We Asked, You Said, We Did

We asked

We sought views, information and factual evidence on the need for change to the Opticians Act 1989 (‘the Act’) (the legislation that underpins the regulatory work of the GOC, as well as defining some aspects of optometry and dispensing optics practice). We also sought views through a consultation on associated GOC policies.  

The call for evidence and consultation covered a wide range of areas including: protection of title, restricted activities and registers; regulation of businesses; testing of sight; fitting of contact lenses; sale and supply of optical appliances; and delivery of remote care and technology.

We consulted for 16 weeks from 28 March to 18 July 2022. We asked respondents a range of questions, including a) if the legislation created any unnecessary regulatory barriers, b) what the advantages, disadvantages and impacts were of the legislation remaining as it is, and c) what the arguments were in favour of and against changing the legislation.

You said

We received 353 consultation responses from a range of stakeholders including optical representative organisations, patients and members of the public, government, education providers, optical businesses and our registrants. The findings are summarised in our analysis of responses.

We have published responses where respondents gave us permission to publish. Responses from organisations who gave us permission to publish their names can be viewed from the 'published responses' section further down this page. All other responses can be viewed in the 'files' section further down this page in a document containing the file name 'combined redacted responses'.

We did

We discussed an initial analysis of responses with our Council at its meeting in September 2022 and decided to carry out further research in the areas of refraction and business regulation to fill the gaps in our knowledge and evidence base. The research reports are published on our website: https://optical.org/en/publications/policy-and-research/research-associated-with-the-call-for-evidence-on-the-opticians-act

We shared our full analysis of responses and the above research with our Council at its meeting in March 2023 (papers are available here). Council agreed to the publication of our GOC response to the call for evidence on the Opticians Act and consultation on associated GOC policies located in the 'files' section further down this page – see the executive summary for details of the commitments we made. An impact assessment is also available.

We asked

The GOC’s overarching objective is the protection of the public. Although not a specific statutory duty, or part of our core functions, we may act on reports about alleged illegal optical practice (illegal practice) when necessary to protect the public.

Illegal practice is conduct that amounts to a criminal offence under Part IV of the Opticians Act 1989 ('the Act'). We carried out a review of our illegal practice strategy and protocol because we wanted to be more proactive in our approach to illegal practice and provide clarity on when we will take action and what action will be taken.

We undertook a full public consultation on our proposed updates to the policy, which was open for 12 weeks from 27 October 2021 to 24 January 2022. We consulted on an updated illegal practice protocol which included the following changes:

• the addition of acceptance criteria;
• setting out our approach to illegal online sales;
• requiring early lawyer input into investigations;
• the introduction of a process for test purchases; and
• greater clarity about when we will consider a prosecution.

You said

We received 26 written consultation responses from a range of stakeholders including optical representative organisations and our registrants.

Key findings from the consultation were:

• 42% agreed or strongly agreed that the updated protocol links more closely with our overarching objective of protecting the public (the same percentage disagreed);
• 42% agreed or strongly agreed that the updated protocol will improve sector awareness of our remit regarding illegal optical practice;
• 58% agreed or strongly agreed that the updated protocol will provide clarity on when we will act and what action will be taken;
• 61% felt that there were matters unclear or missing from the protocol; and
• 62% felt there were no aspects of the updated protocol that could discriminate against stakeholders with specific characteristics.

We did

Based on feedback received during the consultation we have decided to make the following amendments to the protocol that we consulted on:

• potential for serious harm has been included as a factor indicating higher risk in addition to actual harm caused by illegal practice;
• the case assessor and/or reviewing lawyer will seek advice from the GOC’s clinical advisers about clinical risk in appropriate cases;
• sections about legislation relating to the testing of sight and sale of prescription spectacles have been made clearer; and
• provision that the GOC may re-open a complaint following a referral to a third party if the third party is unable to act and the statutory time limit for bringing a prosecution has not expired

Further detail about the amendments and the areas we considered are in our GOC response to the consultation located in the 'files' section below (see pages 15-18 for the conclusions). An impact assessment is also available.

We published the updated protocol on our website on 29 June 2022: https://optical.org/en/publications/illegal-practice-protocol/  

We asked

We consulted on proposals to update our requirements for specialist entry to the GOC register as a Contact Lens Optician.

You said

In general, the proposed Outcomes and Standards for approved qualifications for specialist entry to the GOC register as a Contact Lens Optician were positively received. Our consultation closed in January 2022 and we received 29 responses.

We commissioned Enventure Research to analyse the responses and the report is available to view on our website.

