Gunn Patrick J G, Creer Rosalind C, Bowen Michael, Tromans Cindy, Jackson Andrew Jonathan, Tompkin Andrew P, Harper Robert A
Manchester Royal Eye Hospital, Manchester University NHS Foundation Trust, Manchester, UK.
Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.
Ophthalmic Physiol Opt. 2022 May;42(3):428-439. doi: 10.1111/opo.12952. Epub 2022 Feb 12.
As the landscape in ophthalmology and related commissioning continues to change, there is a pressing need to re-evaluate the current scope of practice of hospital optometrists working within secondary care in the UK. We aim to establish if the skills or services delivered by optometrists have changed to meet varying demands, and to better understand what changes in practice may have arisen as a result of COVID-19.
A survey developed from that used in 2015 was disseminated to 129 optometry Hospital Eye Service (HES) leads in September 2020, including questions on department workforce; core services; extended roles; procedures undertaken within extended roles; level of autonomy; arrangements for prescribing; training and accreditation, and service changes in response to COVID-19.
Ninety responses were received (70% response rate) from within England (76%), Scotland (22%) and Northern Ireland (2%). Whole time equivalents within units ranged from 0.4-79.2 (median of 2.5). In comparison to the 2015 survey, there was an increase in the proportion of units delivering extended roles, with glaucoma (88%) remaining the most common extended role, and new areas of practice in uveitis (21%) and vitreoretinal (13%) services. There was increased use of independent prescribing (67%) in comparison to 18% in 2015 and there was an increase in optometrists delivering laser interventions. In response to COVID-19, optometrists were increasingly delivering telephone consultations and there were new collaborations between primary and secondary care.
Optometrists' scope of practice continues to develop in the HES with an increased variety of roles and an apparent increase in the number of units employing optometrists, often working in roles historically performed by medical practitioners. Such changes appear necessary in recovery and transformation within ophthalmology, alongside wider optometry changes arising at the interface of primary and secondary care.
随着眼科及相关委托业务的格局不断变化，迫切需要重新评估英国二级医疗体系中医院验光师当前的执业范围。我们旨在确定验光师提供的技能或服务是否已发生变化以满足不同需求，并更好地了解因新冠疫情而在实践中可能出现的变化。
2020年9月，向129名验光师医院眼科服务（HES）负责人发放了一份基于2015年使用的调查问卷，问题包括部门劳动力情况、核心服务、扩展职责、扩展职责内开展的程序、自主程度、处方安排、培训与认证以及因新冠疫情而做出的服务变更。
收到了来自英格兰（76%）、苏格兰（22%）和北爱尔兰（2%）的90份回复（回复率为70%）。各单位的全职等效人员数量在0.4至79.2之间（中位数为2.5）。与2015年的调查相比，提供扩展职责的单位比例有所增加，青光眼（88%）仍是最常见的扩展职责，葡萄膜炎（21%）和玻璃体视网膜（13%）服务领域出现了新的业务领域。与2015年的18%相比，独立处方的使用有所增加（67%），进行激光干预的验光师数量也有所增加。为应对新冠疫情，验光师越来越多地提供电话咨询，并且初级和二级医疗之间出现了新的合作。
在医院眼科服务中，验光师的执业范围持续发展，职责种类增多，雇佣验光师的单位数量明显增加，他们常承担以往由医生履行的职责。在眼科的恢复和转型过程中，以及在初级和二级医疗交界处验光行业更广泛的变化中，此类变化似乎是必要的。
