RANZCO referral pathway criticised

A report from OA’s publication Australian Optometry stated that the referral pathway failed to reflect the diversity of optometry expertise, patients’ circumstances or the scope of the optometrists’ practice. The initiative was also said to deviate from current guidelines.The report centred on a mber statent released by OA national president Ms Kate Gifford. Ms Gifford was quoted as saying, “The RANZCO referral pathway was developed without advice from OA, the professional organisation which represents the optometry profession in Australia, yet it seeks to advise our profession on patient care.“Though RANZCO has every right to release referral pathways to its own mbers, it does not have the authority to instruct the optometry profession on how patients should be managed or referred.”Ms Gifford was said to have made the statent following detailed analysis and discussions with the Optometry Board of Australia (OBA) and after consulting “key mbers” of the industry, including OA’s Glaucoma Australia Working Group.As previously reported by Insight, RANZCO and Specsavers Australia and New Zealand announced the joint venture to produce a series of eye-care referral guidelines in August.According to the two parties, the guidelines were developed with input from both ophthalmologists and optometrists, and the first referral pathway, the RANZCO Referral Pathway for Glaucoma Managent, was made available online to all optometrists and GPs across Australia and New Zealand.Ms Gifford was cited as saying the pathway seed “ophthalmology-centric” rather than “patient-centric”.“It fails to recognise the scope of practice of optometrists to diagnose, manage and treat glaucoma. This scope is recognised by the OBA as the regulatory body for our profession,” she stated.“The RANZCO referral pathway instead encourages potentially unnecessary referrals and an increased burden on Medicare, as well as unnecessary financial burden for patients in clinical, travel and time-related costs.”Ms Gifford also criticised the RANZCO referral pathway for diverging from OBA and National Health and Medical Research Council guidelines, as well as for omitting gonioscopy from the standard baseline examination, which she said was an entry-level competency in Australia.“OA will communicate with RANZCO in relation to these concerns and encourage RANZCO to work in a collaborative manner with OA prior to publication of its future referral pathways, to ensure they fully reflect the context of optometry clinical managent in Australia,” Ms Gifford said.RANZCO respondsIn response to the criticism, RANZCO chief executive officer Dr David Andrews told Insight that the organisation welcomed feedback about the project.“RANZCO has been very clear from the start that we hope to receive feedback from all optometrists and other healthcare professionals, as well as from organisations such as OA, so that we can build on the pathways and ensure they are as effective and usable as possible,” he stated.He said the organisation had received positive and constructive advice from a number of eye-health professionals, including optometrists, about the glaucoma pathway, adding that some suggestions had already been incorporated into the pathway.“RANZCO launched the RANZCO Referral Pathway for Glaucoma Managent, and announced the upcoming launch of guidelines for referral of diabetic retinopathy and AMD, with the intention of ensuring that patient pathways to RANZCO fellows are appropriate, effective and safe, and to encourage a transparent and collaborative approach to eye healthcare by all eye healthcare professionals,” Dr Andrews said.