FAQs for members on the GOC's business regulation consultation

The GOC argues that the current system of voluntary business registration is inconsistent. We agree that it would provide more consistency if all businesses were required to register, and therefore subject to the GOC’s standards for optical businesses. These standards, designed to put patients first, are also good for our members. Complying with them makes it less likely that mistakes will be made that lead to patient harm and potential action against our members. Our concerns about the proposals are related to the implementation rather than the overall principle.

The GOC describes five risks it aims to address through its proposals (Paragraph 21):

• The business environment: this should provide practitioners with autonomy to undertake their professional activities to the best of their ability and in line with professional standards
• Clinical governance: systems and protocols are needed to ensure good clinical governance, including clear communication among staff, adequate supervision of assistants and students, consistent management of locums, processes to deal with whistle-blowing and consumer complaints, and appropriate record keeping
• Investment: adequate investment in equipment and training of staff are required to ensure that the level of care is up-to-date
• Commercial considerations: a business could prioritise cost-cutting exercises or income generating incentives over providing safe patient care. These could include pressure on staff to meet sales targets, unrealistic sight testing times or under investment in equipment
• Communication to consumers: in addition to risks to patient health and safety, a business should clearly communicate prices including for services such as sight tests through their advertising and on their website.

We agree that it would provide more consistency if all businesses were required to register, and therefore subject to the GOC’s standards for optical businesses. These standards, designed to put patients first, are also good for our members. Complying with them makes it less likely that mistakes will be made that lead to patient harm and potential action against our members. Our concerns about the proposals are related to the implementation rather than the overall principle.

Our Council, while agreeing that all who provide sight tests should adhere to high standards, has expressed concern about the GOC’s proposal that the obligation to register should also apply to non-profit organisations such as university eye clinics and charities. We want to hear the views of our members who work in these settings.

Annex 4 of the GOC’s proposal describes the role of the Head of Optical Practice (HOP). It states this role is as “a nominated senior manager … with overall responsibility for the conduct of the business in accordance with the GOC’s regulatory arrangements”. It describes the key responsibilities as being to “take reasonable steps to ensure that the business” complies with GOC business standards, declares relevant information to the GOC, and maintains up to date GOC business registration requirements (paragraph 98).

The consultation document discusses how the role might work in practice, recognising that the GOC has not found a model in another sector that could be adopted wholesale into optics. It makes clear that the role does not remove responsibility from individual registrants both to comply with the standards for individual registrants and those set in the business. Nor does it remove responsibility from the business itself. The document offers some scenarios for how this might work in practice.

We can see the value of there being a named individual who has responsibility for standards but we have questions about how it would work in practice. There are examples in other sectors, such as finance, of businesses consistently ignoring the advice of “compliance officers”. We will be considering whether our members who take on such roles find themselves caught powerlessly between the needs of business owners with commercial objectives and the demands of individual registrants feeling under inappropriate pressures.

The role would need to work in single practices, small chains, and large multiples, with the various models of franchises and business ownership in optics making the picture even more complicated. We want to know our members’ views on how it would work in their own circumstances.

The GOC is not proposing an inspection system but it does propose that it have greater powers to investigate concerns about businesses’ compliance with the standards. While recognising that there is “no evidence of any immediate risks to public protection in terms of the powers we currently have” the GOC proposes that it should have the power to visit practices to investigate concerns about compliance with business standards and also be able to impose uncapped penalties on businesses.

There are clearly a number of potential concerns about these proposals. What would be the threshold of concern that could lead to a visit? How many businesses would be inspected per year? Would these visits be issue specific, or would a visit look at all areas of practice? What would the system of visits cost, and who should pay for it? And clearly any penalties should be determined on the basis of the harm that may have been done by any lack of compliance that is discovered. We would want to be consulted over the implementation of this proposal.

Our broader concern is that the system could duplicate the compliance obligations that optical businesses in the four UK nations already have. We are particularly interested to gather data on our members’ experience of the current regulatory burden in their own setting.

The consultation also addresses the role of the Optical Consumer Complaints Service (OCCS), the main question being whether using the service should be mandatory for optical businesses. It also asks whether how the scheme should be funded, for example whether every business should contribute through the registration fee, or the idea of a “pay per use model” whereby the business pays for any complaint made against it that is considered by the scheme.

We are interested in our members’ views on this.