We did

We welcome the feedback received and have reflected on the points that have been raised in the feedback to this consultation. As a result, a number of minor amendments were made to the Outcomes and Standards for Approved Qualifications for Specialist Entry to the GOC Register as a Contact Lens Optician. The record of amendments to the Contact Lens Optician Education and Training Requirements following the Public Consultation may be found on page 303 of the June 2022 GOC Council meeting papers. 

We asked

We asked stakeholders for their views on our proposals to update our requirements for specialist entry to the GOC register in the additional supply (AS), supplementary prescribing (SP) and/or independent prescribing (IP) categories.

You said

In general, the proposed Outcomes and Standards for approved qualifications for specialist entry to the GOC register (AS, SP, IP) and Quality Assurance Method were positively received. There was broad agreement that trainees acquiring a single qualification will help simplify and streamline the route to speciality registration.

Concerns related to detailed points, notably:

• when a suitably experienced and qualified designated prescribing practitioner (DPP) should be selected to supervise trainees learning in practice and the potential adverse impact if is required at the application stage
• whether the Royal Pharmaceutical Society’s (RPS) Competence Framework for all Prescribers should be used instead of the proposed Outcomes (AS, SP, IP), and;
• whether the stipulated timeline to start implementing the proposals (July 2022) is too ambitious given that providers will require 12-18 months to adapt existing approved IP qualifications to meet the new requirements.

We did

We welcome the feedback received and have reflected on the points that have been raised in this consultation. To help implement the proposals, the GOC Council on 8 December 2021 approved the use of reserves of up to £60,000  over a period of three years (2022 - 2025) to facilitate a cross-sector knowledge-led collaboration and information exchange.

In relation to the detailed points noted above (‘You said’), we decided that:

• the DPP should be identified upon or shortly after admission rather than at application stage
• the proposed Outcomes (AS,SP, IP) should be used rather than adopting the RPS Competency Framework for all Prescribers as the framework was drafted explicitly to inform regulators in developing minimum benchmarks for prescribing programmes rather than to replace such requirements, and;
• the timeline for providers to work towards admitting trainees to approved qualifications for specialist entry to the GOC register (AS, SP, IP) should be changed to September 2023 instead of July 2022.

We asked

We asked stakeholders to provide feedback on proposed updates to the GOC Remote Hearings protocol. We were conscious that we implemented the original protocol at pace following rapid consultation and have sought to embed some of the positive principles that we implemented since March 2020. We conducted a full public consultation to assess the impact, benefits or disbenefits to these proposals.

You said

There was a positive consensus in terms of the changes to the protocol. Most respondents agreed that the updated protocol achieved our aim of maintaining the focus on public protection while balancing fairness to registrants. There were some minor elements identified that could be tweaked to achieve the best outcomes. The general feedback suggested:

• The majority agreed with our expectations that most non-substantive events should be conducted remotely. Although some suggested that this should be with the caveat that a physical hearing could be scheduled if required.
• The definitions set out by the GOC as to when the suitability factors for no or minimal government restrictions could be clearer.
• Respondents considered that there were occasions when contested evidence could be dealt with at remote hearings. Suitability factors should not be so narrow to avoid a remote hearing where contested evidence is present.
• The GOC should remove reference to the Coronavirus Amendment Rules which would expire by the time the new document is published.
• The GOC should review advice relating to taking a religious oath or affirmation in line with the Equal Treatment Bench Book.

We did

We reviewed the responses from the consultation and decided whether to accept, reject or incorporate the feedback. The following amendments have been made:

• Made it clear that we expect most non-substantive events to take place remotely but will consider all relevant factors to decide on the best mode of hearing.
• The definitions as to when suitability factors should be used have been revised.
• Removed reference in the suitability factors which implied that contested evidence would be more appropriate at an in-person hearing.
• Removed reference to the Coronavirus Amendment Rules and instead set out the process of adjournments in line with our current Rules.
• Confirmed that the oath or affirmation can be taken even if the holy book is not physically present in accordance with the Equal Treatment Bench book.

We will hold a review of the protocol no later than 31 December 2022 to ensure it remains up to date and invite you to continue to relay your thoughts and experiences during this time to Vineeta Desai – vdesai@optical.org

We asked

There are circumstances in which our legislation requires us to issue statutory notices or notifications (‘notices’) to our registrants (for example, removal of a registrant from the register, refusal to retain or restore a registrant on/to the register, or notice of an interim order hearing) or applicants seeking initial registration or to restore to the register. We are committed to doing this in a way that is fair to registrants/individuals and in line with the requirements of our legislation.

