ABDO Staff

ABDO statement on the GOC’s call for evidence

Statement on GOC call for evidence

ABDO is encouraging its members to consider and respond to the General Optical Council (GOC) call for evidence published to inform its review of the Opticians Act 1989 and related policies.

The GOC is reviewing the legislation so that it can continue to protect the public in the light of changes in optical practice and wider society, including the evolving roles of dispensing opticians and optometrists and developments in technology.

The call for evidence will enable the GOC to develop proposals for legislative change that will then be considered by the Government.

The main areas covered by the call for evidence are:

Regulatory objectives

The GOC has proposed eight objectives to guide its approach to legislative reform.

ABDO broadly supports these objectives but does not agree with the GOC’s description of the objectives as ‘non-hierarchical’. This suggests that all the objectives will carry equal weight, whereas the GOC’s overriding statutory objective is to protect the public and this should be reflected in the GOC’s approach. Listing ‘maintaining public and patient safety’ as one of eight ‘non-hierarchical’ objectives suggests that there could be trade-offs between public protection and other considerations.

Restriction of activities

The GOC has asked which activities should be subject to legal restrictions. This means that they can be carried out only by, or in some cases under the supervision of, the types of registered practitioners specified in legislation.

ABDO’s view is that the overriding need to protect the public makes it necessary to maintain the current restrictions on the:

  • the testing of sight
  • fitting of contact lenses
  • selling optical appliances to children under 16 and people registered as visually impaired
  • selling zero-powered contact lenses

It will also be important to ensure that these restrictions apply to treatments, such as myopia management, which involve the use of spectacles and contact lenses and may be of value to patients who are over 16, as well as to children.

In addition, ABDO’s thinks that the law should restrict the selling of optical appliances to other groups where there is a need for enhanced skills and knowledge, such as people with learning disabilities, people with dementia and people in domiciliary care.

Testing of sight

The GOC states in the call for evidence that, “dispensing opticians could undertake refraction for the purposes of the sight test if they are appropriately trained, competent, overseen and indemnified.” They go on to say that this would be possible only if they were to amend or remove its 2013 policy statement on refraction.

ABDO supports the GOC’s view that dispensing opticians should be able to undertake refraction for the purposes of the sight test, subject to the stated conditions.

We also recognise that refraction by dispensing opticians for the purposes of the sight test should be under the oversight of an optometrist or medical practitioner so that patients will continue to benefit from an eye health examination in conjunction with a refraction. This is a major strength of the UK’s system of eye care and enables eye and wider health issues to be identified and addressed at an early stage in line with the wider health policy focus on prevention.

Enabling dispensing opticians to support optometrists and medical practitioners in carrying out sight tests would enable patient care to be provided in a more flexible way while upholding the fundamental principle that a sight test should involve both a refraction and an eye health examination.

Fitting of contact lenses

The GOC has asked for comments on the legislation governing the fitting of contact lenses.

ABDO’s view is that in order to protect the public it is necessary to maintain the current requirement that contact lenses can be fitted only by a contact lens optician, optometrist or medical practitioner. This does not create any unnecessary regulatory barriers.

We are also of the view that the fitting of contact lenses should begin before the re-examination date specified in a valid prescription, i.e. dated no more than two years previously.

We agree that the fitting of contact lenses should certainly begin before the re-examination date specified in a valid prescription, i.e. dated no more than two years previously, and would advise going further than this to ensure that the fitting of contact lenses is completed before the expiry of a valid prescription. The fitting process will often involve the patient trying various different lenses and having a number of appointments. This may lead to the patient being supplied with lenses after the prescription has expired.

Sale of prescription contact lenses

The GOC has asked for views on the legislation governing the sale of prescription contact lenses. The legislation states that prescription contact lenses can be sold:

  • by or under the supervision of a dispensing optician, optometrist or registered medical practitioner; or
  • (as long as the user is not under 16 or registered visually impaired) under the general direction of a dispensing optician, optometrist or registered medical practitioner, who need not be on the premises at the time, if the supplier first receives the original specification or verifies the specification with the prescriber.

