Draft guidance for registrants: Speaking Up

Closed 10 Mar 2021

Opened 17 Dec 2020

Contact

Natalie Michaux

(Standards Manager)

Policy & Standards

nmichaux@optical.org

Feedback updated 1 Nov 2021

We asked

We created speaking up guidance for our registrants in response to recommendations following The Mid Staffordshire NHS Foundation Trust Public Inquiry in 2013, the subsequent Freedom to speak up report and the creation of the National Guardian’s Office in England. We wanted to play our part in making sure that everyone working in the optical sector is free and able to speak up about concerns they have, and therefore created the guidance to make our expectations clear and, hopefully, give our registrants more confidence in speaking up when they need to.

We asked for stakeholders’ views on:

  • the clarity, accessibility and ease of use of the guidance;
  • whether the guidance would give more confidence in knowing what to do if a registrant encountered a patient/public safety concern;
  • whether the guidance would give a registrant confidence to speak up if they identified patient safety concerns;
  • whether there was anything missing, incorrect or unclear in the guidance;
  • whether the guidance was sufficiently flexible to accommodate differences in policy and practice across the nations of the UK;
  • whether the guidance would help to protect patient and public safety;
  • whether there were any specific issues or barriers which might prevent registrants from using the guidance;
  • whether there were any aspects of the guidance that could have an adverse or negative impact on patients and the public, individual registrants, businesses or others;
  • whether there were any aspects of the guidance that could discriminate against stakeholders with specific characteristics; and
  • the extent to which the guidance would have a positive impact on patients and the public, individual registrants, businesses or others.

We also asked about whether there would be any specific supporting activities that would be beneficial to registrants in implementing the guidance and if there was anything further we could do to promote speaking up and a culture of openness and honesty within optical care.

You said

Our 12-week public consultation closed in March 2021 and we received 72 responses from a range of stakeholders including individual registrants and professional/representative organisations. Overall, there were mixed views from respondents on the draft guidance, revealing general support for the guidance in principle but a great deal of hesitance and nervousness around speaking up about potential harm which was only partly allayed by the guidance.

A full summary of the findings from the consultation are available on pages 6-7 of the ‘GOC response to the consultation’ (available at the end of this section). Key findings from the consultation were:

  • 56% of respondents thought the draft guidance was presented in a way that was clear, accessible and easy to use;
  • 52% of respondents thought that the draft guidance would give them more confidence in knowing what to do if they had a patient safety concern;
  • 38% of respondents thought that the draft guidance would give them confidence to speak up about those concerns;
  • 46% of respondents thought there was something missing, incorrect or unclear in the guidance;
  • 39% of respondents thought that the draft guidance was sufficiently flexible to cover all four nations of the UK;
  • 48% of respondents said that the guidance would help to protect patient and public safety;
  • 67% of respondents thought that there were specific issues or barriers which might prevent registrants from using the guidance;
  • 34% of respondents said that aspects of the guidance could have an adverse impact on patients and the public, individual registrants, businesses or others;
  • 56% of respondents did not think there were any aspects of the guidance that could discriminate against stakeholders with specific characteristics;
  • 62% of respondents thought that specific supporting activities would be helpful to registrants in implementing the guidance;
  • 74% of respondents thought that there was more the GOC could do to promote speaking up and a culture of openness and honesty within optical care; and
  • 52% of respondents thought that overall, the guidance would have either a positive impact or a very positive impact on patients and the public, individual registrants, businesses or others.

We did

We reviewed the feedback received during the consultation and made amendments to the guidance, including:

  • giving more information about the use of the terms “speaking up”, “whistleblowing” and “raising concerns”, and the link between them;
  • more clearly explaining our rationale for using the term “speaking up”;
  • more clearly explaining the difference between “speaking up” and “duty of candour”, and the link between them;
  • emphasising the importance of registrants seeking advice from their professional/representative body, trade union and/or speaking up guardians in local optical committees or employers;
  • adding a new paragraph on barriers to speaking up, which addresses the impact of structural inequalities, emphasising this in the section for businesses;
  • making it clear that businesses should do all they can to create an appropriate culture for speaking up and that we will investigate instances of victimisation and discrimination;
  • confirming that we would take very seriously and have the power to take action against any individual or business registrant who discourages anyone from speaking up or treats anyone unfairly because of speaking up; and
  • adding a flowchart to summarise the process to be followed.

Further detail about the amendments and the areas we considered are in our ‘GOC response to the consultation’ located at the end of this section (see pages 30-32 for the conclusions). An updated impact assessment is also available.

The new guidance is available on our Standards site.

Results updated 28 Oct 2021

Files:

Overview

Within the GOC’s Standards of Practice for Optometrists and Dispensing Opticians there is a requirement at Standard 11 to protect and safeguard patients, colleagues and others from harm. This includes expectations to raise concerns about patient/public safety, act on them (if within the individual’s remit) or escalate them if they remain unresolved. There are similar expectations on business registrants under the Standards for Optical Businesses (Standard 1.1) and students under the Standards for Optical Students (Standard 10). We call 'raising concerns' in this way 'speaking up'. You may have also heard the term 'whistleblowing' used to describe it.

We know that there are difficulties with healthcare professionals being able to speak up about patient/public safety and have their concerns listened to and dealt with appropriately. The majority of recent inquiries into wrongdoing within NHS trusts show that staff had concerns about what was happening at an early stage, but they were either blocked from raising them or not taken seriously. The Mid Staffordshire NHS Foundation Trust Public Inquiry in 2013, tasked with looking at a series of failings at Mid Staffordshire NHS Foundation Trust, recommended the formation of the National Guardian’s Office to champion speaking up by staff and that regulators incorporate a duty of candour into their professional standards. A number of more recent inquiries, including the Paterson Inquiry and the Gosport Independent Panel, have also highlighted incidences of concerns being raised by staff but not appropriately actioned.

We are keen to play our part in making sure that everyone working in the optical sector is free and able to speak up about concerns they have, and therefore have created this guidance to make our expectations clear and, hopefully, give our registrants more confidence in speaking up when they need to.

The speaking up guidance on which we are consulting is available to download at the bottom of this page under 'related'.

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