We recognised that there may be additional risks in sending notices by email and so we drafted a policy setting out the safeguards that we will apply to ensure fairness to our registrants and applicants seeking initial registration or restoration.

We consulted on a draft policy for 12 weeks from 30 June to 22 September 2021. We asked respondents about the content of the policy, whether there was anything unclear or missing, where there were any aspects of the policy that could discriminate against or have positive impacts on stakeholders with specific characteristics, and whether there were any other impacts of the policy.

You said

We received ten written consultation responses from a range of stakeholders including optical representative organisations and our registrants.

Key findings from the consultation were:

• 75% agreed or strongly agreed with the content of the policy;
• 62.5% felt that there was something unclear or missing in the policy;
• 62.5% did not think there were any aspects of the policy that could discriminate against stakeholders with specific characteristics;
• 25% thought there were aspects of the policy that could have positive impacts on stakeholders with specific characteristics; and
• 37.5% told us that there were other impacts of the policy that they would like to tell us about.

We did

Overall, there was support for the amended policy from our stakeholders, with suggestions for additions and amendments, particularly from the professional/representative and defence bodies.

On the basis of feedback received during the consultation we made the following amendments to the policy:

• we amended the policy to ensure it is clear that we will comply with section 23A(3) of the Opticians Act 1989 when implementing The General Optical Council (Committee Constitution, Registration and Fitness to Practise) (Coronavirus) (Amendment) Rules 2020;
• we clarified when we will implement the policy on the MyGOC database;
• we updated the consent clause to make it clear:
  • which email address registrants are consenting to and what to do if they wish to change their email address; and
  • that if they do not consent, they will continue to receive other communications except statutory notices by email;
• we clarified that the policy does not apply to our communications with other participants in the fitness to practise process (for example, complainants or witnesses) as this is outside its scope;
• we gave examples of routine fitness to practise correspondence and what reasonable attempts the Fitness to Practise team will make in checking that a notice has been received;
• we made it clear that if we are not satisfied that notice of a hearing sent by email has been received by the individual/registrant, we will send the notice by first class post and, subject to our overriding duty of public protection, we will ensure there is sufficient time for the individual/registrant to prepare in line with statutory timescales;
• we clarified the attempts we will make to contact someone after sending a notice of failure to apply for renewal to anyone who has not renewed their registration in advance of the renewal deadline;
• we made it clear that we will also serve notice by post if we are not satisfied that a registrant is aware of their removal from the register; and
• we amended the paragraph on reasonable adjustments to make it clear that where we receive information that a registrant who has previously consented to receive notices by email may find it difficult to process them in this way (for example, because of a health condition), we will endeavour to meet the needs of the registrant and will consider all reasonable adjustments on a case by case basis.

Further detail about the amendments and the areas we considered are in our GOC response to the consultation located in the 'files' section below (see pages 13-16 for the conclusions). An updated impact assessment is also available.

We published the policy on our website on 20 December 2021: https://optical.org/en/publications/service-of-notices-by-email-policy/

We asked

We asked stakeholders to provide feedback on proposed updates to the GOC Indicative Sanctions Guidance. The aim of this guidance is to assist members of the Fitness to Practise Committee (“FtPC”) to understand their individual and collective responsibilities, leading to the making of fair and just decisions. It was developed by the Council for use by its FtPC when hearing cases and considering what sanction, if any, to impose following a finding of impairment.

You said

Most respondents agreed or strongly agreed that the updated guidance achieved our aim of assisting members of the FtPC to understand their responsibilities and enable the making of fair and just decisions. We are very grateful for the positive and constructive feedback that we received, which included:

• It could be made clearer in the guidance that the FtPC has a duty to the public to provide clear and cogent reasons so that its decision and the reasons for it can be clearly understood.
• The guidance on when a hearing may be heard in private could set out the principle of open justice more clearly.
• A case involving discrimination could be added as a type of case in which a more serious sanction is likely to be appropriate.
• More recent case law could be added in some areas.

