GOC Annual Report 2006/07
confidence in optical professionals competent, ethical, professional confidence in the register transparent, secure, reliable, authoritative confidence in optical training and education rigorous, comprehensive confidence in standards of care safe, high quality confidence in ongoing competence up to date, fit to practise confidence in our systems and procedures effective, efficient, proportionate, fair confidence in our ways of working inclusive, accountable
GOC at a glance
The GOC is the regulator for the optical professions in the UK. Our mission is to protect the public by promoting high standards of education and conduct amongst opticians.
The Council currently registers around 22,000 optometrists, dispensing opticians, student opticians and optical businesses.
We have four core functions:
1. Setting standards for optical education and training, performance and conduct.
2. Approving qualifications leading to registration.
3. Maintaining a register of individuals who are qualified and fit to practise, train or carry on business as optometrists and dispensing opticians.
4. Investigating and acting where a registrant's fitness to practise, train, or carry on business is impaired.
The Council's work is built on a foundation of six core values. These values are based on the Better Regulation Commission's criteria for good regulation:
Proportionate
We will identify and target the issues of greatest risk to public safety.
We will remove unnecessary bureaucracy.
Accountable
We will seek, and respond to, the views of stakeholders and partners.
We will consider and review the consequences of our actions.
Consistent
We will work in collaboration with UK health regulatory bodies and other partners to develop consistent policies and procedures.
Transparent
We will explain and publicise decisions, and make public, wherever possible, Council information, activities and proceedings.
Targeted
We will ensure that our activity is focused on the areas of greatest risk, or where there is most benefit to public health and safety.
Organisational Excellence
We will provide good value for money.
We will pursue high standards of customer service.
We will ensure that the Council is a good place to work, particularly through developing and training our staff and members.
We will promote and develop equality and diversity in all our work.
Chairman’s introduction
Building and sustaining confidence is core to professional regulation.
By assuring standards, the GOC enables the public and service users to have confidence in registered optometrists and dispensing opticians. In turn, professionals and the public need to have confidence in us as a regulator - to be reassured that our systems and procedures are fair, proportionate and effective.
The past year has seen very significant advances, which will enhance confidence in the professions and in the GOC. In February, the Government published its long-awaited White Paper, Trust, Assurance and Safety. The policy framework it sets out brings an end to a long period of uncertainty for health professional regulation. It gives us the confidence to move forward with our reform agenda, which has strengthened our role in public protection, and which is endorsed by the White Paper.
In particular, the GOC's groundbreaking Continuing Education and Training scheme provides assurance that registrants are staying up to date in core competencies. The success of the first statutory cycle, which ended in December, has given us a strong foundation on which to develop systems for professional revalidation. The White Paper also endorses the decisions we have already taken to introduce an independent hearings function, and student registration.
As we move forward, we will continue to make patient safety our overriding concern. Optometry and dispensing optics are relatively low risk professions, but they play a vital role in the delivery of safe, high quality health care. In primary care, optometrists and dispensing opticians are now providing a wide range of services, including specialist services for people with low vision and diabetes. Our registrants work with some of the most vulnerable groups in society. Optical professionals are taking on greater clinical responsibilities with advances in practice, in particular those recognised by our registerable specialties in contact lens practice and therapeutic prescribing.
As a Council, our confidence in facing the challenges ahead derives in large part from the very successful partnerships which we now have in place with a wide range of stakeholders. I would like to give my personal thanks to all the many individuals and organisations who have contributed to our work and successes over the past year. I personally have very great confidence in our future.
Rosie Varley
Chief Executive's introduction
One of the key tenets of the Government's White Paper is that professional regulation must sustain the confidence of both the public and the professions through demonstrable impartiality.
Our challenge as a Council is to maintain our independence without losing the immense value of our partnerships.
Over the past year, we have worked closely with groups representing many of those parties with an interest in optical regulation, including registrants, patients, employers, educators, other regulators and government. Their input and support has allowed us to make real progress in improving the regulatory framework to promote good eye care and protect the public.
I am often asked when I meet registrants, 'What has the GOC ever done for me?'. I hope that this report will help answer that question. We work always and only for the public good - for as those who set up the Council realised, in the long term, the professions can only benefit from a strong, independent regulatory framework.
The GOC continues to protect the public by promoting high standards of education, including continuing education, and conduct.
We have made real progress. The first cycle of statutory CET has been a significant success. Recognised specialties are being further developed to enable practitioners to enhance their practice along a defined route. We are engaging with European and global challenges to support free movement of professionals within a context of public safety. Information on the public register is more detailed, and more accessible. And we have taken action to clarify the legal framework for sale and supply of optical appliances, and to ensure compliance where there are public health or safety issues.
The number of optometrists and dispensing opticians falling below expected standards remains extremely low. But where there have been concerns about registrants, these have been dealt with firmly and fairly. We are also working to communicate our role in tackling concerns, and the importance and benefits of good eye care, to the public. Central to the public's understanding of eye safety and health are the clinical functions reserved to optometrists and dispensing opticians in the Opticians Act. The GOC jealously guards these protected functions as well as the professions' protected titles. Registrants must also play a role in guarding the unique contribution that they bring as optometrists and dispensing opticians to the health and safety of the public.
The optical professions reap the benefits of the Council's work in the form of public confidence and enhanced professional status. Such things are relatively difficult to measure. However, our own performance indicators suggest:
so far, so good.
