“Always look at the photographs”

There was a serious message behind a game show-style presentation that saw the AOP’s clinical and professional director don a gold sequin jacket at 100% Optical (ExCeL London, 24–26 February).

“If I had one take home message from this talk it would be always look at the photographs,” Dr Peter Hampson emphasised during Wheel of misfortune.

The presentation, which was co-hosted by AOP head of clinical negligence, Efa Schmidt, outlined common reasons for clinical negligence claims within optometry – and steps practitioners can take to reduce their risk.

Hampson emphasised that optometrists should review any optical coherence tomography scans or retinal photographs that are taken, ensuring that they look at the full set of images.

He recommended asking the patient if they have had an image taken if this role is performed by another member of the team.

Hampson added that optometrists can also ask practice staff if any images have been taken that they have not yet had a chance to review.

“If an image has been taken, you need to make sure you are aware of it,” he said.

Schmidt clarified key differences between a clinical negligence investigation and a General Optical Council (GOC) fitness to practise investigation.

She shared that it is possible for a patient to bring both a clinical negligence claim and lodge a complaint with the GOC.

In the unlikely event that this occurs, Schmidt shared that the AOP clinical negligence team works closely with their professional discipline colleagues to protect the member’s interests.

Schmidt said that an optometrist is not required to notify the GOC of a clinical negligence claim unless the circumstances affect an individual’s fitness to practise.

She shared that the role of the GOC as the optical regulator is to protect the public. The GOC can sanction optometrists and dispensing opticians – for example, through suspension or erasure – but it cannot award damages.

Schmidt highlighted that clinical negligence claims are not about punishment but about correcting a situation where one party has been wronged, by an error or mistake. Compensation can be provided to patients through clinical negligence claims.

Outlining some of the most common conditions that are involved in clinical negligence claims, Schmidt shared that retinal detachments were the highest volume claim the clinical negligence team received, followed by glaucoma and tumours.

Wet age-related macular degeneration (AMD) is the fourth highest volume claim that Schmidt’s team sees.

There was a 50% increase in wet AMD claims between 2018 and 2022 compared to the five years prior.

“This is almost certainly linked to the rise of OCT scans and retinal photography in practice,” Schmidt observed.

Keratoconus claims, which are the fifth highest volume claim, experienced a 125% uplift between 2018 and 2022 compared to the five years prior.

Reflecting on the duty of candour, Schmidt emphasised the importance of an optometrist seeking advice from their professional body before responding to a potential complaint about clinical care.

“The take home message we would like to convey to our members is reach out to us and get our input from the outset,” she said.

Schmidt outlined the duty of candour – which relates to being honest and open with patients when something has gone wrong with their care.

“It is important to understand that being candid should not be misunderstood as an admission of liability,” she said.