We did

We reviewed the responses from the consultation and decided whether to accept, reject or incorporate the feedback. The following amendments have been made:

• We re-drafted the guidance on decision making so that it is clear to the FtPC that it must have in mind its duty to the public, when giving its reasons for a decision, to ensure that its decision, and the reasons for it, can be clearly understood in the particular circumstances of the case.
• We explained more clearly that hearings involving sensitive allegations or personal matters can be adapted to ensure privacy without the need to hold the hearing in private, depending on the particular circumstances of the case.
• We added cases involving discrimination as an example of a type of case in which a more serious sanction is likely to be appropriate.
• We added recent case law including, Professional Standards Authority for Health and Social Care v General Medical Council [2019] EWHC 1638 (Admin) relating to appropriate sanction for dishonesty and GMC v Awan [2020] EWHC 15553 (Admin) with regard to the FtPC’s approach to insight in cases where facts have been found proved despite a registrant’s denial.

We will hold a review of the guidance no later than 31 March 2023 to ensure it remains up to date

We asked

Our CET exceptions policy consultation sought views on our updates to our ‘Exceptional circumstances in completing CET requirements’ policy. We updated the policy to emphasise public protection, increase transparency in the decision-making process, set out our expectations for registrants on maternity, paternity and adoption leave, and removed the restriction that only those registrants whose exceptional circumstances had resulted in them being unable to practise could be considered under the policy. We felt that the updates to the policy would be fairer to registrants and better protect the public by more clearly setting out our focus on our overriding objective. We asked for stakeholders’ views on:

• to what extent they agreed with our views that the updated policy achieved our aim of appropriately balancing fairness to registrants while maintaining the focus on public protection;
• to what extent they agreed that our expectations for registrants on maternity, paternity or adoption leave sufficiently protected the public;
• whether there was anything unclear or missing;
• whether there were any aspects of the policy that could have a negative or positive impact on stakeholders with protected characteristics; and
• whether there were any other impacts of the policy they wanted to tell us about.

You said

Our consultation closed in July 2021 and we received 28 responses. Overall, there was support for the amended policy from our stakeholders, with suggestions for additions and amendments, particularly from the professional/representative bodies.

Key findings from the consultation were:

• 87% of individual registrants and 67% of professional/representative bodies agreed that the updated policy achieved our aim of appropriately balancing fairness to registrants while maintaining the focus on public protection;
• 72% of individual registrants and 67% of professional/representative bodies agreed that our expectations for registrants on maternity, paternity or adoption leave sufficiently protected the public;
• 25% of individual registrants and 86% of professional/representative bodies thought that there was something unclear or missing in the policy;
• 14% of individual registrants and 71% of professional/representative bodies thought there were aspects of the policy that could discriminate against stakeholders with protected characteristics; and
• 14% of individual registrants and 29% of professional/representative bodies thought there were any aspects of the policy that could have a positive impact on stakeholders with protected characteristics.

We did

We reviewed the feedback received during the consultation and decided to make the following amendments to the policy:

• we have emphasised that the Registrar will first consider the registrant’s reasons for not meeting their CET requirements and whether they took all reasonable steps to meet their requirements but were unable to do so due to exceptional circumstances beyond their control;
• we have clarified that factors associated with COVID-19 could be considered as an example of an exceptional circumstance (this was thought to help with any indirect discrimination that could be experienced by certain groups with protected characteristics under the Equality Act 2010 during the pandemic);
• we have re-ordered and updated the factors to be taken into account by the Registrar during the decision-making process;
• we have updated the examples of decisions from previous cycles with further detail to provide more clarify about the reasoning behind the decision and have changed two of the examples to illustrate a wider range of decisions;
• we have updated examples of evidence; and
• we have clarified our expectations for registrants who have had a period of maternity, paternity or adoption leave during the cycle if they have also experienced ill health during the cycle.

Further detail about the amendments and the areas we considered are in our GOC response to the consultation located at the bottom of this page (see pages 12-17 for the conclusions). An updated impact assessment is also available.

We published the revised policy on the CET exceptions page of our website on 19 October 2021.

We asked

We asked stakeholders to provide feedback on the case management process, following the conclusion of the pilot which ended on 30 April 2021.   

The process was designed to minimise delays that can arise during the pre-hearing preparation period, which led to hearing dates being vacated, and at the hearing stage, where valuable time is often spent dealing with preliminary matters which can ordinarily be resolved before the hearing. 

As part of this process, we expected to facilitate up to two discussions between hearing parties.  These discussions would take place remotely, via a conference call 

We anticipated the first conference call would be held around three months from the date of Rule 29 disclosure on the Registrant. 

The second conference call was expected to take place four to six weeks prior to the first day of the substantive hearing. 

You said

The general feedback was that the case management process was a positive proposal to assist with the timely management of cases.  There were some minor elements that could be tweaked in order to achieve the best outcomes. 

