No images? Click here Newsletter September 2023 Message from the PresidentWelcome to the mid-year issue of the Optometry Council of NSW newsletter. This is my third message to you as Council President and I’m pleased that my colleagues and I continue our role protecting the public of NSW. I would like to thank the NSW division of Optometry Australia for their collaborative work with the Council in producing and promoting a series of educational webinars and podcasts. These resources are designed to remind and inform all NSW registrants of their professional responsibilities and to share some insights into the regulation and complaints process here in NSW. If you have not already watched or listened to these productions, you can do so via the link below. I would also like to draw your attention to Ahpra's recently published advice on managing health records. Here, you can find a helpful summary of obligations in this area, as well as a self-reflective tool to help assess the adequacy of your record management. Derek Fails President, Optometry Council of NSW Changes to NSW complaints component of registration fee for 2023/24While the Optometry Board of Australia is yet to issue the annual registration fee request for 2023/24, we can confirm that the NSW complaints component of this fee will decrease. For NSW optometry practitioners, this portion of the fee will decrease from $86 to $52 for general and limited registration. The national registration fee for all NSW registered health professionals under the national scheme comprises of two components:
The complaints component for NSW health practitioners is subject to approval by the NSW Minister for Health under section 26A of the Health Practitioner Regulation National Law (NSW). The complaints component is a cost recovery model and is not subsidised by other health professions. Further information about the 2023/24 annual registration fee for registered optometrists will be provided by the Optometry Board of Australia. NSW Health Professional Councils and Health Professional Councils Authority joint Aboriginal Cultural Safety Strategy 2023-24In June 2023, the NSW Health Professional Councils and the Health Professional Councils Authority (HPCA) launched its joint Aboriginal Cultural Safety Strategy. The joint Strategy aims to improve the experiences of Aboriginal people who interact with the NSW healthcare and regulatory system. Our Strategy aligns with existing state and national initiatives to improve health outcomes for Aboriginal people. The Councils, HPCA and regulatory system exist for the benefit and protection of the NSW community and we acknowledge that Aboriginal people have, and continue to suffer, disproportionate levels of disadvantage, including in health outcomes. Our Strategy aims to strengthen cultural safety within the NSW regulatory system through increased participation of Aboriginal people and collaboration with stakeholders. To read more about the Strategy and its launch, visit the HPCA website. What is informed consent?Informed consent is defined as a person’s voluntary decision about healthcare that is made with knowledge and understanding of the benefits and risks involved. It is a fundamental principle of healthcare ethics that requires practitioners to provide patients with information about their condition, the proposed treatment, and the risks and benefits of the treatment, and to obtain the patient's consent before providing treatment. It is an important part of the healthcare relationship for a number of reasons. First, it helps to ensure that patients are able to make informed decisions about their care. When patients are fully informed about their condition and the treatment options available to them, they are better able to make choices that are right for them. Second, informed consent helps to protect patients from harm. When patients understand the risks and benefits of a treatment, they are less likely to agree to a treatment that is not in their best interests. How is it obtained? The practitioner should endeavour to confirm that their patients understand any information communicated to them. Determining whether a patient is sufficiently informed is a matter of discretion on the basis of the practitioners’ own assessment. The duty of obtaining informed consent cannot be sufficiently discharged when the patient has more questions. It requires a conversation with the patient, clarifying any further questions they may have, before confirming whether they give their consent. In circumstances where the patient may lack either the maturity or capacity to understand, depending on the nature of the proposed care, patient consent for examination and treatment ought to be obtained by a parent, carer or substitute decision-maker for the patient. However, an exception to this is in emergency situations. Ensuring the requirement in more complex situations, such as where there are multiple patients, or for culturally diverse patients, it may be appropriate to take further steps to satisfy this duty including ensuring confidentiality and privacy are maintained or engaging a translator. Some additional tips for obtaining informed consent:
What are the risks of not obtaining consent? Consent not appropriately obtained leads to risks of compromised quality of care and may result in conduct related complaints to the regulatory authorities. The right to make a complaint, if invoked, will result in the circumstances of the case being considered by the appropriate regulatory body. Rights and responsibilities Finally, it is important to acknowledge that whilst it is a patient right to raise a concern or make a formal complaint about their care, it is the practitioner’s responsibility to ensure that the patient’s care is not affected or jeopardised as a result of the complaint made. This will be a matter of discretion by the practitioner, and in some cases may require referral to another practitioner. Continuity of care - what does it mean?Ahpra's shared Code of Conduct states that “Providing good care includes that you facilitate coordination and continuity of care”. But what do we mean by continuity of care, and why is it important? The Australian Government’s Australian Institute of Health and Welfare defines continuity of care as “the ability to provide uninterrupted care or service across programs, practitioners, and levels over time”. Patients diagnosed with an eye condition often receive care from more than one practitioner, and may have to attend multiple services (e.g., hospital, general practitioner, optometrist, pathology service, diagnostic imaging, etc.). This is particularly true in the case of complex or chronic conditions such as cataracts or diabetic retinopathy. The more complex the situation, the more likely it will be that multiple practitioners and systems are involved. In such cases the risks that continuity of care may be disrupted are amplified but continuity is important in every instance. A 2018 systematic review of many studies reporting on continuity of care showed that increased continuity of care can be associated with a reduction in patient mortality (1). In certain settings, continuous care has also been associated with more satisfied patients, better disease prevention, increased adherence to medication, and reduced hospital use (1). Continuity is important. Are there factors that can hinder or help continuity of care? One of the challenges involved in maintaining continuity of care is the frequent need for collaboration between various health practitioners such that it requires lots of efforts and clear communication for all those involved in delivering care to a given patient to stay informed on what others have examined and treated. There can be confusion over the characteristics of continuity of care leading to what has been jokingly called “continuous confusion” (2). Researchers have identified two core elements of continuity of care and described three types of continuity (see table below) (3). Two core elements were identified, namely the care of an individual patient (sometimes called patient-centred care) and care delivered over time. The possible dimensions of continuous care can be described as relational (or the practitioner-patient relationship), informational (or the availability of appropriate information), and management (or the systems that enable consistency of delivery). Characteristics of continuity of care In practice, this might mean sharing information through appropriate use of secure file sharing, electronic management systems, referral letters and reports. Management continuity can be achieved through shared care plans and shared protocols. Care plans are one of the tools available that can help to coordinate care over time and between health practitioners. These can help to coordinate care over time and between health practitioners but do not themselves equate to perfect continuity of care. Relational continuity is facilitated by clear communication and a focus on core practitioners. Relationship between a practitioner and a patient expressed in terms of trust fostered by communication and responsibility. In summary, a patient will experience continuity of care if they feel that all practitioners are well informed on what has happened to all aspects of their health in the past and what is foreseen for the future, and if all practitioners are in agreement as to the management plan to follow and who is to deliver it. In practice this might mean diligent use of referrals and reports detailing your management plans to all practitioners involved in the care of your patient, maintaining honest and clear communication with your patient over time, and making use of support systems such as for example electronic health records and prescribing software when available. Tell us what you thinkYou can send us an email if you have a particular comment or suggestion about this edition or you can have your say via our anonymous survey which is open all year round https://www.surveymonkey.com/r/FGWJJDH |