Orthoptists

At the point of registration, orthoptists must be able to:

• 1. practise safely and effectively within their scope of practice

  
  1.1 identify the limits of their practice and when to seek advice or refer to another professional or service

  1.2 recognise the need to manage their own workload and resources safely and effectively, including managing the emotional burden that comes with working in a pressured environment

  1.3 keep their skills and knowledge up to date and understand the importance of continuing professional development throughout their career

   

• 2. practise within the legal and ethical boundaries of their profession

  
  2.1 maintain high standards of personal and professional conduct

  2.2 promote and protect the service user’s interests at all times

  2.3 understand the importance of safeguarding by actively looking for signs of abuse, demonstrating understanding of relevant safeguarding processes and engaging in these processes where necessary

  2.4 understand what is required of them by the Health and Care Professions Council, including, but not limited to, the standards of conduct, performance and ethics

  2.5 respect and uphold the rights, dignity, values and autonomy of service users, including their role in the assessment, diagnostic, treatment and/or therapeutic process

  2.6 recognise that relationships with service users, carers and others should be based on mutual respect and trust, maintaining high standards of care in all circumstances

  2.7 understand the importance of and be able to obtain valid consent, which is voluntary and informed, has due regard to capacity, is proportionate to the circumstances and is appropriately documented

  2.8 understand the importance of capacity in the context of delivering care and treatment

  2.9 understand the scope of a professional duty of care, and exercise that duty

  2.10 understand and apply legislation, policies and guidance relevant to their profession and scope of practice

  2.11 recognise the power imbalance that comes with being a healthcare professional, and ensure they do not abuse this for personal gain

   

• 3. look after their health and wellbeing, seeking appropriate support where necessary

  
  3.1 identify anxiety and stress in themselves and recognise the potential impact on their practice

  3.2 understand the importance of their own mental and physical health and wellbeing strategies in maintaining fitness to practise</strong>

  3.3 understand how to take appropriate action if their health may affect their ability to practise safely and effectively, including seeking help and support when necessary

  3.4 develop and adopt clear strategies for physical and mental self-care and self-awareness, to maintain a high standard of professional effectiveness and a safe working environment

   

• 4. practise as an autonomous professional, exercising their own professional judgement

  
  4.1 recognise that they are personally responsible for, and must be able to justify, their decisions and actions

  4.2 use their skills, knowledge and experience, and the information available to them, to make informed decisions and/or take action where necessary

  4.3 make reasoned decisions to initiate, continue, modify or cease treatment, or the use of techniques or procedures, and record the decisions and reasoning appropriately

  4.4 make and receive appropriate referrals, where necessary

  4.5 exercise personal initiative

  4.6 demonstrate a logical and systematic approach to problem-solving

  4.7 use research, reasoning and problem-solving skills when determining appropriate actions

  4.8 understand the need for active participation in training, supervision and mentoring in supporting high standards of practice, and personal and professional conduct, and the importance of demonstrating this in practice

  4.9 coordinate a complete service user pathway, where appropriate, and in line with local guidelines

   

• 5. recognise the impact of culture, equality and diversity on practice and practise in a non-discriminatory and inclusive manner

  
  5.1 respond appropriately to the needs of all groups and individuals in practice, recognising that this can be affected by difference of any kind including, but not limited to, protected characteristics,* intersectional experiences and cultural differences

  5.2 understand equality legislation and apply it to their practice

  5.3 recognise the potential impact of their own values, beliefs and personal biases (which may be unconscious) on practice and take personal action to ensure all service users and carers are treated appropriately with respect and dignity

  5.4 understand the duty to make reasonable adjustments in practice and be able to make and support reasonable adjustments in their and others’ practice

  5.5 recognise the characteristics and consequences of barriers to inclusion, including for socially isolated groups

  5.6 actively challenge these barriers, supporting the implementation of change wherever possible

  5.7 recognise that regard to equality, diversity and inclusion needs to be embedded in the application of all HCPC standards, across all areas of practice
  
  

  * The Equality Act 2010 defines the protected characteristics as age, disability, gender reassignment, race, religion or belief, sex, sexual orientation, marriage and civil partnership and pregnancy and maternity. Equivalent equality legislation in Northern Ireland protects age, disability, gender, race, religion or belief and sexual orientation.
  