The general feedback suggested: 

The Case Management Meeting plan 

• The meetings are an excellent opportunity for the parties to raise any issues that would ordinarily be left to a much later stage.  It encourages parties to plan ahead and agree matters before the hearing. 

The Hearings Questionnaire 

• The Hearings questionnaire is a useful and effective case management tool, in ascertaining availability and mode of hearing.  There is some information specified in the document which the defence are unable to provide at an early stage, but do not consider it to be an issue. 

• Case management meeting effectiveness could be increased if there was a clear focus on how the APD process will work in suitable cases. 

The conference call record 

• Full consensus that the case management meeting conference call records were a helpful summary for both parties and in particular unrepresented registrants.   

• Records are generally adequately reflective of the discussion, clear and helpful summaries of the call. 

• Noted lack of timetabling to resolve some issues.  Clear deadlines are needed to enable the process to be effective. 

Timings of the Call 

• Generally, there was some consensus in relation to the current timeframes for calls.  This included meetings to be held at three months from the date of disclosure and/or four to six weeks prior to the start date of the substantive hearing so that issues could be resolved.   

• Four weeks before a hearing was considered by some to be too late.  

Additional comments 

• There was strong agreement that a case management meeting is useful tool for all hearing types.  

• Overall, the benefits of having a case management meeting even if no issues arise are likely to outweigh any time implication concerns and are likely to be helpful at avoiding delays. 

We did

We reviewed the feedback from the plan and associated documents, and decided whether to accept, reject or incorporate the feedback in an adapted form. 

The following amendments have been agreed: 

• We propose to launch the revised case management process in September 2021. 

• We have reviewed the timings of the call.  We will offer the first call at three months from the date of disclosure by the GOC to the Registrant.   If parties are unable to hold meaningful discussions at this stage, a call will be offered at around six weeks prior to the start date of the substantive hearing so that a clear timetable can be set when issues need to be resolved.  

• A case management meeting will be arranged for all substantive hearing types, with the exception of conviction only cases which will fall outside of this policy. 

• A call will be arranged at the three month stage so that a clear timetable can be set for agreed panel disposal hearings. 

• We will organise further training to assist the team in effectively managing and timetabling issues.  

We continue to invite you to relay your thoughts and experiences with the case management process so we can continue to improve it. Please contact hearings@optical.org  

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.

We asked

We ran a public consultation seeking stakeholder views on changes we intend to make to our Continuing Education and Training (CET) Rules 2005 (amended in 2012). We are amending our CET Rules in order to underpin the changes that we will introduce at the start of the new three year Continuing Professional Development (CPD) cycle in January 2022.
 

You said

We received 57 responses in total, with 19 from organisations and 38 from individuals. These are some of the key findings. 

• The majority of respondents, 59%, agreed that the amended CET Rules reflected the changes we are seeking to make to the scheme in January 2022.
• The majority of respondents, 62%, thought that the amendments made to the CET Rules were clear.
• Greater clarity was needed on what the CET provider fee, currently set at £45 a year, would be, if this was removed.
• Greater clarity was needed on the ability of registrants to obtain up to 50% of their CPD points from non-approved GOC providers in future.
• Greater clarity was needed about what the GOC expected from registrants in relation to the new requirement to undertake a reflective activity.
• Some dispensing opticians were concerned about introducing a new peer review requirment for this group of registrants. 

We did

We would like to thank all those who responded to the consultation and we have taken on board all the feedback received. The next steps will be for us finalise the amended CET Rules then present this consultation report and the amended Rules to the Department of Health and Social Care (DHSC). In order to amend our CET Rules we will need legislative change including approval from the Secretary of State for Health and Social Care and the Privy Council.

We asked

Our COVID-19 statements consultation sought views on how we could continue to support our registrants and the optical sector throughout the COVID-19 pandemic as different parts of the UK experienced local and potentially national restrictions now and in the future.

In particular, we asked for views on:

• a proposed framework for when our existing COVID-19 statements should apply going forwards, linked to The College of Optometrists’ red/amber/green classification system;
• the content and impact of our existing COVID-19 statements; and
• whether there were further areas of GOC regulations, legislation or guidance that needed to change or be put in place to ensure more effective regulation in the future, either during a pandemic or as a result of the pandemic.

You said

Our consultation closed in January 2021 and we received 72 responses.

We commissioned Enventure Research to analyse the responses and the report is available to view on our website. 

We did

We published our response to the consultation on our website on 28 May 2021.

We decided to align all of our statements to The College of Optometrists’ red/amber/green classification system.

