Eye care risk and safety issues identified by Optometrists in Scotland: a focus group study

Introduction

Evidence on the nature and scale of risk and safety concerns in Optometry practice is very limited, especially compared with other primary care professions. In Scotland, many changes occurred in the profession during and because of the Covid-19 pandemic. The theme of risk and patient safety was, therefore, chosen as the priority focus for the 2022 mandatory national training programme, which Optometrists providing General Ophthalmic Services in Scotland are required to undertake.

Aim

To explore and identify perceived current and future safety risks and how these might be mitigated in relation to professional Optometry practice in Scotland.

Methods

Study participants were all registered General Optical Council (GOC) members from nine of the 14 regional health boards in Scotland. Data was collected via three online focus groups over a 2-month period during 2021 with each comprising six to eight participants. Data were transcribed with permission and then subjected to a basic thematic analysis.

Results

16 Optometrists participated in the study. Six principal themes were generated from the data analysis: 1. Current Overview and Context (e.g. perceived increased risk); 2. Competency Risks (e.g. skills and knowledge to manage disease); 3. Conduct Risks (e.g. behaviours of practitioners); 4. Contextual Risks (e.g environmental issues); 5. Future Risks (e.g. technology); and 6. Risk Mitigations (e.g education and training.)

Conclusion

The Optometry profession is concerned the level of clinical risk is increasing, mainly related to technology, scope of practice, role development and changes in patient demand. Multiple recommendations are made to minimise risks including education for new roles; increased focus on improving care quality; support to those involved in safety incidents and complaints; taking a systems approach to areas of high risk; and sharing good practices.

What is already known on this topic

summarise the state of scientific knowledge on this subject before you did your study and why this study needed to be done

• Research into patient safety and exploring clinical and organisational risks in the primary care professions is underdeveloped compared with secondary care settings.

• In professional optometry practice empirical evidence of safety concerns and risks is even more limited.

• Latterly, there has been some focus on these issues from a professional regulatory, policy, research and education perspective, but this is still rudimentary compared to other primary and community-based professions.

What this study adds

summarise what we now know as a result of this study that we did not know before

• The findings generated provide some evidence of the reported safety and risk concerns perceived by experienced optometry professionals, particularly related to competency, professional conduct, organisational issues, and future risks. Suggestions for risk mitigations were also captured.

How this study might affect research, practice or policy

summarise the implications of this study

• The findings provide some insights for policy makers, educators and practitioners on reported safety and risk priorities in the optometry profession.

• Study outcomes have informed the development and implementation of targeted patient safety and risk management education for the optometry profession in Scotland which should be of interest to others in the UK and beyond.

• The findings could also lay the groundwork for a future programme of patient safety improvement and risk reduction interventions similar to those introduced in other primary care settings.