Peter Coe
2006/7 in focus
17,500,000 sight tests*
129 complaints to the GOC
22 registrants referred to FTP Committee
13 registrants referred for performance assessment or review
3 interim orders for suspension from the register
2 registrants erased from the register
*Based on FODO's Sight Test Volume and Workforce Survey, 2006
Assuring independence
Over the past year, the Council has striven to ensure that it is an independent and effective regulator.
In February 2007, the Government published a white paper on the future of health professional regulation. Trust, Assurance and Safety: The Regulation of Health Professionals in the 21st Century aims to ensure the independence of the regulators, in order to exercise their functions effectively and command the confidence of patients, the public and the professions.
The General Optical Council welcomed its publication and is now working with the Government and others to implement the Paper's recommendations. At our meeting in March, the Council agreed to propose reducing its size to a maximum of 13 members, with a majority of lay members. Members endorsed the white paper recommendation that Councils should become smaller and more 'board-like' to allow for more effective decision-making. Council also set up a project board to take forward work associated with this and other recommendations. The White Paper implementation project board will oversee four work streams, focusing on the themes of 'governance', 'revalidation', 'tackling concerns', and 'registration'. The board will also ensure appropriate consultation with and involvement of stakeholders in the project.
Principles
The White Paper set out key principles underpinning statutory professional regulation:
Its overriding interest should be the safety and quality of the care that patients receive from health professionals.
Professional regulation needs to sustain the confidence of both the public and the professions through demonstrable impartiality. Regulators need to be independent of government, the professionals themselves, employers, educators and all the other interest groups involved in healthcare.
Professional regulation should be as much about sustaining, improving and assuring the professional standards of the overwhelming majority of health professionals as it is about identifying and addressing poor practice or bad behaviour.
Professional regulation should not create unnecessary burdens, but be proportionate to the risk it addresses and the benefits it brings.
The system must ensure the strength and integrity of health professionals within the United Kingdom but be sufficiently flexible to work effectively for the different needs and approaches across England, Scotland, Wales and Northern Ireland, as well as to adapt to future changes.
Supporting and advancing good practice
A key role for Council is setting the standards that must be achieved to gain entry onto the register and maintained by registrants once on the register. We work in close partnership with the professions and government to ensure the standards set by Council sustain and improve the levels of conduct and performance expected of optometrists and dispensing opticians.
Competencies
Council's Standards Committee is charged with keeping under review the competencies required for qualification as an optometrist or a dispensing optician, and also those competencies which must be achieved for approved specialties to be marked against a practitioner's name in the register.
Early in 2006, Standards Committee began the first stage of a strategic review of the competencies. The review has looked at the overall framework for competencies to ensure that the different sets of competencies share a common structure and terminology.
The project has taken into account influential work undertaken by the Optometrists Association Australia and the World Council of Optometry. Creating a unified competency framework across optics in the United Kingdom should make it easier to compare the skills and achievements of optical professionals qualifying in the UK with those qualifying overseas.
A consultation on the first stage of the review will take place in Summer 2007. The second stage of the review, which will consider the content of the competencies, will commence in 2008.
Standards of conduct and performance
The Council sets clear standards of conduct and performance expected of optometrists, dispensing opticians, student registrants, and business registrants. Codes of conduct for individual registrants (including student registrants) and business registrants set out the core standards.
Council also keeps under review the detailed guidance issued by the professional and representative bodies on matters covered by the codes. Practitioners are expected to be familiar with this guidance. Reference may be made to it in the exercise of the GOC's functions (for example when investigating allegations about a registrant's fitness to practise).
A key project in 2006/7 has been the review of the College of Optometrists’ and the Association of British Dispensing Opticians’ guidance on the sale and supply of optical appliances. Guidelines were examined to ensure that they were in synergy with changes to the law that were introduced in 2005.
A key project in 2006/7 has been the review of the College of Optometrists’ and the Association of British Dispensing Opticians’ guidance on the sale and supply of optical appliances.
Standards challenges
To ensure that standards for good practice and conduct are widely accepted, understood and followed by the eye care professions:
· Review the competency framework for prescribing optometrists to ensure it is fit for purpose should independent prescribing of medicines be introduced
· Establish a unified competency framework across optics in the United Kingdom
· Introduce a proportionate and targeted system for the revalidation of optometrists and dispensing opticians in the light
· of the directions of the Government's white paper, Trust, Assurance and Safety
· Ensure professional guidance reflects learning from our investigation and fitness to practise processes.
Ensuring educational quality
Confidence in the register depends on the GOC monitoring the entry of appropriately qualified individuals to practise in the UK.
The GOC defines the content and standards of the education and training required to achieve the competencies for registration. It monitors and approves UK education, training and assessments leading to registration as opticians, optometrists or specialists.
For the UK route to registration, only those people who have been registered as students and who have successfully completed a GOC-approved training programme and approved assessment may practise in the UK.
Visits
Quality-assurance of courses and assessments is managed by a programme of visits, carried out by an independent panel of visitors. Visits aim to give the Council and the public confidence that practitioners who enter the register have been appropriately trained and assessed as competent and fit to practise.
In 2006, the GOC re-appointed its panel of visitors. Visitors were appointed to include dispensing opticians, optometrists, educationists and ophthalmologists. The selection process was followed by three days of training.
In 2006/7, Education Committee and its visitors participated in 63 quality assurance visits and meetings.
The main challenge for optometry training establishments has been to give students enough experience with patients. The GOC recommends minimum numbers of patient episodes to ensure that students are competent to carry out appropriate techniques and identify ocular pathology. Sufficient exposure to different patient scenarios is also critical to enable students to provide a credible service during their practice placements.