We reviewed all of our statements on the basis of feedback from the consultation and updated each of them, clearly indicating the phase of the pandemic in which they apply.

Our response and the updated COVID-19 statements are available on our COVID-19 latest information webpage.

We asked

We asked stakeholders to provide feedback on our acceptance criteria for business registrants. We recognise the proposed introduction of the criteria could affect a variety of stakeholders.

These acceptance criteria are a case management tool used by the GOC to decide whether a complaint may amount to an allegation of impaired fitness to carry on business as defined by section 13D of the Opticians Act 1989 and requires investigation.

The purpose of the acceptance criteria for business registrants is to ensure that when a complaint is made against a business registrant, a formal investigation is only opened by the fitness to practise department in appropriate cases.

You said

The acceptance criteria for businesses was broadly welcomed and considered to be well drafted. The majority of the feedback received was in relation to the wording of the criteria and making it more ‘user friendly’.

There were further questions/statements which will not be addressed through the acceptance criteria but are addressed separately in other GOC policies/statements. These include:  

• Why is the legislation so restrictive and only allows certain businesses to register with the GOC? The GOC may only register businesses that fall within the registration requirements set out within legislation that was drafted in the 1950s. The legislation is under review but will require parliamentary input to amend.
• What is the internal guidance/policy on applying the criteria? This guidance is contained within the Fitness to Practise triage map and is available on the GOC website: https://www.optical.org/en/get-involved/Council_meetings_and_papers/july-2019.cfm
• Will this criteria put extra responsibilities onto businesses/individuals? No, the acceptance criteria formalises the triage process on receipt of a complaint against a business registrant.
• Further information should be included within the criteria e.g. information for whistle-blowers and further useful contacts. There is a separate whistle-blowing policy available here:  https://www.optical.org/en/Investigating_complaints/raising-concerns.cfm and the website contains further useful contacts.

We did

We reviewed all 23 responses from the consultation and decided whether to accept, reject or incorporate the feedback. The following amendments have been made:

• Replacing ‘legal’ terminology with more user-friendly terminology.
• Clarifying what complaints the GOC will accept when they relate to eye surgery.
• Ensuring consistent phraseology is used.

The acceptance criteria for business registrants is available on our website: https://www.optical.org/en/Investigating_complaints/fitness-to-practise-guidance/  

We will hold a review of the acceptance criteria annually to ensure it remains up to date. We would encourage you to relay your thoughts and experiences during this time to Kayleigh Allen – kallen@optical.org

We asked

We consulted on proposals to update our requirements for approved qualifications leading to registration as an optometrist or a dispensing optician.

You said

Our consultation closed in October 2020 and we received 187 responses.

We commissioned Enventure Research to analyse the responses and the report is available to view on our website.

We did

We published our response to the consultation on our website in February 2021. 

We decided to further develop the Outcomes for Registration, paying particular attention to the development of separate profession-specific outcomes and indictors within the Clinical Practice category of the Outcomes for Registration. 

A sector-led co-produced indicative document has been commissioned to provide more granular guidance on the design of curricula and approaches to assessment for providers of approved qualification providers and those applying for qualification approval in respect of each optical profession's scope of practice.

We continued to review the Standards for Approved Qualifications in light of the detailed commentary received as part of the consultation from individuals and organisations.

We proposed to keep the financial impact assessment under review during the implementation period and will support the sector as appropriate as it makes the case for additional funding.

In response to stakeholder feedback, we have reverted to using our existing term ‘provider’ to describe the awarding body / academic organisation responsible for the award of the approved qualification (in simple terms, the organisation whose name/logo appears on the candidate’s approved qualification certificate).

We asked

We ran a public consultation seeking stakeholder views on changes we intend to make to free up our Continuing Education and Training (CET) scheme, after intially consulting in 2018. We were interested in views on the following proposals:

• Replacing the competencies which currently underpin the scheme, as these are seen as overly prescriptive.
• Allowing registrants more control over their learning and development and the ability to tailor it to their own personal scope of practice.
• Enhancing requirements for registrants to reflect on their practice.
• Changing the name of the scheme from CET to Continuing Professional Development (CPD). 
• Introducing a new proportionate system of CPD approvals.

You said

We received 484 unique responses to the survey - 451 from individuals and 33 from organisations. We also held focus groups and interviews with stakeholders from across the sector and all nations of the UK. These are some of the key findings.

