A RANZCO bid to overturn a scope-of-practice change allowing some New Zealand optometrists to perform two types of laser surgery has reportedly been rejected.
Earlier this year, the Optometrists and Dispensing Opticians Board (ODOB) – a regulator which carries out functions determined by the Health Practitioners Competence Assurance Act – authorised specially qualified optometrists to perform Nd:YAG laser for capsulotomy or peripheral iridotomy in an approved hospital setting.
The change followed a pilot and consultation with the sector, with the policy coming into effect on 1 July.
However, RANZCO – which raised concerns about patient safety and lost training opportunities in the consultation phase – lodged a complaint with the New Zealand Regulations Review Committee (RRC) over the final ODOB decision.
In it, the college said was an “unusual or unexpected” use of the ODOB’s powers and it questioned the consultation process. RANZCO also said the decision didn’t consider the full understanding of the pros and cons of laser, as well as the full range of complications that can be derived from short training courses.
The college also said optometrists would not have “the depth and breadth” of hospital training that is required to understand and perform these procedures to a high degree of safety and repeatability.
NZ Optics reported that the RRC rejected the college’s complaint, ultimately maintaining the ODOB’s decision.
“This is an important outcome for optometry practice in New Zealand,” the regulator was reported as saying.
“The specialist scope-of-practice will safely enable changes to models of care, and allow suitably qualified optometrists to increase the available support and treatment options for the existing and anticipated pressure on ophthalmology services in New Zealand.”
ODOB chair Ms Kristine Hammond told Voxy.co.nz said there was irony in RANZCO complaint due to the fact “that it was a group of New Zealand hospital-based ophthalmologists who suggested and developed this change in the first place, followed by an official request from the former Auckland District Health Board”.
“The limited surgeries this covers are very basic and are only open to optometrists who have been adequately trained in the procedures, and have at least three years of work experience in appropriate ophthalmology hospital clinics,” she said.
“People often couldn’t get to see an ophthalmologist for this surgery for up to 12 weeks or longer. This unnecessarily increased the risk of further damage and preventable vision loss, but now an optometrist can easily and safely perform it earlier, and at a fraction of the cost to the public health system.”
According to NZ Optics, RRC concluded the ODOB had acted within its powers and had consulted sufficiently with RANZCO. Regarding patient safety it ruled it was “not clear on the evidence” that patient safety is compromised and the ODOB had considered patient safety when making its decision.
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