Navigating the professional conduct pitfalls of an increasingly digital world

Cautionary tales about sharing patient information and using WhatsApp for guidance were shared as part of the 100% Optical presentation Virtual insanity (28 February, Excel London).

AOP head of clinical negligence, Efa Schmidt, outlined the concepts of causation and breach of duty within clinical negligence claims.

When establishing whether a breach occurred, the optometrist’s actions are assessed against the steps that would be taken by a reasonably competent optometrist in the same set of circumstances.

She highlighted that causation involves examining whether an action or inaction caused something avoidable to happen.

“Every case is fact-specific and can take different directions,” Schmidt highlighted.

“I really do want to get across that causation is complicated and does involve multiple experts, so these claims can take some time to be resolved,” she said.

Schmidt told delegates that the AOP sees around 60 to 80 clinical negligence claims per year.

She added that in 2024–2025 the General Optical Council (GOC) triaged 464 complaints and opened 137 new investigations. These numbers represent a 21.4% increase in the optical regulator’s caseload.

“That is substantial. But I think it’s worth pointing out the context – there are 25 million sight tests that take place across the UK each year,” Schmidt shared.

She highlighted that the most common misdiagnosis category that her team supports members with is retinal detachments.

“Due to the increased number of optical coherence tomography (OCT) scans that are being performed, if there is a clear retinal detachment, it can be very difficult to defend,” Schmidt said.

AOP clinical and policy director, Dr Peter Hampson, discussed the risks of using online messaging platforms, such as WhatsApp, for advice on patient management.

Hampson shared that it is important when people seek advice that the person who is providing guidance is qualified to do so and will take accountability for the advice that it is given.

“For these informal WhatsApp groups and forums, anyone can register and anyone can post in them,” he said.

“Within WhatsApp, often the messages disappear after a period of time or people delete messages,” he said.

Hampson emphasised the importance of carefully reviewing all imaging that is performed – including OCT scans.

“I know people are busy and we have so much data that is coming at us, but if something is captured – whether it is an OCT, Optomap, corneal topography or visual fields – it is really important that you stop and look at it,” he said.

Hampson highlighted to delegates the need to keep patient information confidential – discouraging practitioners from taking screenshots of patient management software if, for example, a well-known individual has an appointment.

He referred to a case where two Ipswich Hospital staff were disciplined after they accessed Ed Sheeran’s care record without a legitimate clinical reason.

“We should respect our patients’ privacy. We should make sure that all information is kept confidential and we don’t share it. I think that’s really important,” Hampson said.