Ophthalmology is the busiest NHS specialty - attendance continues to rise and it accounts for 10% of the entire NHS waiting list (NHS England, 2023). The ophthalmology workforce census reported large-scale staffing shortages as a serious problem in the UK, with paediatric ophthalmology being an area of particular concern – a third of NHS Trusts reported paediatric ophthalmology had the most concerning backlog (2022 Royal College of Ophthalmologists workforce census).
To lessen the capacity - demand gap, we offer a programme which upskills capable and experienced paediatric eye-care practitioners to become specialist paediatric ophthalmology ACPs. During the three years of part-time online MMedSci study, supported by work-based learning, trainee ACPs gradually take on paediatric ophthalmology clinical work. As such, they start managing their own clinics, independently diagnosing and treating a variety of patients, escalating care to ophthalmologists where required. Our trainees study core and optional areas of the paediatric ophthalmology curriculum, chosen to suit their personal and paediatric service needs. ACPs help provide increased access to the right care at the right time. With more specialist ACP roles emerging, now is an exciting time to increase ACP workforce. Experienced Orthoptists, Optometrists and Ophthalmic nurses, who love working with children, have a lot to offer this emerging profession. The new apprenticeship pathway available for September 2024 entry offers new possibilities for funding via the apprenticeship levy.
What our students say: Kate Hon
“Training as an ACP in paediatric ophthalmology at Sheffield has offered me great opportunities to learn and develop as part of the ophthalmic team. I’ve enjoyed discussions with fellow trainee ACPs, and relished the opportunities to learn from qualified ACPs and Orthoptists leading the way to expand the Orthoptic role in leadership and education as well as clinical aspects.
"I have also benefited from discussion with students further on in their ACP and would encourage other Orthoptists, Optometrists and ophthalmic nurses to consider how the specialised ACP in paediatric ophthalmology course could support their career journey.”
Kate Hon (2nd year tACP in paediatric ophthalmology)
What does the work involve?
Throughout the three years of part-time online MMedSci study, trainee ACPs gradually take on paediatric ophthalmology clinical workload with the support of a local mentor – a paediatric ophthalmologist who provides the role of clinical supervisor and supports with clinical learning. Trainee ACPs study core and optional areas of the paediatric ophthalmology curriculum, chosen to suit their personal and paediatric service needs. The curriculum includes clinical topics such as: blepharitis and BKC, dry eye, allergic conjunctivitis and VKC, juvenile idiopathic arthritis associated uveitis, inherited retinal disease, retinal imaging, electrodiagnostic testing, refraction and retinoscopy, detecting glaucoma, managing contact lenses, cerebral visual impairment, communicating with vision impaired children, optic disc screening, nasolacrimal duct obstruction, chalazia, surgical consent, surgical listing and emergency eye care.
Paediatric ophthalmology is an area with high screening demand. Systemic conditions such as juvenile arthritis have ophthalmic complications, which can lead to silent and preventable blindness, if not managed well. Innovative solutions are needed and the advanced skills of ACPs make significant impact. Our programme includes assignments, which require ACPs to detail service implementation plans and evaluate and lead on screening pathways, to equip this profession to transform care and provide vision around clinical education and research within their own unit. There are many professions involved in eye-care and the ACP mandate to work across traditional profession-specific boundaries can positively impact holistic patient care.
How is the programme accredited?
Our programme is accredited with NHS England’s Centre for Advancing Practice, meaning those who successfully complete, will be able to obtain official recognition as ACPs at the end of their studies.
The apprenticeship route
At the University of Sheffield, we’re known for our successful apprenticeship programmes, having been awarded Expert Apprenticeship Provider status by the Department of Education (DfE). This course has been designed to meet the specific skills, knowledge and behaviours that will be required of ACPs in paediatric ophthalmology, fully aligned with the ACP integrated degree standards set out by the Institute for Apprenticeships and Technical Education (IfATE). It is ideal for students who want to fulfil their career aspirations, whilst drawing on the university’s pioneering health research.
What our students say: Emma Gilbert
“I'm approaching the end of the course and starting to make a big, positive impact in clinic, which helps spur me forward through the more challenging aspects of the course. I am now able to autonomously diagnose and manage a range of paediatric patients. As such, numbers seen in our paediatric ophthalmology clinics have increased by six per clinic, meaning approximately 600 extra patients are seen each year. Patients and parents are experiencing streamlined care; better wait times and more senior colleagues have slightly less pressure on them.
"Studying remotely has allowed me to continue working full-time in the South West.
"Paediatric ophthalmology is challenging and has stretched me way beyond my comfort zone, but I love my new role at work and feel all the hard work has really paid off.”
Emma Gilbert (3rd year tACP in paediatric ophthalmology)
How will this help patients?
The new role of ACP in paediatric ophthalmology supports Trusts to continue providing a responsive and accessible paediatric ophthalmology service to patients, amid an acute shortage of paediatric Ophthalmologists. ACPs are expected to demonstrate a high degree of autonomy and make complex decisions; use their expertise and decision-making skills to inform clinical reasoning approaches; and initiate, evaluate and modify interventions. We currently have 45 students taking our programme across three years of study, with first intake completing in August 2024. All of our students testify as to the impact and importance of their role, with many patient comments received around positive tACP interventions and communications. Many patients currently seen by paediatric ophthalmologists, could be successfully managed within an ACP clinic, freeing up consultant time to deal with more complex, challenging and surgical cases.
