1. Definition of Additional Supply
Those optometrists who qualify in Additional Supply are allowed to sell, supply or write written orders for drugs for a specified formulary of prescription-only medicines.
2. Learning Outcomes
The General Optical Council have specified the following learning outcomes for the practical element of Additional Supply:
- To be competent in the assessment, diagnosis and management of common ophthalmic conditions.
- An ability to recognise sight-threatening conditions that should be referred.
- An ability to consult effectively with patients.
- An ability to monitor the response to treatment and modify the management accordingly.
- An awareness of his/her own limitations and the ability to make clinical decisions based on the needs of the patient.
- An ability to critically analyse and evaluate his/her ongoing performance in relation to prescribing practice.
Examiners in the Common Final Assessment for Specialist Therapeutics must be satisfied that these learning outcomes have been met.
3. Assessment in Additional Supply
Candidates applying for assessment in Additional Supply will require to have undertaken/evidenced the following:
3.1. Clinical Placements: complete a minimum number of 10 clinical sessions (equivalent to 5 days) in the Hospital Eye Service or Specialist General Practice under the supervision of a designated ophthalmologist. Candidates must see a range of cases.
3.2. Extended Case Reports: submit 4 extended case reports, based upon a chosen selection from the cases seen during the clinical sessions. Original jottings relating to each extended case report must be submitted with these reports.
Candidates must include a range of cases and provide a synopsis of those cases.
Candidates must prepare a selection of extended case reports from the following list:
- A condition requiring a topical antibiotic
- A condition requiring a topical antihistamine or mast cell stabiliser (ie allergic conjunctivitis of any form
- A condition requiring tear substitutes
- Drug sensitivities or side effects
- Complications of contact lenses causing ‘red eye’
- Any condition which may be considered in the differential diagnosis of the ‘red eye’.
It is essential that the extended case reports evidence the breadth and depth of experience acquired and that they reflect those conditions which are most likely to be managed by the optometrist in practice.
Each extended case report should be informed by a review of the clinical literature. References should be cited in the text and a bibliography included at the end of each report. Particular emphasis should be given to evidence-based practice i.e. using the medical literature to support any clinical intervention.
An extended case report should include full information regarding each patient’s clinical presentation, management and follow up. The discussion and the literature search should be relevant to each patient. Candidates will be tested on their independent ability to critically comment on the literature relevant to the case.
Candidates should work up the case reports with particular reference to evidence-based practice and any existing professional good practice guidelines.
Each extended case report should be no longer than 1000 words. The following checklist should be used when preparing an extended case report:
- Actual presentation (signs and symptoms) versus expected presentation
- Differential diagnosis
- Clinical evidence for the clinical intervention
- Indications, contraindications, cautions and adverse effects of any pharmaceutical treatment used
- Consideration of the holistic needs of the patient (e.g. psychomotor, physical)
- Management from an optometric viewpoint (e.g. professional accountability, codes of conduct in relation to additional supply/supplementary prescribing)
3.3. Portfolio: completion of all other aspects of the Portfolio. General presentation must be consistent with a Higher Qualification professional examination and show:
- Clear indexing and summary
- All information with appropriate dates
- Sequence of case history to be presented in chronological order
- Observance of patient anonymity
- Key to abbreviations used
- Relevant supporting documentation
- Each sheet to have a patient number and candidate number
- Any copied documentation should be of good quality