11 March 2026
The stages of a fitness to practise process and how practitioners should handle the situation was the subject of Professor Bruce Evans’ Saturday morning presentation at 100% Optical 2026 (28 February–2 March).
Evans opened the session, entitled Prevention and survival of the dreaded solicitor's letter, by explaining that as well as working as an expert witness, he has seen friends come out stronger after the conclusion of fitness to practise cases.
One quarter of fitness to practise cases are a result of dishonesty, Evans told attendees, whilst the most common clinical context for a fitness to practise case is around glaucoma.
In outlining the demographics most likely to find themselves facing a case, he noted that the likelihood is three times higher for males than for females, and that men have a five times greater risk of erasure from the General Optical Council’s (GOC) register than women.
Eye care practitioners qualified for more than 30 years are the most likely group to have a clinical fitness to practise case brought against them, he revealed.
‘Fields at collection:’ analysing a hypothetical scenario
Optometrists split into groups, where they were presented with a scenario in which the practitioner had written ‘fields at collection’ on the patient’s notes.
Practitioners discussed the legal and clinical risks of this action, and what the practitioner could have done instead in order to ensure that the situation was safe.
Noting a specific booked appointment when fields would be assessed or documenting that the patient would be in touch in order to book the appointment were suggestions made by practitioners.
A second discussion between practitioners centred on whether it would be worse to have not made a record of a test that had been performed, or to have misled a GOC hearing by making a record for a test that had not been performed.
During the session, attendees also considered when a dilation might be necessary in a case of a patient presenting with flashes and floaters.
Evans emphasised that the most important thing throughout a fitness to practise process is to have an “argument that you can defend – that you have done something sensible.”
What to know about the law
The relevant law is the ‘tort of negligence,’ Evans explained, where a breach of duty of care is owed to those who may foreseeably be injured by any particular conduct.
The ‘balance of probabilities’ applies in such cases, Evans explained, and practitioners are likely to find that they have an adequate defence if they have acted in accordance with expected standards.
The term ‘responsible’ in this case means capable of standing up to logical scrutiny, Evans said.
He also talked attendees through the typical stages of civil litigation, starting with the complaint, which he urged practitioners not to ignore or deprioritise dealing with.
When the GOC receives a complaint they will consider whether or not to pursue it, Evans said.
Receiving a complaint is the moment to “be your best self” in terms of dealing with the situation, Evans emphasised.
The GOC will apply the balance of probabilities on whether to pursue the case, he said.
He explained that practitioners may then receive a request for their records from the GOC as they gather their evidence, followed by a ‘letter of claim.’
The practitioner will receive a summary, and a case examiner’s review will take place afterwards, Evans said, before more evidence is potentially requested.
Every stage of the case is an opportunity for the case to be dismissed, Evans told attendees.
“The GOC knows that people make mistakes, and that they are human,” he said.
The regulator will look for idiosyncratic behaviours such as unusual prescribing when gathering their evidence, he added.
Evans advised: “Once you get a solicitor’s letter, only do what the lawyers tell you to do.”
Also, he said: “Use an insurer that has got your interests at heart. They are not just interested in minimising the claim against you, but are also thinking about your reputation.”
Having the same insurer as your employer can be helpful, Evans said, because if a claim has been made against the practice as well as the practitioner, the respective solicitors can work together.
The GOC knows that people make mistakes, and that they are human
Following the GOC’s Standards of Practice
Evans also emphasised that displaying that the GOC’s Standards of Practice have been followed is “a must.”
Standards that are vital to evidence include standard 5.1, being competent in all that you do, standard 7.2, which involves displaying that you have either provided or arranged further investigations, and standard 7.6, that you have provided care that is in the patient’s best interests.
Evans also noted standard 11.3, which involves raising concerns if the public might be at risk, including internally.
This might be a difficult thing to do, but it is the standard and is mandatory rather than optional, Evans emphasised.
He also noted the importance of refraining from disparaging colleagues (standard 13.4) as well as standard 19, which involves being candid when things do go wrong.
Mental health during a fitness to practise case
Practitioner mental health is important to acknowledge in fitness to practise situations, Evans acknowledged.
“Some people go through this and they cope with it well. Some find it unbelievably stressful,” he said.
The truth is that practitioners make decisions every day, and an instance of a decision having the wrong outcome does not mean the person responsible is a bad practitioner, Evans emphasised.
“If you do have a solicitor’s letter and you are feeling stressed, bear in mind that it is going to get better. You will get through this, and you will be ok at the end,” he said.
He also advised that practitioners who are really struggling reach out to the Samaritans.
Speaking to loved ones, friends, or others within the profession also cannot be underestimated, Evans reminded attendees.
He closed the session by emphasising that, whilst going through a fitness to practise process is “horrible,” often optometrists do find that they have become better at their job after having been through it.
“You will benefit in the end,” Evans said.
Comments (0)
You must be logged in to join the discussion. Log in