GOC refraction decision “disappointing”
After “careful consideration” of the responses to its call for evidence on the Opticians Act (1989) and consultation on associated policies, the General Optical Council (GOC) has decided not to permit refraction by dispensing opticians for the purposes of the sight test.
The regulator has though agreed to “revisit its 2013 policy statement so that it reflects contemporary practice, taking account of technological developments and changing business models”.
ABDO CEO, Alistair Bridge
Commenting on the decision, ABDO CEO Alistair Bridge, said: “It is obviously disappointing that the GOC has decided not to allow dispensing opticians to carry out refraction as part of the sight test. Under our proposal, dispensing opticians would have been allowed to refract only under the oversight of an optometrist and after receiving appropriate training, thus guaranteeing patient safety.
“It is unfortunate that many of the people who responded to the GOC’s consultation seem to have seen this limited change as a threat to the role of the optometrist, and as a challenge to the UK’s long-standing and successful model of combining refraction with an eye health check, a model which we fully support.
“Developments in technology, including the use of autorefractors, mean the way that sight tests are provided is changing already. We therefore welcome the GOC’s decision to review its 2013 policy statement on sight-testing so that it reflects contemporary practice and clarifies the role of multi-disciplinary teams, including the role of dispensing opticians.
“More widely,” Alistair continued, “we welcome the GOC’s commitment to considering how its standards could improve the dispensing of spectacles to vulnerable patients. It is vital that children and vulnerable patients more generally benefit from the expertise of dispensing opticians. In particular the dispensing of spectacles for myopia management will be effective only if those spectacles fit well.”
The College of Optometrists welcomed the decision. Its president, Professor Leon Davies, said: “We are pleased to see in the GOC’s draft response that we have successfully influenced the process and that many of our recommendations have been included, most crucially, that the sight test will be preserved as a refraction and ocular health assessment conducted by an optometrist or registered medical practitioner.”
The Association of Optometrists (AOP) said it broadly welcomed the summary put forward by the GOC. Adam Sampson, AOP chief executive, said: “We are pleased to see that the GOC has heeded concerns expressed by the AOP, along with other stakeholders in the profession, and in particular the importance of optometrists remaining in control of the sight test. While it has never been our intention to limit the aspirations of our dispensing optician colleagues, we recognise the significant concerns that our members voiced in this process, particularly the risk of missed pathology. The patient benefit and protection must be at the centre of any reform.”
In 2022, the GOC asked registrants, sector bodies, employers, patients and the public to contribute a body of evidence to support future legislative changes to the Opticians Act (1989). The call for evidence is linked to planned reforms of health and social care regulators by the Department of Health and Social Care (DHSC).
The GOC has now approved the response to the call for evidence and its analysis, conducted to help it consider whether the Opticians Act is fit for purpose –and whether there is any evidence of impact (positive or negative) to support any changes to the Act. This was combined with a consultation on associated GOC policies, specifically whether the GOC should amend or remove its 2013 statement on testing of sight, which provides that refraction cannot be delegated for the purposes of a sight test.
The call for evidence sits alongside the DHSC’s ongoing consultation designed to modernise the regulatory frameworks for fitness to practise, education, registration, and governance across all healthcare regulators.
The GOC said a key priority will be to develop and consult on a new framework for business regulation. It has agreed to seek legislative change that would extend regulation to all businesses carrying out restricted activities, regardless of their name, corporate structure, or who owns and manages them. The next phase of work will be to develop a draft framework for business regulation, which will be subject to public consultation.
Through a review of its standards, the GOC will be able to make progress in key areas without legislative reform, including dispensing to vulnerable patients and the use of technology in optical services. It also plans to discuss regulations related to criteria for visual impairment and online spectacle sales with the DHSC.
The GOC anticipates publishing the final response document in April. It will then prepare a timetable to deliver on the commitments set out in the response document. Where the GOC considers changes to legislation or GOC policy are necessary and can be evidenced, it will carry out further public and targeted stakeholder consultation activities on its proposals.
Read more about the GOC’s legislative reform and analysis of the 2022 call for evidence responses.