From theory to practice: How ATP placements are strengthening eye care in Wales

Published: 17/07/2026

Advanced Training Practices (ATPs) are helping to strengthen optometry services in Wales by increasing clinical placement opportunities and supporting the development of advanced skills in the workforce. Led by Health Education and Improvement Wales (HEIW), ATPs bring learning into community settings, where experienced optometrists support trainees while developing their own roles as supervisors and clinical leaders. This approach ensures placements are well managed and of a consistent quality, contributing to a workforce that is better equipped to deliver advanced eye care and improve access to services for patients across Wales.

Zahra has recently completed her clinical placement for Independent Prescribing (IP) in an ATP and has kindly shared some insights into her experience…

Tell us a bit about you?

My name is Zahra and I am an Independent Prescribing (IP) Optometrist based in Cardiff. Having recently completed my IP qualification and placement within an Advanced Training Practice (ATP), I have had the opportunity to develop both clinically and professionally in ways that have truly shaped the way I deliver patient care. 

How was your ATP experience?

Going into the placement, I expected it to be challenging but structured, an opportunity to build on my clinical knowledge under supervision. In reality, the experience was even more rewarding than anticipated - the breadth of cases, the level of responsibility and the supportive learning environment all exceeded my expectations. 

One of the biggest surprises was how quickly I was able to transition from observing to actively managing patients. The hands on nature of the placement combined with guided supervision, accelerated my learning significantly. 

My placement was based across several settings. Firstly, I had 10 sessions at the Cardiff University Teach & Treat Clinics where I was exposed to a diverse case mix. 

I found it extremely beneficial working alongside other optometrists that were also on their IP placement. There were typically 2-3 of us per session and before each session started we would sit together as a group with our supervisor, Gareth and review the cases booked in beforehand. This gave us an opportunity to discuss challenging cases, ask questions in a supportive setting and come up with a tentative diagnosis. Observing Gareth’s friendly and professional manner with patients was particularly valuable. Patient’s presenting in these clinics were anxious and distressed but Gareth consistently created a comfortable and trusting environment which demonstrated genuine care. 

My next 10 sessions were based in a community practice – Direct Eyecare. The patients I encountered ranged from acute red eye presentations and anterior segment conditions to more complex conditions such as corneal hydrops and post-operative complications. My supervisor, Pervaze was extremely helpful and highly knowledgeable throughout my placement at his practice. His ability to explain clinical concepts in a practical and approachable way made it easier to build both confidence and understanding.  

My remaining sessions were completed in the University Hospital of Wales Ophthalmology Department. These sessions were a combination of Glaucoma and Eye Casualty clinics. Here, I had the privilege of observing and learning from consultant ophthalmologists. I found the Eye Casualty clinics particularly interesting and enjoyable due to the variety and unpredictability of cases - ranging from ocular trauma injuries to nerve palsies and lots of swollen optic nerves! This experience was invaluable in broadening my clinical understanding beyond the more commonly encountered primary care presentations. It highlighted the importance of recognising red flag features that require urgent/emergency referrals. I was given the opportunity to remove corneal foreign bodies using an Alger brush. Practicing this procedure in a controlled environment with direct supervision significantly improved my confidence. Since then, I have successfully utilised these skills in community practice.  

The aspects that had the greatest impact on my development included: 
• the variety of cases, which strengthened my diagnostic skills. 
• the quality of supervision, allowing me to discuss and reflect on decisions in real time .
• the supportive learning environment, where questions were encouraged and learning was continuous .

Did you feel supported in your learning environment?

The clinic environment was both busy and highly educational. I was able to see a wide range of patients, often with complex or acute presentations, which helped build my confidence in clinical reasoning.  

Supervision played a crucial role throughout my placement. Having access to experienced IP optometrists meant I could: 
• discuss cases in depth 
• gain reassurance when making prescribing decisions 
• learn practical approaches to patient management 

Did you experience any challenges?

Initially, one of the main challenges I encountered was confidence - particularly around writing prescriptions and ensuring I was making safe, appropriate decisions. Understanding local referral pathways and knowing when to manage versus refer was another area that required development. 

How do you feel your ATP experience will impact on patient and services?

As a qualified IP optometrist, I am able to: 
• manage patients more efficiently within practice 
• reduce unnecessary referrals to secondary care 
• make more informed triage decisions 

This has improved access to care for patients, allowing them to be treated promptly and closer to home. Qualifying as an Independent Prescriber has also enhanced continuity of care. I can now follow patients throughout their clinical journey, from initial presentation to treatment and follow-up, resulting in a more seamless and reassuring experience for them. 

Additionally, my experience in the ATP has strengthened the capability of the practice. Learning from experienced practitioners has helped me better understand: 
• my scope of competence 
• when to escalate or refer cases 
• how to deliver safe, effective, patient-centred care 

How do you feel your ATP experience has contributed to your professional development as well as service developments?

The ATP experience has been instrumental in developing my confidence, autonomy and clinical judgement. I now feel more equipped to: 
• make independent prescribing decisions 
• take ownership of patient management 
• contribute more effectively to the wider healthcare system 
 
It has also reinforced the importance of community optometry in supporting primary and secondary care services. 

What advice would you give future ATP learners?

Some key advice I would give: 
• don’t be afraid to ask questions, this is where the most learning happens 
• take every opportunity for hands on experience 
• focus on building confidence gradually, it comes with time and exposure 
• stay organised and manage your time effectively 
 
For those just beginning their ATP placement, I would offer reassurance that you are well supported. Supervisors, peers and organisations such as HEIW are there to guide you throughout the process. You are not expected to know everything at the start, learning is the goal. 

Do you have any final reflections?

The ATP placement has transformed my confidence and clinical practice, allowing me to provide more complete and patient-centred care.

Looking ahead 

As the role of Optometrists continues to evolve, Independent Prescribing will play an increasingly vital role in improving access to eye care services. My hope for the future is that more practitioners are supported through pathways like the ATP, enabling them to deliver high-quality care within the community and reduce pressure on secondary services. 

The future of eye care is collaborative, accessible and community-focused and I’m proud to be part of that journey. 

To find out more about Advanced Training Practices please visit the HEIW website or email the team.