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Response to the GOC consultation on its CET exceptions policy

Our response to the consultation, July 2021

Ophthalmologist wearing protective face mask on when working at practice

Between April and July 2021 the GOC consulted on a draft CET exceptions policy, which will be used in deciding whether to allow registrants who fail to meet the mandatory CET requirements in the 2019-2021 CET cycle to remain on the register.

Overview

At the end of each CET cycle, we provide support to members who wish to appeal GOC decisions about removal from the register because of failure to meet the CET requirements. In the light of this experience, we think the GOC’s proposed new exceptions policy is helpful. We particularly welcome the removal of the requirement that registrants must have been unable to practise in order to be eligible to be retained on the register, and the proposal to take into account CET completed before and after the relevant cycle when taking decisions under the policy.

In our response to the consultation, we have suggested that the new policy should be amended to:

  • Apply the proposed approach to registrants on maternity, paternity or adoption leave to other registrants unable to meet CET requirements because of a planned absence, such as people taking on caring responsibilities
  • Expand the case studies to help registrants understand how the GOC will apply the policy

In seeking member views on the new policy, we heard some feedback that applications to the GOC to remain on the register after failing to meet CET requirements are not always handled with understanding and sensitivity. We hope and expect that in applying the new policy, the GOC will treat all applicants in a sensitive, fair, and supportive way while ensuring the public is protected. 

Q1. To what extent do you agree that the updated policy achieves our aim of appropriately balancing fairness to registrants while maintaining the focus on public protection?

AOP response: Agree

Q2. To what extent do you agree that our expectations for registrants on maternity, paternity or adoption leave sufficiently protect the public?

AOP response: Agree

Q3. Is there anything unclear or missing in the updated policy?

AOP response: Yes

Principles to be applied (Section 4 of the policy)

It is right that the GOC should take all relevant circumstances into account when taking decisions about registrants who have failed to meet CET requirements, and it is helpful that the policy includes an illustrative list of factors that it will consider in section 4.2 of the policy. However, we think the descriptions of some of those factors need to be expanded or amended.

Section 4.2.1 of the policy says that the GOC will take into account a registrant’s length of time in practice, and implies that experienced registrants may be treated more favourably than others. This could be unfair to recently qualified registrants; in some respects a registrant who has only recently completed their clinical training may be a safer practitioner than one who qualified a long time ago, and the circumstances of each case will be different. We therefore suggest this factor should be framed more widely and neutrally – for instance, along the lines of:

“Previous practising and educational experience”

Section 4.2.3 of the policy says the GOC will take into account how far the registrant’s CET has covered the required competencies and interactive elements. We suggest expanding this to include consideration of whether the registrant has completed CET that is relevant to their own specific learning needs and scope of practice. This is consistent with the policy’s focus on public protection.

Finally, we note that although the consultation paper says “the fact of whether or not a registrant could work during the exceptional circumstances is now one of the factors to be considered, rather than the focus”, this issue is not included in the list of factors in section 4.2 of the policy. We suggest that it be added to the list, and that the wording should make it clear that (as the consultation paper notes) a registrant who is working may be more able to maintain their skills than one who is not.

Maternity, paternity and adoption leave (section 4.4 of the policy)

Section 4.4 of the policy says that where an applicant under the policy has taken maternity, paternity or adoption leave, the Registrar will take into account the overall length of that leave and the number of periods of such leave taken during the CET cycle. It also sets out an expectation that such registrants should complete the equivalent of at least one CET point for each month they have been on the register and not on such leave during the cycle.

It is not clear from the policy why these provisions only apply to people on maternity, paternity and adoption leave. We understand from the GOC team that their policy aim here is to ensure that those on such leave are treated fairly, and that the expectation of at least one CET point a month is intended to give registrants on planned leave a reasonable and supportive steer about the number of points they should plan to achieve. We support this aim, but think the approach set out in section 4.4 of the policy should also apply to registrants taking other types of planned leave, such as time off to take on caring responsibilities, to undergo a healthcare procedure such as an operation, or to take a career break.

Case studies (Section 5 of the policy)

We welcome the idea of including case studies in the policy, because it could help registrants and the public understand how the GOC applies the factors set out in the policy. However, the case studies as currently drafted do not make it clear why the GOC reached the decisions it did in each case, and could therefore confuse readers rather than assist them. We suggest that each of the case studies should be expanded to include a brief explanation of the key factors that the GOC took into account in reaching its decision.

Q4. Are there any aspects of the guidance that could discriminate against stakeholders with specific characteristics? (Please consider age, sex, race, religion or belief, disability, sexual orientation, gender reassignment, pregnancy or maternity, caring responsibilities or any other characteristics.)

AOP response: Yes

As we have said in our response to question 3, the provisions in section 4.4 of the policy to support registrants who take maternity, paternity or adoption leave are welcome, but could lead to real or perceived unfairness for other groups with specific characteristics, such as those with caring responsibilities or those undergoing a planned healthcare procedure that relates to a specific characteristic. Our proposed change to section 4.4 of the policy would resolve this problem.

Q5. Are there any aspects of the guidance that could have a positive impact on stakeholders with specific characteristics? (Please consider age, sex, race, religion or belief, disability, sexual orientation, gender reassignment, pregnancy or maternity, caring responsibilities or any other characteristics.)

AOP response: Yes

As noted in our response to question 4, the provisions in section 4.4 of the policy are potentially helpful to those taking maternity, paternity or adoption leave, and should be expanded so that they also help others taking planned leave, including people with specific characteristics such as caring responsibilities.

Q6. Are there any other impacts of the updated policy that you would like to tell us about?

AOP response: Yes

We particularly welcome the removal of the requirement that registrants must have been unable to practise in order to be eligible to be retained on the register under the exceptions policy, and the proposal to take into account CET completed before and after the relevant cycle when taking decisions under the policy. These changes have the potential to create fairer outcomes for registrants who have been unable to complete the full CET requirements, without any downside in terms of public protection.