• 42% of respondents thought replacing the current CET
  competencies with the Standards of Practice for Optometrists and Dispensing Opticians would have a positive impact on them or their organisation, with 13% thinking it would have a negative impact.
• The majority of respondents (68%) thought that allowing registrants to use non-approved CPD to count as points towards their CPD would have a positive impact.
• There was some concern over the requirement that CPD be designed for healthcare professionals and last a minimum of one hour.
• Attitudes towards reflection appeared to be split, but there was disappointment that peer review was not being introduced for dispensing opticians.
• A large majority of respondents stated that changing the name of the scheme from CET to CPD would have either a positive impact (42%) or no impact (54%) on them or their organisation.
• The proposal to approve and audit CPD providers, rather than the CPD they produce, was perceived as a positive change, with only 8% thinking it would have a negative impact.

We did

We are very grateful to everyone who responded and have considered all the feedback received. We have made some small changes to our proposals in line with the comments received. The next steps include amending the CET Rules, developing the MyCPD portal, and communicating the new scheme requirements to providers and registrants.

We asked

We asked stakeholders for their views on our new draft strategic plan. 

You said

Thank you for all your feedback. We have considered all the comments we recieved and this has helped us to finalise the plan. 

We did

On 1 April 2020 our new strategic plan came into force.

Our ‘Fit for the future’ strategy for 1 April 2020 to 31 March 2025 describes what we plan to do over the next five years to achieve our vision of being recognised for delivering world-class regulation and excellent customer service.

2020 has proven to be an unprecedented time for the optical professions and we did not anticipate that our strategic plan would be published during such extraordinary circumstances.

COVID-19 has impacted the way we currently regulate and will no doubt impact the future of the optical professions and in turn, our strategic plan. Therefore, as we continue to monitor the situation, we will revisit this plan after one year.

The three main strategic objectives for the next five years are:

• Delivering world-class regulatory practice
• Transforming customer service
• Building a culture of continuous improvement

We asked

We asked the Open Canvas audience to provide feedback on the first task as conducted by the Expert Advisory Group (EAG). 

You said

The general feedback was that Knowledge, Skills and Behaviour applied to all categories, the EAG also agreed with this.

Under the following categories and elements, the Open Canvas feedback suggested:

• Communication category: Under Communication the elements ‘Attitude' and 'Demeanour’ should read as ‘Professional Conduct’. ‘Breaking Bad News’ and ‘Managing Patient Expectations’ should read as ‘Explaining and Advising’
• Supporting Others to Develop category: Under this category it was felt by a respondent that the element ‘Teaching’ should read as ‘Teaching and Assessing’
• ‘Lifelong Learning’ category could incorporate ‘Supporting Others to Develop’
• Clinical Excellence category should be merged with Clinical Management category
• A respondent disagreed with the element ‘Entrepreneurship' sitting under Clinical Excellence and felt the name of this element was unsuitable
• Disagreement with the element ‘Multimodal’ which sits under the Communication category.

We did

We presented the feedback from Open Canvas for Task 1 to the EAG they then decided whether to accept, reject or incorporate the feedback from Open Canvas into the next stage. The EAG feedback can be seen below:

• Communication category - Under Communication the group decided that:
  • ‘Professional Conduct’ is a more suitable term than ‘Attitude and Demeanour’.
  • ‘Breaking bad news’ and ‘Managing patient expectations’ should fall under an element called ‘Advising the patient’.
• Supporting Others to Develop category: Under this category the group decided that the element ‘Teaching’ should be ‘Teaching and Contribution to Assessing’
• The EAG felt that the Lifelong Learning category should be kept as is and should not be merged with Supporting Others to Develop
• The EAG felt that the ‘Clinical Excellence’ category and the ‘Clinical Management’ category should not be merged.
• The element ‘Entrepreneurship’ (under Clinical Excellence) should read as ‘Innovation’ instead and the EAG decided against the use of ‘Multimodal’ as an element under the Communication category.  

We continue to invite you to relay to your stakeholders that the ESR Open Canvas is a platform open to the thoughts of all interested parties as we continue to develop the ESR.

We asked

We asked the Open Canvas audience to provide feedback on Task 1 as conducted by the Expert Advisory Group (EAG).

You said

The general feedback was that Knowledge, Skills and Behaviour applied to all categories, the EAG also agreed with this.

Under the following categories and elements, the Open Canvas feedback suggested:

• Communication category: Under this category there should be an additional element called ‘Personal Appraisal’
• Multi-disciplinary teamworking category: There should be an element added in this category called ‘Awareness of professional boundaries’
• Clinical Excellence category: In this category the element ‘Research’ should read as ‘Conduct and critically evaluate research’, the element ‘Learning from near misses’ should be changed as it is difficult to define what a near miss is.

