There was a new sense of purpose at the General Optical Council and it was not just the smart new offices the organisation now inhabits at 10 the Old Bailey in the City of London. The level of activity has been high for some time and coincides with the arrival of a new registrar and chief executive.
Vicky McDermott, who took over the top job at the GOC in the summer, has been busy meeting the heads of other associations and regulators. She revealed that the GOC had recently passed the milestone of 30,000 registrants and set its annual report before parliament.
Her report praised the senior management team for its efforts in the interregnum, since Samantha Peters left. Preparations have also begun for a Professional Standards Agency annual performance review. Also on her agenda has been the Government’s consultation into regulatory reform. A process, she warned, that could lead to changes in CET, fitness to practise process and even mergers or deregulation.
The meeting also made time to discuss the integrity of the register, perhaps with governance, and the PSA review, in mind. Council heard that there were 300 boxes of registrant education records in storage that needed to be sample-audited. ‘We need to be able to assure ourselves that someone is legitimately on the register,’ said chairman Gareth Hadley (pictured). Registrants will also have to update their education records as part of the process. ‘This just goes to show that for some time this place was a governance-free zone,’ said Hadley.
It was item 11, of a meaty 34, in McDermott’s report that set the tone. Education and standards went on to dominate the meeting courtesy of the ESR and the suggested guidance to be given to registrants on the back of the GOC’s vision and safe driving research.
The meeting came shortly after Halloween and McDermott used the opportunity to raise the work it has been doing through its Love Your Lenses campaign and working with other optical bodies. DO member Glenn Tomison asked if the number of problem lenses encountered was growing. McDermott said the GOC did not have a baseline figure for the issue. There was agreement that the campaign had had a good public profile and Hadley concluded that there would be more activity next year. The responsibility to raise the issue: ‘falls fairly and squarely on us,’ he said.
The chairman’s report also raised the issue of regulation and education. Hadley said meetings with a broad group of regulators and representative bodies showed there were common themes spanning patient needs and registration. ‘There were some very strong messages that chimed with the consultation: earlier experience for optometry students plus more marketing and training,’ he said.
In the follow up questions from around Council optometrist member David Parkins said clinical experience should be that and not just viewing. ‘Optometrists have to have experience of managing problems,’ he said. Hadley had earlier referred to CET and CPD [continuing professional development] and Parkins made the point that whatever training is called it will have to align with the work being carried out and future contractual arrangements will have to change. ‘In the future people will have to take on an increased level of risk. It’s not about being a technician.’
The meat of the ESR consultation was introduced by director of strategy Alistair Bridge (pictured) who said some clear messages came back, including those from other health regulators. ‘We hope that we can learn from them and not re-invent the wheel,’ he said.
Some of the common themes were: an outcomes-based approach, earlier clinical experience, providers being more flexible and innovative, multi-professional learning and a risk-based approach to quality assurance. He also welcomed thoughts from providers, a round table discussion of stakeholders had highlighted many of the same themes.
The Continuing Education and Training project is inextricably linked to the ESR and, following an update, the project’s approach was broadly welcomed. Parkins said it would be useful to have a younger perspective. ‘It would be useful to have the views of newly qualified optometrists because they have just gone through the system,’ he said. ‘Forty years ago I had clinical experience in my first year and it seems to have changed over time.’
Helen Tilley optometrist, said additional qualifications should also be taken into consideration as they are going to become more important in the future. Roshni Samra optometrist said: ‘I work very closely with third year students and they had expressed a desire to have their thoughts heard.’
Tomison suggested CET/CPD could not be delivered with a one size fits all approach. Mike Galvin, lay member, raised the issue of progress and how long the project was taking and if things were getting ‘a little bit off track’. Josie Forte, optometrist member, agreed.
Dr Scott Mackie (pictured) said it was paradoxical that the GOC does not regulate for qualifications but regulated fitness to practise for everybody on the register. ‘There are very different paths and ways of working so they all have to be considered.’
Bridge added that the current system was designed for a different era and was not based on sound evidence. ‘The new system has to have buy-in from stakeholders.’ He said there was a balance between making progress and getting it right. ‘It’s being delivered on the timetable but is that timetable right?’ asked McDermott.
Carrying on the education theme Head of Education and Standards Marcus Dye contended that the CET scheme is a CPD scheme and a revalidation scheme all rolled into one. ‘We are one of only four regulators to have a revalidation scheme.’ Council agreed that CET and the ESR had to be considered together, Dye said there would be changes to the scheme: to improve customer service, marketing and accessibility, but the plan was for it to retain its current structure.
Dr Mackie said the question of engagement was an issue. ‘The big problem we have got in the profession is people who do the basic minimum and others who do eight million [CET points].’ He suggested CET was still seen as a tick box exercise by some and a PDP [personal development plan] with tailored learning was a better approach. ‘The dichotomy is the people who do not interact,’ he said. Hadley concluded that for education and supervisory issues the legislative framework was not particularly helpful.
It was discussion on the outcomes from the ‘Vision and safe driving report’ (Optician 17.11.17) that elicited some of the keenest debate. Dr Mackie said while he agreed with the research he suggested the interpretation of its findings were wrong. The intention of the guidance was good but it did not go far enough. ‘This is an archaic system,’ he said ‘We are using tests on the public which aren’t evidence based.’
He said it was all too common to see patients in practice who would be told they could not drive and leaving them to self-report. He also said that up to 85% of appeals by glaucoma sufferers to have their driving licence restored were successful. More specific instruction to registrants around reporting to the driving agencies was needed. ‘If you do not make it more robust people will still die. We have to go for legislative change,’ he said.
Hadley responded by saying the issues raised were beyond the GOC’s remit. ‘Scott has raised valid issues but ones that relate to public policy. I do not think it is within our power to introduce a new piece of public policy.’
Tomison said false positives in field testing HGV drivers was a real issue which could see people lose their livelihood and said the insurance industry could do more to help. Lay member Sinead Burns said she had sympathy for Mackie’s position but said the guidance had gone as far as legislation would allow. Samra said it was ‘a very fuzzy area for registrants’, and difficult for registrants to phone the DVLA. She suggested many would be scared of ending up in front of a fitness to practise panel.
It was great to see so much enthusiasm, lay interest and passion at the Council. A round of applause after Dr Scott Mackie’s interjection on driver’s vision would not have gone amiss. If the GOC continues to hold meetings as lively as the latest it will have queues to rival those outside its Old Bailey neighbour.