  
  

• 6. understand the importance of and maintain confidentiality

  
  6.1 adhere to the professional duty of confidentiality and understand when disclosure may be required

  6.2 understand the principles of information and data governance and be aware of the safe and effective use of health, social care and other relevant information

  6.3 recognise and respond in a timely manner to situations where it is necessary to share information to safeguard service users, carers and/or the wider public

  6.4 understand the need to ensure that confidentiality is maintained in all situations in which service users rely on additional communication support (such as interpreters or translators)

  6.5 recognise that the concepts of confidentiality and informed consent extend to all mediums, including illustrative clinical records such as photography, video and audio recordings and digital platforms

   

• 7. communicate effectively

  
  7.1 use effective and appropriate verbal and non-verbal skills to communicate with service users, carers, colleagues and others

  7.2 communicate in English to the required standard for their profession (equivalent to level 7 of the International English Language Testing System, with no element below 6.5*)

  7.3 understand the characteristics and consequences of verbal and non-verbal communication and recognise how these can be affected by difference of any kind, including, but not limited to, protected characteristics,* intersectional experiences and cultural differences

  7.4 work with service users and/or their carers to facilitate the service user’s preferred role in decision-making, and provide service users and carers with the information they may need where appropriate

  7.5 modify their own means of communication to address the individual communication needs and preferences of service users and carers, and remove any barriers to communication where possible

  7.6 understand the need to support the communication needs of service users and carers, such as through the use of an appropriate interpreter

  7.7 use information, communication and digital technologies appropriate to their practice

  7.8 understand the need to provide service users or people acting on their behalf with the information necessary, in accessible formats, to enable them to make informed decisions

  7.9 recognise the need to modify interpersonal skills for the assessment and management of children
  
  

  * The International English Language Testing System (IELTS) tests competence in the English language. Applicants who have qualified outside of the UK, whose first language is not English and who are not applying through the Swiss Mutual Recognition Route (SMR) must provide evidence that they have reached the necessary standard. More information is available here: Statement on English language proficiency requirements for internationally trained health and care professionals.
  
  ** The Equality Act 2010 defines the protected characteristics as age, disability, gender reassignment, race, religion or belief, sex, sexual orientation, marriage and civil partnership and pregnancy and maternity. Equivalent equality legislation in Northern Ireland protects age, disability, gender, race, religion or belief and sexual orientation.
  
  

   

• 8. work appropriately with others

  
  8.1 work in partnership with service users, carers, colleagues and others

  8.2 recognise the principles and practices of other health and care professionals and systems and how they interact with their profession

  8.3 understand the need to build and sustain professional relationships as both an autonomous practitioner and collaboratively as a member of a team

  8.4 contribute effectively to work undertaken as part of a multi-disciplinary team

  8.5 identify anxiety and stress in service users, carers and colleagues, adapting their practice and providing support where appropriate

  8.6 understand the qualities, behaviours and benefits of leadership

  8.7 recognise that leadership is a skill all professionals can demonstrate

  8.8 identify their own leadership qualities, behaviours and approaches, taking into account the importance of equality, diversity and inclusion

  8.9 demonstrate leadership behaviours appropriate to their practice

  8.10 act as a role model for others

  8.11 promote and engage in the learning of others

  8.12 understand the need to engage service users and carers in planning and evaluating diagnostics and therapeutic interventions to meet their needs and goals

  8.13 recognise the need to participate effectively in the planning, implementation and evaluation of multi-professional approaches to healthcare delivery by liaising with other health or social care professionals

  8.14 recognise the orthoptist’s role in the promotion of ocular health by other health professionals

   

• 9. maintain records appropriately

  
  9.1 keep full, clear and accurate records in accordance with applicable legislation, protocols and guidelines

  9.2 manage records and all other information in accordance with applicable legislation, protocols and guidelines

  9.3 use digital record keeping tools, where required

   

• 10. reflect on and review practice

  
  10.1 understand the value of reflective practice and the need to record the outcome of such reflection to support continuous improvement

  10.2 recognise the value of multi-disciplinary reviews, case conferences and other methods of review

   

• 11. assure the quality of their practice

  
  11.1 engage in evidence-based practice

  11.2 gather and use feedback and information, including qualitative and quantitative data, to evaluate the response of service users to their care

  11.3 monitor and systematically evaluate the quality of practice, and maintain an effective quality management and quality assurance process working towards continual improvement

  11.4 participate in quality management, including quality control, quality assurance, clinical governance and the use of appropriate outcome measures

  11.5 evaluate care plans or intervention plans using recognised and appropriate outcome measures, in conjunction with the service user where possible, and revise the plans as necessary

  11.6 recognise the value of gathering and using data for quality assurance and improvement programmes

   

