Guidance review 2019

Tell us your views on the proposed changes to the Guidance for Professional Practice.

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The Guidance for Professional Practice is the College’s view of good optometric practice and is publically available. The Guidance is reviewed every three years, and was last published in late 2017. The review process includes a public consultation on the content of the Guidance and is split into two parts:

  1. Knowledge, Skills and Partnership domain (reviewed October/November 2019)
  2. Safety and quality, Communication partnership and teamwork, and Maintaining trust domains (to be reviewed in February/March 2020)


Part one: Knowledge, Skills and Partnership domain

We have summarised the main proposed amendments to the Knowledge, Skills and Partnership domain below, and these are also shown in tracked changes in a downloadable document. Please note that changes to references and useful information are not shown in tracked changes.

Summary of changes
  1. Updated some of the content to reflect new Scottish GOS legislation and moved some chapters into a more logical order.
  2. Expanded introduction to include reference to other College services, and to make it clear that the Guidance is good, rather than best practice.
  3. Added a section on imaging to Patient records chapter (paras A28-A31).
  4. Amended A48b (The routine eye examination) to make it clear that you should determine the patient’s habitual VA rather than unaided vision where possible.
  5. Amended A52 and A282 (The Routine eye examination) to say that you should write on the patient’s prescription if they are registered as SI or SSI (because these patients can only have it made up by or under the supervision of a registered person).
  6. Made it clear that frequency of eye exams guidance applies to private and NHS patients (GOC Standard 7.6).
  7. Added a new chapter on The needs led examination – paras A67-A71.
  8. Added a new section on examining patients who have hearing loss – paras A89-A96 (Examining patients with a disability).
  9. A106 (Examining patients with low vision) changed to a ‘must’ (and therefore separated from A107 which is a ‘should’).
  10. Added an additional point to A134g (Examining patients with learning disabilities) about using dynamic retinoscopy on patients with learning disabilities.
  11. A136 strengthened to a ‘must’.
  12. Added a new chapter on Examining patients with autism (A139-A149)
  13. Revised the chapter on Examining patients with specific learning difficulties (A152, A153, A155 and A157).
  14. Added a couple of additional pieces of equipment to A183f (Domiciliary sight tests)
  15. Added some prescribing guidance to A189 (Examining younger children) from Susan Leat’s paper (Leat SJ (2011).  To prescribe or not to prescribe?  Guidelines for spectacle prescribing in infants and children.  Clin Exp Optom; 94:6:514-527)
  16. Added some additional detail to A250b and A253 and an additional point about seeking a second opinion as A251 (Examining patients who drive), though this chapter may need updating when the GOC publish their guidance on this. This chapter will be revisited when the GOC guidance is published.
  17. Added something about not prescribing blue blocking lenses to A269 (Examining patients who work with DSE).
  18. Amended A310 (Sale and supply of spectacles) to make it clear that the statement is only for use by College members, and if it is used it should be used in its entirety.
  19. Removed ‘especially’ from A319 (Fitting contact lenses) and made it clear what we mean by specialist contact lens areas.
  20. Changed the title of the ‘specialist contact lenses’ chapter to ‘Contact lenses for overnight wear’, as that is what the chapter is about. Changed ‘you should teach them how to remove their lenses’ to a ‘must’ in A384/385 (Contact lenses for overnight wear), as this is in GOC Standard 2.5.
  21. Removed the reference to the increased risk in children wearing orthoK in A389 (Contact lenses for overnight wear) in response to the OPO paper ‘Safety and efficacy following 10 years of overnight orthokeratology for myopia control (2018) 38(3):281-289.  This says ‘No significant difference was found in the number of adverse events found between the OK (110) and SCL (103) groups (p=0.72)’

Please complete the questionnaire below by 31 October 2019. 

The GOC are due to publish their guidance on confidentiality and driving shortly. If there is conflict between the GOC guidance and our Guidance we will revisit this chapter, but in the meantime we have removed the suggestion that the optom should notify the patient’s GP (A254), as the GP will not be able to do anything about it.

In the same chapter we have also mirrored what the General Medical Council say and added (A253) that the optometrist should tell the patient that they intend to tell the DVLA/DVA, and should consider the patient’s reasons for objecting to this if they do.