In order to be supplied with prescription contact lenses, a patient must have an in-date contact lens specification which has been issued following a contact lens fitting or check. Where the sale is being made under the general direction (rather than supervision) of a registrant, and an original of the contact lens specification is not provided, the legislation requires the specification information (referred to as ‘particulars of the specification’) or a copy of the specification to be verified with the person who provided the original specification.

ABDO’s view is that this legislation is required to protect the public and does not create any unnecessary regulatory barriers. The exception to this is that it should be acceptable for a patient to provide an electronic copy of their in-date contact lens specification without the need for this to be verified, provided it can be read clearly. However, we do not agree with the GOC’s view that the requirement to verify the particulars of a specification should be removed as this would potentially enable contact lenses to be sold without a patient having an in-date specification and therefore without receiving appropriate aftercare.

ABDO is also of the view that what constitutes ‘appropriate aftercare’ should be defined, although we suggest that the GOC should explore whether this needs to be specified in legislation rather than in a policy statement that could be reviewed and updated more easily. An important issue that will need to addressed is what should be the maximum time that can be recommended prior to an aftercare appointment.

Zero-powered contact lenses

The GOC has asked for views on the legislation governing the sale of zero-powered contact lenses.

ABDO’s view is that the legislation should continue to require that zero-powered contact lenses can be sold only by or under the supervision of a dispensing optician, optometrist or medical practitioner.

This is necessary to protect the public. Whereas the sale of prescription contact lenses is permissible under general direction rather than under supervision, this can happen only if a patient has been fitted with contact lenses by a registered practitioner and has an in-date specification. In contrast, the sale of zero-powered contact lenses does not require an in-date specification, meaning that it is necessary to have the extra safeguard of requiring such lenses to be sold by or under the supervision of a registered practitioner.

Sale and supply of spectacles by non-registrants

The GOC has asked for views on the requirement that non-registrants may supply spectacles (to patients who are 16 or over and who are not visually-impaired) only in accordance with a written prescription issued within the previous two years.

ABDO’s view is that this requirement is necessary to protect the public. A prescription may be used only after a sight test has been carried out. This means that as well as a refraction to test their vision, the patient benefits from an eye examination that can reveal eye or wider health issues of which they were unaware.

Supply of sportswear optical appliances to children under 16

The GOC has asked for views on whether the restrictions on the supply of spectacles and contact lenses should continue to apply equally to sportswear such as swimming goggles, sports goggles (such as for rugby, football or squash) and dive masks.

ABDO’s view is that these restrictions are necessary to protect the public and should be maintained. We do not agree that the fitting process for such sportswear is ‘not as complex’ as for spectacles or contact lenses. Sports eyewear is fitted not only to ensure optimum vision but to afford protection to the wearer. Therefore, it is more rather than less complex to fit, requiring detailed questioning about usage and enhanced dispensing skills to ensure a safe, optimum fit.

The call for evidence also suggests that the restrictions might be unnecessary because sportswear is ‘usually only worn for short periods’. While diving masks , swimming goggles or sport goggles can be worn for short periods, they can also be worn over an extended length of time. In any case, if such optical appliances have not been fitted correctly and/or appropriate advice has not been given, there is clearly an increased risk of harm if a child is unable to see clearly under water or is wearing a poorly fitting pair of rugby goggles. This could also result in harm to team members or competitors.

Regulation of optical businesses

The GOC is seeking views on:

  • whether the requirement to register as a business should be extended to all optical businesses that carry out the activities restricted to registrants rather than being limited to corporate bodies that use a protected title
  • what powers are necessary to ensure compliance with its business standards

ABDO’s view is that there should be a consistent approach to business regulation, recognising that some activities are within the control of businesses as opposed to individual registrants. It will be important to ensure, however, that the system of business regulation is proportionate and minimises costs.

Delivery of remote care and technology

The GOC has asked for views on the regulatory implications of technological developments and the potential for increased remote care.

ABDO’s view is that technology can be used to enhance and increase the efficiency of patient care. However, it is vital that technology is used in an appropriate way with oversight from UK-registered practitioners and registered optical businesses, thus ensuring that standards of eye care are maintained.

We recognise that the potential for care to be delivered remotely from outside the UK creates an enforcement challenge for the GOC. There will be a need, therefore, to raise public awareness of the importance of receiving eye care that is under the oversight of a UK-registered professional working for a UK-registered business.