title: Scope of practice of optometrists working in the UK Hospital Eye Service: a national survey.
abstract: OBJECTIVE
  The role of the optometrist in the Hospital Eye Service (HES) has undergone significant development in recent years to include extended areas of clinical practice more traditionally undertaken by ophthalmologists, commensurate with a growing demand for increased capacity in ophthalmic services. In this report, we present the findings from a national survey of the scope of practice of optometrists working in the UK HES.
  
  
  METHODS
  A survey was designed to incorporate questions on the provision of core services before seeking detailed information on the scope of practice within extended roles to include: ophthalmic sub-specialist areas where optometrists currently practice; the undertaking of specific procedures within these services; the relative autonomy of practice within these extended roles; and the training and accreditation requirements for working within extended roles. SurveyMonkey was used to disseminate the survey to the head of optometry in 79 HES units throughout the UK.
  
  
  RESULTS
  Responses were received from 70 of the 79 (89%) survey invitations. A substantial majority of respondents (N = 67/70, 96%) indicated that optometrists undertook extended roles. Glaucoma is the leading extended role service provided by optometrists (92% of respondents providing extended role services), with roles in macula (71%), medical retina/diabetes (67%), cataract (55%) and corneal services (55%) also being relatively common. A wide variety of clinical procedures or interventions are undertaken as part of these services, which for a small number of optometrists now also includes the undertaking of specific laser procedures. There is evidence for a significant degree of autonomy within these extended roles. The primary mode of training is an 'apprentice' model, incorporating sessions worked under supervision in ophthalmology clinics. Methods of accreditation for optometric participation in extended role services are varied.
  
  
  CONCLUSIONS
  While optometrists working within the UK HES continue to undertake the traditional clinical roles of refraction, clinically necessary contact lenses, and low vision rehabilitation, it is clear that these professionals now undertake a wide range of extended clinical roles, with a transformed scope of practice now incorporating diverse roles traditionally undertaken by medical practitioners.
authors.affiliation: Manchester Royal Eye Hospital, Central Manchester University Hospitals NHS Foundation Trust and Manchester Academic Health Sciences Centre, Manchester, UK.|Centre for Ophthalmology & Vision Sciences, Institute of Human Development, Faculty of Medical and Human Sciences, University of Manchester, Manchester, UK.
authors.forename: Robert
authors.initials: R
authors.lastname: Harper
authors.affiliation: Manchester Royal Eye Hospital, Central Manchester University Hospitals NHS Foundation Trust and Manchester Academic Health Sciences Centre, Manchester, UK.
authors.forename: Rosalind
authors.initials: R
authors.lastname: Creer
authors.affiliation: Royal Victoria Hospital, Belfast, UK.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Jackson
authors.affiliation: Moorfields Eye Hospital, London, UK.
authors.forename: Daniel
authors.initials: D
authors.lastname: Ehrlich
authors.affiliation: St Paul's Eye Unit, The Royal Liverpool University Hospital, Liverpool, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Tompkin
authors.affiliation: College of Optometrists, London, UK.
authors.forename: Michael
authors.initials: M
authors.lastname: Bowen
authors.affiliation: Manchester Royal Eye Hospital, Central Manchester University Hospitals NHS Foundation Trust and Manchester Academic Health Sciences Centre, Manchester, UK.|Centre for Ophthalmology & Vision Sciences, Institute of Human Development, Faculty of Medical and Human Sciences, University of Manchester, Manchester, UK.
authors.forename: Cindy
authors.initials: C
authors.lastname: Tromans
mesh_terms: D005128:Eye Diseases / Q000628:therapy*; D005260:Female; D006302:Health Services Research; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D009885:Ophthalmology / Q000458:organization & administration*; D009907:Optometry / Q000379:methods / Q000706:statistics & numerical data; D010819:Physician's Role; D024382:Professional Role; D014786:Vision Disorders / Q000628:therapy*
keywords: Hospital Eye Service; extended roles; optometry; scope of practice