A General Optical Council (GOC) meeting held on March 22 approved the regulator’s response to the 2022 call for evidence on the Opticians Act.
The GOC’s proposed programme of legislative reform was based on an analysis of responses submitted by stakeholders.
The call for evidence was conducted to help the GOC consider whether the Opticians Act was fit for purpose and whether there was any evidence of impact to support any changes to the Act.
It was part of the Department of Health and Social Care’s (DHSC) consultation that sought to modernise the regulatory frameworks for fitness to practise, education, registration and governance across all healthcare regulators.
The GOC consulted on associated policies, specifically whether the GOC should amend or remove its 2013 statement on testing of sight, which stated that refraction cannot be delegated for the purposes of a sight test.
It was decided not to permit refraction by dispensing opticians for the purpose of a sight test. However, the GOC agreed to revisit its 2013 policy statement so it reflected contemporary practice and took into account technological developments and changing business models.
The GOC commissioned research to assist its decision-making process on refraction by dispensing opticians for the purposes of the sight test. This included a report on the public’s views on refraction from an online community discussion, telephone interviews and a survey of 2,003 people in the UK.
It found the public supported dispensing opticians being able to conduct refraction for the purposes of sight tests with appropriate training and safeguards.
The GOC asked participants how comfortable they would be seeing an optometrist for the refraction part of a sight test and eye health check, and 85% said they were very or somewhat comfortable.
When participants were asked if they were comfortable seeing a dispensing optician for the refraction and then an optometrist for the eye health check, 71% said they were very or somewhat comfortable.
However, the GOC then gave respondents more information on sight tests, including the current roles of optometrists and dispensing opticians.
It asked respondents if they supported or opposed dispensing opticians being allowed to conduct refraction as part of the sight test. 52% strongly or somewhat supported it, 19% neither supported nor opposed or did not know, and 29% strongly or somewhat opposed it.
Business regulation reform
The GOC said a key priority would be to develop and consult on a new framework for business regulation. This included extending regulation to all businesses carrying out restricted activities, regardless of their name, corporate structure, and who owned and managed them.
A draft framework for business regulation would be developed that would be subject to public consultation, the GOC said.
In addition, the GOC said a review of its standards, which did not require legislative reform, would enable it to progress policies on dispensing to vulnerable patients and the use of technology in optical services. It also planned to discuss regulations related to criteria for visual impairment and online spectacle sales with the DHSC.
A final response was slated for publication in April, followed by a timetable to deliver on the commitments outlined in the response document.
Professional bodies react
Welcoming the GOC’s summary, the Association of Optometrists (AOP) said it was important optometrists remained in control of the sight test.
Adam Sampson, chief executive at the AOP, said: ‘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.
‘The GOC’s commitment to a full consultation before any changes are implemented is also a welcomed move. This is pertinent when it comes to issues of funding, online sales and business regulation, which require interrogation and we look forward to positive engagement on these.’
The College of Optometrists also said it was crucial the sight test was preserved as a refraction and ocular health assessment conducted by an optometrist or registered medical practitioner.
‘The College worked tirelessly with members to draft our response, and to ensure that the role and scope of the optometrist is advanced as a consequence of the review. We look forward to working in consultation with the GOC, and, as always, will ensure our members’ voices are heard as part of the next stages,’ said Professor Leon Davies, president of the College.
However, the Association of British Dispensing Opticians (ABDO) was confused by the GOC’s decision to review its sight testing statement while ruling out allowing dispensing opticians to conduct refraction.
Alistair Bridge, chief executive at ABDO, said: ‘We welcome the GOC’s commitment to considering how its standards could improve the dispensing of spectacles to vulnerable patients. But less easy to understand is the GOC’s decision to, on the one hand, review its 2013 policy statement on sight-testing and, on the other hand, to rule out amending this statement to enable dispensing opticians with appropriate training to carry out refraction as part of the sight test under the oversight test of an optometrist.’