• 12. understand and apply the key concepts of the knowledge base relevant to their profession

  
  12.1 understand the structure and function of the human body, together with knowledge of physical and mental health, disease, disorder and dysfunction relevant to their profession

  12.2 demonstrate awareness of the principles and applications of scientific enquiry, including the evaluation of treatment efficacy and the research process

  12.3 recognise the role(s) of other professions in health and social care and understand how they may relate to the role of orthoptists within the integrated teams that serve communities

  12.4 understand the structure and function of health and social care systems and services in the UK

  12.5 understand human growth, physical and mental, and human development across the lifespan, as it relates to the practice of orthoptics

  12.6 understand the development of anatomical substrates and their relevance to the development of binocular single vision, visual function and visual perception

  12.7 know the detailed anatomical and physiological development of the visual system, and understand which components of the visual pathway and cortex relate to specific aspects of visual function and visual perception

  12.8 understand neuroanatomy and the effects of disruption of neural pathways on the visual system, cranial nerves and supranuclear control of eye movements

  12.9 know the factors which influence individual variations in human ability and development

  12.10 demonstrate awareness of human behaviour and recognise the need for sensitivity to the psychosocial aspects of ocular conditions, including strabismus

  12.11 know how psychology and sociology can inform an understanding of health, illness and healthcare in the context of orthoptics, and know how to apply this in practice

  12.12 understand the theoretical basis of, and the variety of approaches to, assessment and intervention

  12.13 understand ocular alignment and binocular single vision, and the sensory and motor elements required to attain and maintain these

  12.14 know the principles governing visual function and the development of vision, and be able to apply them to clinical practice

  12.15 understand the factors which can cause the disruption of binocular vision

  12.16 know the principles governing binocular vision, its investigation and the significance of its presence or absence, and be able to apply them to clinical practice

  12.17 understand the principles of uniocular and binocular perception, and the anatomical substrate of these functions

  12.18 understand refractive error and its effect on ocular alignment, visual perception and visual development

  12.19 know how convergence, accommodation and pupillary response affect investigation, diagnosis and service user management, and be able to apply them to clinical practice

  12.20 understand ocular motility systems, their neural control and how typical and atypical anatomical structures influence them

  12.21 know the principles governing ocular motility and their relevance to diagnosis and management, and be able to apply them to clinical practice

  12.22 know the sensory and motor adaptive mechanisms that occur in order to compensate for strabismus and abnormalities of binocular vision

  12.23 recognise the functional and perceptual difficulties that may arise as a result of defective visual, binocular or ocular motor functions

  12.24 understand the effect of other acquired disorders of the body on the eye, the visual and ocular motor systems including paediatric, endocrine, autoimmune, oncological, trauma, psychological and neurological disease

  12.25 know about the range of ophthalmic conditions which can disrupt vision, binocular vision and produce eye movement disorders

  12.26 understand the principles and application of orthoptic and ophthalmological equipment used during the investigative process 

  12.27 plan, operate and evaluate appropriate vision screening programmes

  12.28 demonstrate safe use of medicines, including being able to undertake drug calculations accurately

  12.29 understand pharmacological principles which include pharmacodynamics and pharmacokinetics of medicines relevant to their practice and how these may be altered by certain characteristics

  12.30 understand the legal context relevant to the use of exemptions in legislation for the sale, supply and administration of medicines, as well as current local and national policy and guidance concerning medicines use

  12.31 understand the differences between the sale, supply and administration of medicines using exemptions, other supply or administration mechanisms and prescribing mechanisms

  12.32 understand when to sell or supply medicines using exemptions, based on a relevant examination, assessment and history taking

  12.33 understand the different non-pharmacological and pharmacological approaches to modifying disease management relevant to their practice and the risks and benefits of each option

  12.34 understand the potential for medicines to have adverse effects and how to minimise them including effects caused by medicines given in error

  12.35 monitor response to medicines and modify or cease treatment as appropriate within their professional scope of practice, including referral to another professional

  12.36 apply the principles of evidence-based practice, including clinical and cost-effectiveness, to the supply and administration of exemption listed medicines relevant to their practice

  12.37 understand antimicrobial resistance and the roles of infection prevention and control

  12.38 understand the importance of shared decision-making with service users to encourage self-care and adherence with medicines advice

   

• 13. draw on appropriate knowledge and skills to inform practice

  
  13.1 change their practice as needed to take account of new developments, technologies and changing contexts

