Last year was the first time the GOC had collected full monitoring data for registrants; previous years had only measured age and gender. The new data, presented to council at its quarterly meeting in central London, threw up some difficult issues that both the GOC and profession must work together to address.
In its Equality, Diversity and Inclusion (EDI) Report for 2017/18, the GOC found that Black and Minority Ethnic (BME) registrants were ‘more likely to have a Fitness to Practise (FTP) allegation made against them and are more likely to be referred for a FTP hearing’. Furthermore, a ‘disproportionate number of BME optometrist registrants (predominately Indian and Pakistani British) are subject to FTP investigation’, compared to the GOC’s registrant profile. Linked to this, ‘a disproportionate number of Muslim, Hindu and Sikh registrants are subject to FTP complaints,’ said the report by Nicola Ebdon, head of governance at the GOC.
‘The finding that men and/or BME registrants are more likely to be subject to a complaint is one that we take seriously,’ Ebdon told Optician. ‘There could be a number of reasons for the findings, so it is important that we first explore the data in more depth to see if there are any patterns.’
Selina Ullah, chair of the GOC education committee, has long advocated the collection of monitoring data. She said: ‘The finding that men and BME registrants are more likely to be subject to a complaint is not unique to the GOC among regulators, so it may be the case that not all the factors behind it are entirely within our control.
‘We need to spend time understanding the data and undertaking further analysis to uncover any identifiable reasons for this before considering what action to take. We are keen to work with the Optical Consumer Complaints Service, other healthcare regulators and other complaints bodies to understand this data trend.’
EDI data showed that individuals of Indian/British Indian ethnicity made up 18% of GOC registrants but accounted for 27% of FTP investigations. Meanwhile, 20% of registrants subject to FTP investigations identified as Muslim, compared with 11% of all GOC registrants – a similar pattern emerged for Hindus, who represent 10% of registrants but comprise 14% of FTP investigations.
‘There is a risk we might not effectively embed EDI awareness and deliver our EDI activities and therefore not meet our legal responsibilities and suffer reputational damage,’ said Ebdon’s report. ‘To mitigate these risks, we agree an EDI strategy every three years, which includes EDI objectives mirroring our strategic objectives.’
The GOC’s current EDI strategy – for the period 2017-20 – was ‘developed with the aim of embedding and promoting EDI’ within the regulator and to ensure the requirements of the Equality Act of 2010 are met. The Act provides protection against discrimination on the basis of nine protected characteristics: age; disability; gender reassignment; race/ethnicity; religion or belief; gender; sexual orientation; marriage and civil partnership; and pregnancy and maternity.
As part of its current equality strategy, the GOC commits to ‘remove or minimise disadvantages and barriers experienced by people due to their protected characteristics’ and to ‘tackle prejudice and promote understanding’.
Despite the above issues associated with ethnicity, religion and FTP – something the industry must investigate – optics remains a diverse occupation. Compared with the UK profile, people who identify as Muslim or Hindu are well-represented in the industry – 21% of GOC registrants either identify as Muslim or Hindu, compared with only 5% in the greater population. Furthermore, 30% of registrants identify with BME categories, which is far higher than the national average of around 15%.
Given this was the first time the GOC was able to analyse and report on the new data, Ebdon was not sure of what to expect. ‘The results do show similar trends to other regulators,’ she said, ‘however, I am conscious that only 85% of registrants provided data and for each protected characteristic up to a further 16% of respondents ticked the prefer not to say option – I’d really encourage all registrants to take part so we can get as accurate a picture of the register as possible.’
Gender
The findings of the report also revealed a gender imbalance when it comes to FTP cases. While there are more female optometrists and dispensing opticians registered with the GOC (62% of all registrants are female), men were more likely to be referred to, and investigated by, FTP tribunals. Conversely to the industry’s demographics, 68% of the total registrants complained about were male, with 32% being female. This is an increase from the year before (2016/17) when men made up 56% of complaints.
The data showed that 65% of optometrists subject to FTP investigations were male, compared with 35% female. And 78% of DOs subject to investigation were male, with only 22% being female. Moreover, the allegation type differed for male and female registrants: male registrants were ‘slightly more likely to have a nonclinical complaint than female registrants’.
The report stated: ‘The gender distribution of registrants subject to FTP investigation differs across fully qualified and student registrants. For both optometrists (54%) and dispensing opticians (62%) a higher proportion of those subject to an FTP investigation were male. For students, the gender distribution of those subject to an FTP investigation was equal.’
Ebdon stressed that ‘it is worth remembering too how few registrants end up in the FTP process – only around one per cent of registrants are subject to a complaint each year, with only a single-figure number erased out of a register of over 30,000’.
Business standards
As well as elucidation on EDI in the sector, the council meeting also approved a new set of standards for optical businesses. Amendments to the standards had previously been made after feedback from stakeholders during a consultation period. Following this, the GOC’s amended standards made clearer the regulator’s expectations of business registrants.
Feedback from the draft standards provided by patients, practitioners, businesses and optical bodies highlighted language issues and applications to online businesses. Much of the disagreement that emerged from the consultation focused on issues around the supervision of students and what employers were required to do, communication to businesses, and business readiness when it came to the implementation date of the new standards, which is October of this year.
The GOC said: ‘GOC has addressed these concerns by rewording some standards to ensure that they can be achieved in a variety of business settings and where possible standards have been made more specific, although in some areas flexibility is required to allow businesses to use their judgement when applying the standards to their particular circumstances.’
Natalie Michaux, standards manager at the GOC who had a key role in creating the standards, said most of the changes, following consultation, had focused on language clarity as the GOC did not want to constrain businesses. ‘The purpose was to clarify expectations, not to increase the burden on business,’ she added.
Consultation analysis found high approval ratings from respondents. Around seven in 10 respondents agreed that the standards could be applied to, and by, different types of optical business and 81% agreed that the GOC’s expectations were clear. Patient feedback also indicated that the vast majority, 84%, would rather ‘use an optical business that meets a certain set of standards, than one that does not’.
Other notable businesses issues to be discussed at the council were the absence of optometrists from the NHS Long Term Plan, which council members dubbed ‘disappointing’ but admitted was out of their remit as a regulator rather than representative of the industry, the plan to celebrate
CET achievers rather than focus solely on those who did not attain their required points and the GOC’s preparations for a no-deal Brexit, which it said had been extensive.