What Roles do we Use in Specsavers Alloa?
- Retail director
- Ophthalmic director
- Optical practise manager
- Optometrists
- Dispensing Optician
- Contact Lens Optician
- Optical Assistant
- (Other Healthcare Professionals)
Role of the Retail Director
- Has no ophthalmic qualification or registration number (business is registered, not them)
- Will look after the retail and business aspects of the business and look after the team
Role of the Ophthalmic Director
- Is a registered GOC practitioner with relevant qualifications
- Deals with side of business regarding optical products and equipment, using their knowledge to facilitate diagnostic capabilities
Role of Optical Practise Manager
- Not likely to have received any formal optical training or have GOC membership
- Will bridge the gap from ownership to floor staff
- Needs in-depth knowledge of many factors relevant to the business including GOS contract, optical British standards and GDPR etc.
- Also involved in high up management such as holidays and rota work, in combination with directors.
Role of Optometrist
- Fully qualified GOC professionals
- Can be further qualified in areas such as IP, or glaucoma specialist which determines what they are able to perform, but they are all able to perform GOS eye examinations
- Can be a supervisor if undertaken college training module and been qualified for 3 years and have currently got 2 years of continuous registration.
Role of Dispensing Optician
- GOC registered
- Can sign off prescriptions and instils drops, but cannot issue prescriptions or make choice of drops
- Receive extensive training on dispensing issues making them better qualified to deal with problems than we are
- Can dispense and sign off VIP and U16 dispenses
- Good first point of contact for ocular concerns with public
Role of Contact Lens Optician
- Trained as DO, so has DO experience and abilities
- Have detailed knowledge on CL matters including pathology
- Must be GOC registered
Role of Optical Assistant
- Not GOC registered
- Able to assist with frame and lens choices in the vast majority of patients
- Able to take clinical measurements e.g. pressures/photos though the interpretation is left upto optometrist
- Can dispenseVIP/U16 but has to be signed off by registered practitioner
- Can complete a voucher but no issue one, and cannot complete vouchers for pretected groups i.e. VIP/U16
Who is Entitled to a Free GOS Eye Exam?
- Live in UK
- Are refugee/asylum seeker
- Eligible oversees visitor (FT student on recognised course)
2006 Changes to Eyecare in Scotland
- Optometrist was made first port of call for ocular issues
- GPs no longer needed to send HES referral
- More focus on shared care schemes such as pharmacy and stroke teams
National Shared Care Schemes
- GOS Sight Tests
- DR screening
- HES referral
- Pharmacy First
GOS Supplementary Codes
2.0 - Cyclo refraction
2.1 Paedeatric review (without dilation)
2.2 Follow-up/repeat procedure (without dilation)
2.3 Suspect glaucoma (without dilation)
2.4 <60 requiring dilation following PEE
2.5 Anterior eye condition (without dilation)
2.7 Post-operative cataract exam (without dilation)
2.8 Unschedules appointment (without dilation)
2.9 Cataract referral advice and councelling
3.0 Additional appointment to complete PEE in patient with additional needs
GOS Sight Test in Shared Care
- Adapted in 2006 to provide a primary care function which can be progressed into a secondary setting if required
- Allowed more conditions to be managed in community without need for referral
- Introduced supplementary examinations which can be used to treat conditions or refine referrals
GOS Enhanced Supplementary Codes
4.1 Paediatric review (with dilation)
4.2 Follow-up/repeat poprcedure (with dilation)
4.3 Suspect glaucoma (with dilation
4.5 Anterior eye condition (with glaucoma)
4.6 Cycloplegia refraction of child referred from HES
4.7 Post-operative cataract examination (with dilation)
4.8 Unschedules appointment (with dilation)
DR Screening in Shared Care
- Not designed to replace sight test as primary eyecare
- Uses funds photos to detect deferrable DR which can be acted upon by optometrists with the relevant qualifications in the field
- Every diabetic over the age of 12 invited to attend yearly appointment which can take as little as 10 mins (30 if drops required)
- Aims to improve referral accuracy and improve convenience for patient
- Contact GP to get screening set up if patient is not yet attending
HES Referral
- Using SCI Gateway
- Can be Routine, Urgent or Urgent (suspected Cancer)
- Amount of information is dependent on condition
Example of Management Guideline from Eyes.Scot
- Supply chloramphenicol 1% ointment tds for 1 week in case of bacterial conjunctivitis
- Refer if corneal involvement or fails to resolve
SIGN Glaucoma Referral Guidelines
- Optic disc signs consistent with glaucoma in either eye
-Reproducible VF defect consistent with glaucoma in either eye - Grade 2 or 1 VH angle
- 270 or more degrees of gonioscopy where the posterior pigmented TM is not visible
- Pressures under 26mmHg and CCT under 555nm if under 65 years of age
Local Scheme Protocols
- Use of SCI gateway to send referrals which will be triaged by lead consultant who gets the final say on urgency
- Forth valley has a document made which shows where to refer different conditions to, and what information would be expected in these referrals
Local Shared Care Schemes
- Forth Valley Board Specific HES Referral
- Triage phone line
- GP referral
Who is Eligible for Pharmacy First?
- Essentially anybody living in Scotland
- Visitors excluded
How Does Pharmacy First Work?
- Pharmacy first means patients should present at pharmacy for minor conditions rather than e.g. GP
- Eye conditions can be referred to optometry from here
- Entry-level practitioners can use pharmacy first sheet to issue prescription via pharmacy rather than via GP
What Medications Available on Pharmacy First?
Infected Eyes
- Chloramphenicol 0.5% eye drops
- Chloramphenicol 1% eye ointment
7.2 Inflammaed/Dry Eyes
- carbomer 980 0.2% gel
- clinitas carbomer gel
- Xailin gel
- Xailin night eye ointment preservative free
- Hylonight ointment preservative free
- Hypromellose 0.3% eye drops
- Sodium cromoglicate 2% eye drops
7.3 Allergic Eye Conditions
- Olopatidine drops