  13.2 gather appropriate information

  13.3 analyse and critically evaluate the information collected

  13.4 select and use appropriate assessment techniques and equipment

  13.5 undertake thorough, sensitive and detailed patient medical history, including an appropriate medication history

  13.6 undertake or arrange investigations as appropriate

  13.7 conduct appropriate assessment or monitoring procedures, treatment, therapy or other actions safely and effectively

  13.8 recognise a range of research methodologies relevant to their role

  13.9 recognise the value of research to the critical evaluation of practice

  13.10 critically evaluate research and other evidence to inform their own practice

  13.11 engage service users in research as appropriate

  13.12 use diagnostic and therapeutic procedures to address anomalies of binocular vision, visual function and ocular motility defects, resulting in a clinically defined outcome, which can be recorded and monitored in a manner appropriate to safe orthoptic practice

  13.13 know the principles and application of measurement techniques used to assess binocular vision and other ocular conditions

  13.14 conduct a thorough investigation of ocular motility

  13.15 take a comprehensive case history

  13.16 know the tests required to aid in differential diagnosis

  13.17 identify where there is a clinical need for medical, neurological, social or psychological investigations or interventions

  13.18 use investigative techniques to identify ocular defects within a specific population to form a diagnosis and devise an appropriate course of action

  13.19 diagnose conditions and select appropriate management

  13.20 diagnose a range of vision, binocular vision and ocular motility defects and all categories of strabismus

  13.21 identify pathological changes and related clinical features of conditions commonly encountered by orthoptists

  13.22 understand the principles and techniques of, and be able to perform, an objective and subjective refraction

  13.23 understand the principles and techniques used, and be able to perform, an examination of the anterior and posterior segments of the eye

  13.24 understand the principles and techniques used, and be able to perform, visual field assessments

  13.25 understand the principles and techniques used in electrophysiological assessment of visual function and the visual pathway

  13.26 formulate specific and appropriate management plans, and set timescales

  13.27 know how to apply orthoptic and ophthalmological intervention appropriately at different stages of visual development and ageing

  13.28 know how to use optical methods to influence vision and binocular vision

  13.29 recognise and document any adverse reaction to treatment and take appropriate action in response to this

  13.30 know the role, pharmacological action, clinical indications and contra-indications of ophthalmic drugs and how they may be selected and used in orthoptic practice

  13.31 understand research in the fields of ocular motility, strabismus, amblyopia and binocular disorders and how it could affect practice

   

• 14. establish and maintain a safe practice environment

  
  14.1 understand the need to maintain the safety of themself and others, including service users, carers and colleagues

  14.2 demonstrate awareness of relevant health and safety legislation and comply with all local operational procedures and policies

  14.3 work safely, including being able to select appropriate hazard control and risk management, reduction or elimination techniques, in a safe manner and in accordance with health and safety legislation

  14.4 select appropriate personal protective equipment and use it correctly

  14.5 establish safe environments for practice, which appropriately manage risk

  14.6 know how to position or immobilise service users correctly for safe and effective interventions

   

• 15. promote health and prevent ill health

  
  15.1 understand the role of their profession in health promotion, health education and preventing ill health

  15.2 understand how social, economic and environmental factors (wider determinants of health) can influence a person’s health and wellbeing

  15.3 empower and enable individuals (including service users and colleagues) to play a part in managing their own health

  15.4 engage in occupational health, including being aware of immunisation requirements

   

• Development

  We first published standards of proficiency for orthoptists when our Register opened in July 2003.

  We review the standards regularly to look at how they are working and to check whether they continue to reflect current practice in the professions we regulate. Our most recent review began in 2019 and included a formal consultation and close collaboration with key stakeholders, registrants and professional bodies. The revised sets of standards for all 15 professions were formally approved by our Council in March 2022 and came into effect on 1 September 2023. 

  The profession-specific standards for orthoptists were developed with the input of the relevant professional bodies and the views of stakeholders during our consultation work. We are confident that the standards are fit for purpose and reflect safe and effective professional practice in orthoptics.

• Ensuring the standards remain relevant

  As part of our commitment to ensuring the standards remain relevant to current professional practice, will continue to listen to our stakeholders and keep the standards under regular review.

  This may result in updates to the standards in future, which may include corrections, amendments or changes to ensure the standards remain relevant.

  This is a crucial component in fulfilling our purpose to promote excellence in the professions we regulate, and championing high quality care that the public can access safely and with confidence.  

• Publication information

  This document contains minor amendments to typographical errors, meaning it may differ slightly from previous versions published on our website.

  The publication code for these standards is 20230901POLPUB ORSoP.