Threlfall appeal goes before High Court

The outcome of the Nicole Threlfall legal appeal will have ramifications for the whole profession, the High Court heard last week. The optometrist was found guilty of serious professional misconduct in May, and the outcome of her appeal will not be known until later this month at the earliest. Last week (October 8), the High Court heard how she was fined £500 after a GOC disciplinary panel found all allegations against her proven earlier this year. The 'test case' appeal stems from an appointment of a 34-year-old in 2002 who saw Threllfall at the Makerfield Eye Centre, Lancashire. He was told there was nothing to worry about and to go home, but the vision in the right eye was deteriorating and hours later he discovered he needed an emergency operation. The AOP-backed appeal last week heard Beverley Lang QC claim that the disciplinary committee's decisions increased 'the scope of the professional duty' and that Threlfall was not under a duty to diagnose. 'There is concern for others who may find themselves in the same situation,' said Lang, for Threlfall. 'It went beyond the proper limit.' Threlfall had not seen any evidence of retinal detachment but after attending the Warrington Accident & Emergency, the patient was referred to the Royal Liverpool University Hospital for surgery. The optometrist said the reason she did not carry out more tests was because 'I knew I was going to refer him [to hospital] and I knew this examination was going to take place.' As Threlfall knew she was going to refer the patient, Lang told the High Court, she complied with her professional duties under the rules. Referring to the Injury or Disease of the Eye 1999 and Sight Testing (Examination) and Prescription (No 2) Regulations 1989, examinations are for the purpose of 'detecting signs' they constitute an investigation rather less than diagnosis, said Miss Lang. 'She doesn't have to diagnose. 'She has made a professional judgement. He was too agitated to dilate the pupils and knowing she was referring him and that dilating would be done at hospital, she didn't need to dilate.' Of the disciplinary committee's judgement Lang said: 'The test that was applied was too high Ð the standard was too high for a finding of serious professional misconduct.' Although the original grounds of appeal included a failure by the committee to give any or adequate reasons, Lang told the High Court the GOC had now provided 'meagre' ones. Alison Foster QC, for the GOC, said reasons are not generally given in professional conduct committee cases. Referring to the GOC she said: 'They don't shrink from best practice of providing reasons but it's not absolute law.' The hearing was adjourned until October 22 for Foster's reply to the main submissions before judgement will be reserved.