A decision not to implement a facility to allow payment of General Optical Council (GOC) fees in staged instalments was perhaps the most controversial of the Council's decisions at its meeting on September 23 in Harley Street.
Despite repeated and vociferous demands from the Association of British Dispensing Opticians to introduce staged payments (News 04.12.09), the Council decided that such a scheme would require significant development and ongoing costs to provide.
Hearing from its registration department that it was not convinced that the benefits for some registrants would outweigh the significant administrative costs, the Council concluded that a staged payment facility should not be implemented at this point. Matthew Tait of the registration department described it as 'a finely balanced issue' and revealed that potential overheads were estimated at around £30,000 in one-off establishment costs and £50,000-£100,000 in ongoing annual costs depending on take up and other factors. It was also revealed that no other regulator with yearly fees below £400 per year currently offers a staged payment facility.
The conclusion was that if the GOC wished to focus on assisting low income or part-time earners, an alternative approach such as a reduced fee would be more effective. A different fee for registrants on a lower income was seen to be potentially of more benefit to women practitioners, older people and disabled registrants and the registration department was instructed to develop proposals along that basis.
However, the Council also heard that there would be establishment and ongoing costs for implementing any measure such as a reduced fee and that any new measure would be difficult to achieve before the next retention period.
In a heavy agenda, revalidation was the other issue which attracted the most debate.
Having considered the recommendations of the GOC's continuing education and training (CET) policy and development group, the Council agreed a number of revised principles and requirements for the CET scheme post 2012. The proposals, based on research on risks in optical practice and feedback from stakeholder events, included a number of main changes. It was agreed the new scheme should maintain a three-year cycle and a 36-point requirement for all practitioners, but that a minimum annual requirement of six points per year should be introduced. Proposals for a maximum number of points that can be obtained via multiple-choice journal-based distance learning per cycle and a wider scale of points to reflect the nature of activity were also agreed. For example, interactive CET by peer review and clinical skills CET would carry greater points than attendance at lectures or distance learning. Under the proposals optometrists would be required to complete one peer review CET activity involving patient records and challenging decision-making per cycle. Specialists such as contact lens opticians and therapeutic prescribers would be required to obtain six speciality points per year, which for contact lens opticians would be within their general points and for therapeutic prescribers in addition to their general points. Registrants would also be expected to demonstrate that they had a development plan in place for their CET activity to ensure that they met the annual and three-yearly targets and that the CET they chose to undertake was linked to their scope of practice. Council member Kevin Lewis, an independent optometrist, voiced concern that the recommendations appeared 'very focused on when we do points rather than what we do' and questioned the implications for those who wished to take career breaks, go travelling or have children.
The agenda papers also revealed that the GOC's director of education was currently producing a business case to consider the potential savings in administration costs by bringing some elements of the CET scheme in-house. A paper is being produced separately about this issue.
Not discussed in the public session, the GOC's draft response to the Department of Health's report Liberating the NHS and the arm's-length bodies' (ALB) review for consideration by the Council were revealed in the papers published for the meeting. According to the GOC, the review could have implications for its core competencies, and fitness to practise (FTP) investigations, if new quality standards for optometry were developed by the National Institute for Clinical Excellence (NICE). The GOC said it was unclear how the funding for CET available to optometrists would be accessed under the new arrangements. However, it added that the key issues arising from the review would be the transfer of the Council for Healthcare Regulatory Excellence (CHRE) from the ALB sector to self-funding status. The GOC said the CHRE would need to demonstrate that any levy imposed on the GOC was proportionate. It added that, along with the other healthcare regulators, it would need to work closely with the CHRE as it developed its fee and budget proposals, to ensure that the work it carried out was 'cost-effective, in the interests of patients and the public, and does not overburden the GOC and prevent it from carrying out its functions efficiently and effectively'.
Changes to the way FTP information was displayed on the Opticians Registers agreed at the meeting meant that details of struck-off former registrants would not be included in the public registers. However, additional clarification would be included on the GOC website. In future, FTP committee decisions would remain accessible in the Past Hearings section of the GOC website only while a sanction was in force. In the case of hearings where no impairment was found, the decision notice and transcript would be removed from the website after a year. ?