Independent prescribing

You must have been practising in the UK and registered with the GOC for two full years before beginning the clinical placement. During the placement, you must complete a clinical logbook to demonstrate learning outcomes have been achieved. You will be required to see a sufficient number of patients presenting with the conditions that you will manage therapeutically. 

Your clinical placement will be in a hospital eye service (or in a specialist general practice) under the overall supervision of a designated ophthalmologist, approved by the College. 

You must complete a minimum of 24 x 3 hour sessions in the HES or specialist general practice. These can be divided into:

• a minimum of 11 x 3 hour of face-to-face sessions (45%)
• a maximum of 13 x 3 hour sessions in remote or virtual clinics (55%)

All remote or virtual sessions must generate evidence of activities relevant to the GOC-specified learning outcomes. Each session, whether face-to-face or remote, must be signed off by a designated ophthalmic practitioner. This practitioner must:

• Have at least two years post-specialist qualification experience and be listed on the appropriate regulator’s register as such
• Be working under the supervision of the designated ophthalmologist
• Be approved by The College of Optometrists to undertake this role

For the purposes of College approval, the designated ophthalmic practitioner must either be:

• An IP-qualified optometrist who has at least two years’ experience as an IP-qualified optometrist and is listed on the GOC register as such

Or:

• A GMC registered doctor currently engaged on, and at least two years into, an ophthalmic-specialty training programme, listed on the GMC register as such

The overall review mentor (designated ophthalmologist) retains the overall responsibility to sign off the clinical placement logbook. 

Within the context of the relevant specialism the period of practice-based learning (clinical placement) should ensure that you:

• are competent in the assessment, diagnosis and management of the ophthalmic conditions for which you intend to prescribe
• are able to recognise sight-threatening conditions that should be referred
• are able to consult effectively with patients
• are able to monitor the response to treatment, to review both the working diagnosis and to modify treatment, refer, consult or seek guidance, as appropriate
• can make clinical decisions based on, and with reference to, the needs of the patient
• are aware of your own limitations
• critically analyse and evaluate your ongoing performance in relation to prescribing practice

The following lists the minimum time which must be spent in clinical placement for Independent Prescribing:

1. for those who have already passed Additional Supply - a minimum of 14 sessions of not less than three hours (7 days)
2. for those who have no previous prescribing qualifications - a minimum of 24 sessions of not less than three hours (12 days).

Within the context of the relevant specialism the period of practice-based learning should ensure that you:

• are competent in the assessment, diagnosis and management of the ophthalmic conditions for which you intend to prescribe
• are able to recognise sight-threatening conditions that should be referred
• are able to consult effectively with patients
• are able to monitor the response to treatment, to review both the working diagnosis and to modify treatment, refer, consult or seek guidance, as appropriate
• can make clinical decisions based on, and with reference to, the needs of the patient
• are aware of your own limitations
• critically analyse and evaluate your ongoing performance in relation to prescribing practice

Clinical training should be structured to ensure that you are exposed to sufficient numbers of patients presenting with the conditions that you will manage therapeutically. In addition, you should be exposed to a range of ophthalmic conditions to develop your differential diagnostic skills.
 
You should maintain this online logbook of practice evidence to verify that learning outcomes have been achieved.
 
On successful completion of the requisite period of clinical practice you may apply to sit the Common Final Assessment in Specialist Therapeutics.

The mentor will provide supervision, support and arrange appropriate clinical experience so that the optometrist can develop links between the theory and practice of prescribing.

Furthermore, the mentor will facilitate in the achievement of the learning outcomes specified by the General Optical Council (GOC).

It is not the mentor’s responsibility to formally assess the learning outcomes since these will be assessed by the University and The College of Optometrists.

During an initial meeting with the optometrist, the mentor can plan a training programme based on the optometrist’s learning needs. During the placement the mentor should:

• facilitate learning by encouraging critical thinking and reflection
• provide dedicated time and opportunities for the trainee to observe how the mentor conducts a consultation with patients and the development of a management plan
• allow opportunities for the trainee to carry out consultations and suggest management and prescribing options, which are then discussed with the mentor
• provide opportunities for case-based discussions to consolidate the learning experience

As the approach to teaching and learning is developed on an individual basis, it is difficult to predict how much time this will involve for the mentor. However, given that all those undertaking clinical placements are experienced optometrists, it is hoped that this will not be too onerous.

The optometrist will not need to spend the entire placement with the mentor, as other designated ophthalmic practitioners may be better placed to provide some of the learning opportunities. However, the designated ophthalmologist maintains overall responsibility for the trainee and will validate their clinical experience.

Clinical training should be structured to ensure that you are exposed to sufficient numbers of patients presenting with the conditions that you will manage therapeutically. In addition, you should be exposed to a range of ophthalmic conditions to develop your differential diagnostic skills to prepare for the final examination. Remember, too, that 10% of the final examination is based on glaucoma, so it is advisable to see glaucoma patients during your clinical placement.

On taking up the clinical placement for independent prescribing you must inform the College of the details of the placement.

Candidates using the paper logbook must download and complete the form below and email it to exams@college-optometrists.org. You do not need to wait to receive confirmation from the College regarding the placement before you begin.