The Professional Standards Authority (PSA) for Health and Social Care has released its 2019/20 performance review of the General Optical Council (GOC). In the review, the PSA found the GOC met the requirements for 16 out of its 18 standards of good regulation but failed to adequately meet its requirements to maintain and publish an accurate register and process fitness to practise cases in a timely manner.
Despite failings in these two areas the GOC has welcomed the PSA’s findings, and explained that it was implementing measures to improve its performance in relation to the areas where it did not meet regulatory standards.
Registration issues
The two standards for good regulation the GOC failed to meet were listed by the PSA’s review as Standards 10 and 15. Standard 10 required that the GOC maintain and publish an accurate register of members who meet its requirements, including any restrictions on their practice. According to the PSA, three separate, unrelated errors on the GOC’s register meant the organisation had not met standard 10.
During its checks the PSA identified one individual listed as registered while they were serving a suspension. A subsequent GOC investigation found this was caused by an administrative error. Another mistake was identified wherein the GOC had added 10 individuals to its register who had graduated with a qualification that the GOC had not approved.
The PSA’s review conceded that the GOC had made changes to its processes to reduce the risk of this sort of error being repeated. These measures included a greater use of checks, a fortnightly review of all open cases and additional training for staff.
However, the PSA explained: ‘In each case, the GOC subsequently took appropriate action to correct the register and change its processes. Together, however, they indicate that during the performance review period the GOC did not have sufficiently robust processes to ensure that it only added people to its register when they were appropriately qualified and that suspensions were clearly marked.
‘There appeared to be a combination of systemic flaws, such as the limitations of the customer relationship management system, and individual errors.’
GOC chief executive and registrar, Lesley Longstone, commented: ‘The accuracy of our registers is a fundamental part of our duty to protect the public. Although the errors noted were resolved in good time, we will be taking on board the feedback that we have received from the PSA to ensure that we are continuously improving and on track to delivering world-class regulatory practice.’
Timeliness concerns
The GOC also failed to meet standard 15, which investigated the regulator’s process for examining and investigating fitness to practise cases, and whether they were fair, proportionate and dealt with in a timely manner. For the sixth year in a row, this standard was not met based on the time it took the GOC to come to decisions.
The PSA review said: ‘The GOC continues to take too long to conclude its fitness to practise casework and this is the sixth year in a row that it has not met our standard relating to timeliness. Its performance, in terms of the length of time it takes for a case to be decided, remains the worst of the 10 regulators we oversee. The GOC, however, has shown a firm commitment to tackling the issue and is implementing an improvement plan that is starting to make an impact.’
Longstone commented: ‘We are aware that there is still work to be done to improve the timeliness of our fitness to practise cases and have been working to implement our improvement plan, in line with our Fit for the Future Strategic Plan for 2020-25.’
Cases aged between one and two years were significantly reduced by the GOC during the review period, an indication that the regulator has tackled its more complex cases. However, the PSA review demonstrated that dealing with this backlog had increased the median time it took for fitness to practise cases to be completed. In the previous review period (2018/19) the average time from receipt of referral to case examiner decision was 51 weeks, and this rose to 60 weeks in the 2019/20 review. The median time from a case examiner decision to a final hearing remained static at 67 weeks, while the time from receipt of referral to final committee determination rose from 112 weeks to 120.
Longer times for decisions were not entirely related to disruption from the coronavirus pandemic, explained the PSA. ‘Although this coincided with the first six months of the Covid-19 pandemic, the GOC had already forecast the median figure to increase to 130 weeks in the third quarter of our performance review period before the outbreak had started.’
While not entirely comparable owing to higher or lower risk professions, the next slowest regulator that the PSA monitors, the General Dental Council (GDC), achieved a median time from receipt of initial complaint to final determination of 107 weeks. The General Medical Council (GMC) took a median 89 weeks from receipt of a fitness to practise complaint to hold a final hearing.
Of the seven performance reviews for 2019/20 that the PSA has released, only the GMC and General Chiropractic Council met all of PSA’s standards for fitness to practise, and many failed more standards within the fitness to practice category than the GOC did. The GDC failed to meet standards on both timeliness and properly identifying risks, while the Health and Care Professionals Council only met one out of five fitness to practise standards.
Coronavirus response
The GOC’s response to the coronavirus pandemic was praised in the PSA’s review, which said that the regulator had ‘responded quickly and constructively’ to the ‘unprecedented set of challenges’ the pandemic presented.
According to the PSA: ‘The GOC consulted quickly and constructively with key stakeholders as it made these changes, and has consulted more widely and thoroughly as it considers making longer-term changes.’ The review noted that the GOC issued timely guidance for registrants and businesses on a range of topics that was well received by many stakeholders.
Additionally, the PSA explained that the GOC’s decision to keep its strategic plan under review and to seek feedback on its published guidance during the pandemic helped it meet Standard 2,
which measured the regulator’s ability to be clear about its
purpose and appropriately apply its policies.
Concerned registrants
Praise for the GOC’s coronavirus response stood in contrast to a number of petitions posted by members of the profession, both during and soon after the review period for the PSA’s recent report.
June 2020 saw the authors of a petition signed by over 8,000 people call for the GOC to be investigated by the PSA for what they called ‘a clear conflict of interests’. The petition claimed that ‘many optometrists and dispensing opticians feel let down by the complete lack of leadership and clarity from the GOC throughout the pandemic,’ and added that the regulator has released ‘conflicting and delayed guidance’ on how to operate during the pandemic.
The PSA responded to the petition a month later following a promise to investigate the concerns it raised. In its response, the authority explained that it believed ‘the GOC consulted with an appropriate range of stakeholder organisations’ and would not be undertaking a special review owing to a lack of serious concerns about the regulator’s performance.
In its review, the PSA noted that concerns over conflicts of interest raised in this petition were concerns that it had shared over the course of its past two performance reviews. However, it explained: ‘The GOC has acted to address our concerns and published an updated management of interests policy in 2020. It has circulated this to all members and staff, and provided training to Council members in September 2020.’ The GOC planned to roll out mandatory training on this subject to all members during early 2021, added the PSA.
Following the end of the 2019/20 review period, in January 2021, the Ophthalmic Practitioners’ Group, an optometry trade union, posted a petition that claimed the GOC had ‘failed to protect the public, listen to stakeholders and will fail to maintain standards for education if left to its own devices.’ Nearly 800 people signed this petition after it was posted and added their support to the statement that ‘the GOC has been defiant and has taken no responsibility for their
performance.’
The PSA review disagreed and stated that although some stakeholders had told it that the GOC’s consultations during the pandemic had been too short, it believed that this had to be ‘balanced against the need for action.’
In its conclusion on the GOC’s performance against Standard 5, which evaluated the GOC’s ability to work with and consult relevant stakeholders to identify and manage risks to the public, the PSA said: ‘[The GOC] has struck a fair balance between speed and completeness in consulting on new guidance during the pandemic, and has properly prioritised the need to protect the public’.
- To view the PSA’s full report, visit bit.ly/3apefJP