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Serendipity will continue to strengthen our sector.

As the recession continues (or ends--depending on which economist you listen to) a mixed picture for optical sector activity emerges, with (as reported in OT News, October 6) one survey reporting that optical practices are closing at a lesser rate than other retailers in the High Street, against comments by the Eyecare Trust, which lately ran its National Eye Week, that three-quarters of people are putting off having their sight test.


For those who run their own practice, comments by doom merchants in a related sector--namely primary medical practice--add to the uncertainty.

The NHS Alliance head of patient and public involvement has declared that the small business model of general practice is 'on its way out'.

It was suggested that medical practices operating alone were an 'inefficient and unresponsive way to run primary care' (GP magazine, October 30).

But while many optometrists and dispensing opticians are keen to lead the way into a larger and more specialised allied medical role for their respective professions, we are helped by the happy coincidence that our sector also encompasses a strong business model. This model enables us to select the best from both health and commerce to continue to develop and refine the important service we offer to the consumer, now and into the future.

With an eye to both these elements (and to the forthcoming General Election) astute practitioners will be looking to strengthen their links with their local GP colleagues.

Shadow health secretary, Andrew Lansley (pictured), has already confirmed that there will be a new GP contract if the Conservatives form the next government, and that this new contract will put commissioning responsibility in the hands of the GPs.

LOCs' dialogue on commissioning thus far has probably been almost exclusively with commissioning leads at their respective PCTs, however, tactics suggest that now is the time for LOCs to be looking equally enthusiastically towards the flowering of stronger relationships with their new friends at the LMC (Local Medical Committees).

One of the functions of the various professional representative and member organisations is to provide guidance to members of the professions, and all healthcare professionals are accustomed to relying on such to help them make a whole range of decisions. Within our own sector, debate continues around the guidance issued by NICE relating to the diagnosis and management of glaucoma. It was interesting to note that only last month, the Medical Defence Union was advising GPs that they must be able to justify, for any particular patient, why they may have deviated from NICE guidance.

Further illustration of the fact that even this interpretation is far from clear-cut, was offered by the MDU's medico-legal adviser, Dr Karen Roberts. Speaking at a recent conference she is quoted as saying: "If it is a new guideline, then there may be some debate about how reasonable it is". The message really being that 'guidance' is simply guidance and it is still up to the individual health professional to make--and justify--their own decisions.

And while we are on the subject of guidance, it is interesting to note that in among the new guidance on confidentiality recently issued by the GMC for GPs, lies a guideline that has implications for optometrists.

A dilemma that all practitioners will face at some time is what to do with the patient who, despite their corrected acuity falling short of that required to meet the legal driving standard, makes it clear that they intend to continue driving.

In the past, practitioners may have chosen in specific cases to inform the patient's GP, without necessarily knowing what the eventual outcome of this might be. This is now made much clearer, in that one of the new guidelines for GPs, states that doctors should contact the DVLA or DVA immediately, if a patient continues to drive against medical advice. A clear illustration that when it is unambiguous, professional guidance can be very helpful. Spectator will return in the New Year.
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Title Annotation:SPECTATOR: Keeping an eye on current affairs
Publication:Optometry Today
Geographic Code:4EUUK
Date:Dec 4, 2009
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