structure

Health Education and Improvement Wales (HEIW) recognises the importance of postgraduate placements in all sectors.  Higher qualifications in glaucoma and independent prescribing facilitate better services for patients in optometry practices.  To achieve these qualifications, postgraduate students need placements.

The aims of the advanced training practices are:

  • To provide an additional placement opportunity for Higher certificate in glaucoma, higher certificate in Medical retina and Independent prescribing optometry qualifications.
  • To provide a proper payment mechanism for practices for providing quality assured training.
  • To increase the number of placements available for postgraduate qualifications by including optometry practices to create a mixed model with secondary care placements and Teach and Learn centres in the community.
  • To increase the number of optometrists that complete their higher qualifications.
  • To establish the learning required for practice supervisors to be a HEIW quality approved trainer in line with HEIW cross professional standards.
  • Demonstrate the concept so that in future, other ophthalmic practitioners, such as contact lens opticians, can also have access to placements to complete training or expand knowledge.

 

Mentorship and support

Mentoring facilitates CPD through a network of experienced optometrists that guide newly qualified optometrists. Mentoring considers their scope of practice for CPD requirements as well as providing support and guidance. Mentoring support includes an assigned designated Mentor, an online platform to create a portfolio and a peer support network. Optometrists need support when they take on additional clinical roles and, crucially, enable them to become more adept at managing and accepting clinical risk.

Recent research demonstrated, newly qualified optometrists may over refer. At a time when clinical confidence and experience are still developing, an increased workload on qualification may lead to pressure to make quick and more risk‐averse decisions, and consequently refer more readily. A Mentor, recourse to a peer support network and opportunities to take part in peer review will build confidence and enable newly qualified optometrists to accept an appropriate level of clinical risk.

Leadership

Optometry is taking on an increasing role in the healthcare of our patients in Wales. There has never been a better time to develop clinical leaders in optometry, with integration of optometry into NHS leadership programmes.

As an example, the Welsh Clinical Leadership Training Fellowship (WCLTF) initiated in 2013 has enabled Fellows to take up leadership roles in NHS Wales and Welsh Government. NHS organisations in Wales have been highly engaged and committed to the WCLTF process, offering quality improvement projects within their organisations. The aim is for the optometry profession to lead transformation of the clinical workforce and develop healthcare leaders of the future to support eye care services across NHS Wales.

Eye Care reform in Wales – The patient Management Plan

Included below is Tim Morgan’s presentation about how the contract for Optometry is used to improve eye care for patients and include them in our clinical decision making.

This presentation was delivered by Tim Morgan, our previous HEIW Welsh Clinical Leadership Training Fellow on the 22 September 2021. 

 

Contact Us:

If you would like to find out more or have any questions about what we do, please contact us at HEIW.Optometry@wales.nhs.uk