- You must communicate effectively with colleagues and work with them in ways that best serve your patients’ interests.
- You must act quickly to protect patients from risks posed by colleagues.
- You must treat colleagues fairly.
- If you are the practice owner or manager, you should make it clear to patients that offensive behaviour will not be tolerated and they will not be seen for a consultation if they exhibit such behaviour.
- You should only delegate patient care to appropriately skilled and experienced practitioners.
- You should keep the patient informed when you delegate aspects of their care to a colleague.
- You should write clear referral letters that contain relevant information about the condition, reason for referral and level of urgency.
- You should give patients written information, or a copy of the referral letter and tell them what to expect.
- Use your professional judgement about the urgency of a referral, taking into account College guidance or local protocols.
- If you delegate patient care, or supervise others, you are still responsible for the patient and the clinical findings.
- The protected functions of sight testing or contact lens fitting can only be undertaken by someone who is registered to perform those functions.
- For good continuity of care you must keep good records and provide necessary patient information to practitioners to whom you refer, delegate or are supervising.
- what might the outcome be in the short- or longer-term if I do not raise my concern?
- how could I justify not raising the concern?
References
277 General Optical Council. (2016) Standards of Practice for Optometrists and Dispensing Opticians [Accessed 20 Nov 2020]References
278 ABDO: Optical Confederation (2014) Managing non-tolerance issues [Accessed 20 Nov 2020]- age
- disability
- gender reassignment
- marriage and civil partnership
- pregnancy and maternity
- race
- religion or belief
- sex
- sexual orientation.
References
279 In England, s.2A of Schedule 1 of the General Ophthalmic Services Contracts Regulations 2008 (as amended by the NHS (Miscellaneous Amendments Relating to Ophthalmic Services) Regulations 2010 ) says:
“(1) Where the contractor has agreed to provide services to a patient, it must notify the patient (or, in the case of a child or incapable adult, the person who made the application on their behalf) of the patient’s right to express a preference to receive services from a particular performer where more than one performer is available.
(2) The contractor must try to comply with any reasonable preference expressed under subparagraph (1) but need not do so if the preferred performer has reasonable grounds for refusing to provide services to the patient.”
280 Except if the reason for refusal was because the patient was not eligible for GOS services or because a sight test was not clinically necessary.
- each team member understands the scope of their role, including what decisions and actions have and have not been delegated to them
- the team provides care which is safe, effective and efficient
- the team understands the need to provide a patient-centred service which is polite, responsive and accessible
- patient information is kept confidential
- you encourage a culture that allows open, non-judgemental discussion of problems and mistakes which enables constructive feedback and contributes to continuous improvement
- team members are appropriately supported and undertake professional development that is relevant to their role and level of experience
- team members are not asked to undertake tasks for which they are not competent
- you have the necessary leadership skills, or work to develop the skills.
- may decide not to conduct tests that would have been done at the hospital and record your reasons in these cases
- should bear in mind that a patient being assessed for one condition may not have been checked for another unrelated condition
- should inform hospital eye service colleagues of your findings, if you feel it would influence their management of the patient.
- a sufficient description of the condition
- the reason for deciding not to refer on this occasion
- details of advice or treatment given to the patient.
- ensure they understand why the referral is necessary
- record a full account in the patient records
-
obtain the patient’s signature on a declaration that they do not wish to be referred.
- relevant details from the eye examination
- the reason for referral, including images where appropriate
- details of discussions with the patient and any with the practitioner to whom you are referring
- the level of urgency.
- they decline a copy
- the letter contains information about another person who has not given their consent for you to disclose this information (other than if the patient originally provided this information or if you remove this information from the copy letter)
- you feel it may cause harm to the patient. Giving bad news is an insufficient reason for withholding a copy of the letter.
- find out where they would like it to be sent
- use the patient’s full name in the address and check with them if they share the same name as someone else at that address, and how to avoid confusion with other family members.
References
281 National Institute for Health and Care Excellence Quality Standard 180 (Feb 2019) [Accessed 20 Nov 2020].282 Scottish Intercollegiate Guidelines Network (2015) Glaucoma referral and safe discharge [Accessed 20 Nov 2020]
283 General Optical Council (1999) Rules relating to injury or disease of the eye SI 3267 [Accessed 20 Nov 2020]
284 General Optical Council (2016) Standards of Practice for Optometrists and Dispensing Opticians, para 10.3 [Accessed 20 Nov 2020]
285 Opticians Act 1989, s.26(1)(b)(ii) [Accessed 20 Nov 2020]
286 Sight Testing (Examination and Prescription)(No 2) Regulations 1989 SI 1230 s3(1)(b)(iii) [Accessed 20 Nov 2020]
- the overall management of the patient, and must ensure that your patient receives the same standard of care that you would provide
- the work of the person to whom you have delegated the procedure and any clinical findings.287
References
287 General Optical Council (2016) Standards of Practice for Optometrists and Dispensing Opticians, para 10.3 [Accessed 20 Nov 2020]288 General Optical Council (2016) Standards of Practice for Optometrists and Dispensing Opticians, para 10.3 [Accessed 20 Nov 2020]
- ensure that you have the necessary skills to supervise them
- observe their work
- give them regular constructive feedback on their performance.