GOC response on call for evidence on Opticians Act

In 2022, a call for evidence was conducted to help the GOC consider whether the Opticians Act is fit for purpose and whether there is any real-world evidence to support any changes to the Act. In addition, a consultation on associated GOC policies was carried out including whether the GOC should amend or remove its 2013 statement on testing of sight, which outlines that refraction cannot be delegated for the purposes of a sight test.

The call for evidence sits alongside the Department of Health and Social Care’s ongoing consultation designed to modernise the regulatory frameworks for fitness to practise, education, registration, and governance across all healthcare regulators.

In a meeting on 22 March 2023, the GOC Council received an update on the GOC’s proposed programme of legislative reform, based on an analysis of stakeholder responses – including the submission from the AOP – to the 2022 call for evidence. The Council approved the GOC response, subject to minor amendments.

Our response to the GOC’s summary to Council

We are pleased to see that the GOC has heeded the numerous concerns expressed by the AOP, along with other stakeholders in the profession, regarding the risks that are associated with dispensing opticians being able to refract. It has never been our intention to limit the aspirations of our dispensing optician colleagues, in fact quite the opposite, but we recognise the significant concerns that our members voiced in the research we conducted about the consequences of such a change, particularly the risk of missed pathology.

We also welcome the GOC’s commitment to ensure a further, full consultation process is carried out, before any changes are implemented that may affect the future of the profession. We also support the intention to bring a timetable for these workstreams to the next GOC council meeting and look forward to a positive period of further engagement.

However, following the GOC Council meeting, it is our view that there are several areas that require particular attention and scrutiny:

• Separation of the sight test by time, place, or person. The GOC interpretation is that the Opticians Act does not specifically prohibit separation of the sight test by time, place, or person. We say this is one of the most important and fundamental challenges facing the profession and we are pleased that the GOC have recognised the importance of additional work in this emerging area. We do not seek to limit innovation or prevent progress, but say that change for change’s sake must be avoided, particularly if it increases the risk of harm to the public
• Orthoptists testing sight. The GOC say it is their intention to discuss the issues around orthoptist refraction with the Heath and Care Professions Council (HCPC) and British and Irish Orthoptist Society. We continue to highlight that our concerns about orthoptists testing sight mirrors our objection to dispensing opticians being able to refract
• Online sales. It has long been our position that the GOC could and should do more to tackle online sales. In our policy position on illegal practice, we say the illegal supply of eye care products is a problem in the UK and causes health risks for the public. We welcome the recognition of this challenge by the GOC and we hope they will implement the suggestions that we have put forward in this regard
• Sale of Optical Appliances Order 1984. The GOC has taken the view that the Order does not reflect the reality of online supplies as it predates internet sales. While we agree this is factually accurate, we believe it is not clear currently what parts of the contents of this statutory instrument need to be updated to reflect internet sales. We urge the GOC to provide greater clarity and to consult further on this point
• Remote care and technology. In our response to the call for evidence, we supported the use of optometrist-led remote care and technology and the benefits that these developments can bring to patient care. We say to the GOC that is it critical that all parties are clear about the meaning of the terms being used, so that ambiguity in language doesn’t introduce unnecessary risk
• Business regulation. We are pleased that the GOC plans to do more to regulate businesses within the sector. It is a longstanding policy position of the AOP that there is a gap between the responsibilities placed on the individual registrant and those placed on the business. This has been particularly true where the business is not owned, controlled, or run by registrants. However, we think the GOC’s commissioned research on regulating businesses does raise concerns, particularly around the cost burden this may place on the sector at a difficult financial time. We will continue to contribute to this work to ensure that, wherever possible, the many small practices highlighted in the research aren’t disproportionately affected by changes in regulation
• GOC funding. We say there is at present a lack of specific funding for implementation of the call for evidence or progression of the workstreams. We note the GOC’s intention is to progress these workstreams using the existing GOC policy and standards team. The GOC says that if this approach is not sufficient, it will make a business case to access strategic reserves. Our view is that it is important that this workstream does not lead to increased fees for registrants, particularly during the current high inflationary period