The General Optical Council fitness to practise committee has issued a warning to optometrist Robert Frith of Robert Frith Optometrists after it found his professional performance ‘deficient’, but has ruled that his fitness to practise is not impaired.
The warning was announced yesterday after a two-day hearing into allegations firstly, that Frith did not undertake a visual field test on a patient between 1982 and 2004; secondly, that he did not record the patient’s family history of glaucoma on any records cards since the examination in 1982; thirdly, that he failed to keep adequate records for the patient; and that for these reasons his professional performance was deficient.
Frith, whose group has 10 practices, mainly in the South West, admitted the first two allegations but denied that he failed to complete adequate records of her examination and that he provided a deficient professional performance.
The hearing was told Frith had examined the 80-year-old patient 17 times in 22 years but failed to pick up her glaucoma.
Chris Alder, for the Council, said that despite a visual field test taking only two minutes, Frith did not include one when he examined her.
Denying that his actions fell below the standards of a reasonably competent optometrist, Frith said that he had had no reasons to carry out a visual field test.
He said that, if the patient had come back to him with her concerns, or complained that her peripheral vision was impaired, he would at that stage have carried out the test adding that if he had done that he would ‘not have been the villain, I would have been the hero.’
He said that, from his experience, family history was not as significant a factor in the development of glaucoma as the prevailing professional opinion suggests, and could lead to visual field tests being carried out when they were not necessary.
He said: ‘I do not know why that view has prevailed. I think it may be because we live in a litigious world and it is a test we can do. We are not doing it because it is in the best interests of the patient.’
Frith said he had been qualified for 37 years and was fully up to date with modern procedures, regularly attending world conferences and other industry events.
Sandhya Kapila, representing Frith, said: ‘It’s suggested the admissions are somehow negative but they are not negative.
‘He had the equipment in his clinic and had no reason to refer so the Council’s issue is whether he should have undertaken visual field tests.’
She continued: ‘He told you why he judged not to do visual field tests. Nowhere in the guidelines should it be done every five years – its totally silent – its left to the judgement of the practitioner.’
Kapila added that patient experts considered that something had changed ‘catastrophically’ between the patient seeing Frith and the optometrist she saw next.
The committee’s determination, announced Wednesday, found Frith’s professional performance deficient with respect to the first allegation. For the second allegation, it found that since the family history was recorded on the top card of a continuous record relating to the patient, Frith’s performance was not deficient. For the third allegation, the committee ruled that no consistent record of the patient’s general health had been kept and that Frith’s records were inadequate, therefore his performance was deficient.
However the committee found that the fitness of Frith to practise as an optometrist was not impaired given evidence of remedial action, testimonial evidence of good character and that this was Frith’s first complaint in 37 years. It did however issue the following warning:
‘Experience alone does not guarantee an acceptable standard of performance. The committee requires that you take heed of current best practise in respect of appropriate diagnostic tests and patient record keeping.
‘Public confidence in the profession can be maintained only by consistent application of acceptable standards of practice by registrants. Not withstanding your considerable experience you must ensure your practice in both these areas does not fall below that standard.
‘This committee reminds you once again that it has found you deficient in professional performance in the two allegations surrounding visual field testing and in failing to maintain adequate patient records.’
Frith told the hearing he would ‘take heed’ of the warning about his future conduct.
Useful links
Read the full decision from the GOC fitness to practise committee
Robert Frith Optometrists home page