We did

We presented the feedback from Task 1 to the EAG, they then decided whether to accept, reject or incorporate the feedback from Open Canvas into the next stage. The group agreed the following:

• Communication category: The term ‘Personal appraisal’ is associated with business and strays into employment the EAG felt this was ambiguous in meaning. Furthermore the EAG decided that ‘Personal Appraisal’ can be reflected under the element ‘self-reflection’
• Multi-disciplinary teamworking category: The EAG felt the addition of ‘Awareness of professional boundaries’ as an element is not needed at this stage and will come under referral and signposting and can be reflected in the Ethics and Standards category.
• Clinical Excellence category: The EAG felt that ‘Conduct and critically evaluate’ was going into a more granular level and will be explored later. The EAG agreed that the term ‘near-misses’ was not seen as appropriate and instead felt that NHS Governance terminology such as ‘Impact prevented’ was more suitable.

We continue to invite you to relay to your stakeholders that the ESR Open Canvas is a platform open to the thoughts of all interested parties as we continue to develop the ESR.

We asked

We asked stakeholders to provide feedback on a case management process, being introduced to facilitate the effective running of GOC hearings.  The process is designed to encourage both parties to prepare their cases efficiently, to co-operate with each other in order to keep delays to a minimum, and to and make the best use of hearing time.

You said

The general feedback was that the case management process was a positive proposal to assist with the timely management of cases.  There were some elements that could be tweaked in order to achieve the best outcomes and take into account the practicalities of case preparation and presentation in relation to both parties.

The general feedback suggested:

• The process should commence at an earlier stage, to ensure both parties are equally being held to account.
• A review of the timing of the first call should be undertaken as meaningful discussions are unlikely to occur two months after GOC disclosure in the majority of cases.
• Additional support and guidance should be provided to unrepresented registrants.
• Clarify why costs have been referred to in the plan.

We did

We reviewed the feedback from the plan and associated documents, and decided whether to accept, reject or incorporate the feedback in an adapted form.

The following amendments have been agreed:

• We propose to launch the case management meeting process as a pilot in February 2020.  This will enable us to seek and review feedback from all parties at six, nine and twelve month intervals before implementing a finalised policy in February 2021.
• We have commenced the process, at the point of referral by case examiners, taking into consideration the GOC’s own disclosure obligations.  This will ensure both parties are now equally being held to account.
• We have reviewed the timing of the first call.  This call will now take place at three months from the date of disclosure by the GOC to the Registrant, when it is hoped parties will still be able to hold some meaningful discussions.
• We have reviewed the guidance and support that will be provided to unrepresented registrants throughout this process, offering additional telephone conferences and guidance information, to assist understanding of the processes.
• We hope it is now clearer that costs have been included in the plan as a reminder that under Rule 52 and 53 both parties have the option to  apply to the FTPC  for a costs order.  

We continue to invite you to relay your thoughts and experiences with the case management process throughout the pilot as we continue to develop the plan.

We asked

We asked you whether our draft guidance for registrants on disclosing confidential information about patients:

• was clear and accessible and made it clear when disclosing information might be necessary to protect the public interest;
• what impact (if any) the guidance would have on registrant confidence in disclosing confidential information; and
• whether there was anything additional that we could do to make the decisionmaking process easier in situations where confidential information might need to be disclosed.

You said

280 of you – including optometrists, dispensing opticians, students, businesses, stakeholder bodies and members of the public – provided your views on the guidance and told us:

• Overall, the guidance was clear and made the GOC’s expectations clear, but in some areas the language used could be clarified;
• Some amendments to the structure of the guidance would make the decisionmaking process clearer; and
• A number of additional activities around communication would help support registrants to use the guidance effectively.

As part of the consultation, there was also desire from some stakeholders to see a requirement of automatic notification to the DVLA/DVA if a patient does not meet the vision standards for driving. Whilst we understand the desire for this, previous research (and the consultation itself) supports a discretionary approach so as not to deter patients from seeking eye care and to safeguard (so far as possible) the relationship of trust between patient and practitioner.

We did

We took every piece of feedback we received into account and where possible, made the suggested amendments – particularly in relation to tightening up language. We also restructured part of the guidance to include a step-by-step approach to disclosing information and supported this with a flow chart to make the decision-making process clearer.

In terms of supportive communications, we have been liaising with key stakeholders in advance of publication to ensure that communications can be joint and aligned where appropriate.