Abstract
Introduction
Hospital-based optometrists are undertaking extended roles across ophthalmology that may require them to perform advanced skills (AS). Moorfields Eye Hospital (MEH) is the largest UK employer of hospital-based optometrists, it was sought to investigate which AS are being performed at this centre and how they align to the four pillars of advanced clinical practice (ACP).
Methods
An online survey was sent to MEH optometrists in May 2022 that asked about professional status, sub-specialties worked, qualifications, acquisition and validation of AS, research and leadership.
Results
Ninety-six optometrists with mean post-qualification experience was 16.2 years (SD 10.4) responded to the survey. There were 84 AS that covered clinical, leadership and research, with respondents achieving a mean of 11.8 (SD 10.3). Those with independent prescribing (IP) qualifications (n = 52) had a higher number of AS compared to non-IP optometrists (p = 0.03). There were 68 clinical AS across the sub-specialties (23 clinical AS were common in ≥2 sub-specialties), 49 out of 120 clinical AS could be performed by at least 60% of staff. Twenty-six optometrists identified with leadership, 56 had undertaken research/audit, 27 had published within a peer-reviewed journal and half of the time spent in active research was funded.
Conclusion
AS are being performed by optometrists within a tertiary eye hospital that supports ACP. IP optometrists had higher self-reported AS but current educational frameworks don’t accommodate for some AS. Targeted AS courses with competency-based sign-off may further support high-quality patient care. Further research is required on how advanced care practitioners can support workforce transformation.
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Data availability
The datasets generated from the current study are not publicly available due to data use agreements with MEH. Requests for data will require approval from MEH and the signing of data access agreements; requests can be submitted to the corresponding author.
Change history
13 February 2024
A Correction to this paper has been published: https://doi.org/10.1038/s41433-024-02924-6
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Acknowledgements
The authors would like to thank service leads for their help in devising and disseminating the questionnaire amongst staff. This work was supported in part by the National Institute for Health & Care Research (NIHR) Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology (PJM). The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health.
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Authors and Affiliations
Contributions
AJ: Conceptualization, planning; data acquisition; data analysis; transcripts. SA: survey development, PJM, VA and DS; critical appraisal.
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Due to a typesetting error, references 17 and 18 were added by mistake. They have now both been removed. Consequently, the following sentence should not have had any in-text citations: “The findings of our current work supports the hypothesis that the IP qualification encourages clinicians to undertake further professional development”.
Supplementary information
Supplementary 1.
Advanced Skills Questionnaire
Supplementary Figure 1.
Number of clinical advanced skills and number of clinical advanced skills where 60% or more of staff (optometrists) can perform per service. LVA, Low Vision;, Paeds, Paediatrics; CL, Contact Lenses; MR, Medical Retina; UCC, Urgent Care Clinics, A&E, Accident and Emergency.
Supplementary Figure 2.
Percentage of staff that could perform advanced skills in Cataract and were signed off. YAG, Yttrium aluminium garnet
Supplementary Figure 3.
Percentage of staff that could perform advanced skills in Glaucoma and were signed off. SLT, Selective Laser Trabeculoplasty; YAG, Yttrium aluminium garnet
Supplementary Figure 4.
Percentage of staff that could perform advanced skills in Paediatrics and were signed off. OCT, Optical Coherence Tomography
Supplementary Figure 5.
Percentage of staff that could perform advanced skills in Low Vision and were signed off.
Supplementary Figure 6.
Percentage of staff that could perform advanced skills in External Disease and were signed off. OCT, Optical Coherence Tomography
Supplementary Figure 7.
Percentage of staff that could perform advanced skills in Urgent Care Clinics and were signed off. OCT, Optical Coherence Tomography
Supplementary Figure 8.
Percentage of staff that could perform advanced skills in Medical Retina and were signed off.
Supplementary Figure 9.
Percentage of staff that could perform advanced skills in Contact Lenses.
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Jindal, A., Abdulrasid, S., Mulholland, P.J. et al. An evaluation of optometric advanced skills within a UK tertiary based setting. Eye 38, 1276–1282 (2024). https://doi.org/10.1038/s41433-023-02880-7
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DOI: https://doi.org/10.1038/s41433-023-02880-7
