Standards Review: what have stakeholder conversations told us?

Rebecca Chamberlain, Standards Manager, updates on the progress of the Standards Review following conversations with stakeholders.

As part of our statutory commitment to ensure continued public protection, we launched the Standards Review in April 2023. The purpose of the review is to ensure that our standards are fit for purpose and reflect the current context within which registrants practice, students are trained, and businesses operate. The focus of the Standards Review is the Standards of Practice for Optometrists and Dispensing Opticians, and the Standards for Optical Students, which were last reviewed in 2016. Any changes to these standards, will be reflected in amendments to the Standards for Optical Businesses where necessary.  

Since April, we have focused on engaging with stakeholders by hosting a series of conversations on key topics which we felt would benefit from further consideration. We chose areas where we think expectations and/or practice have changed, or where we identified there were potential gaps in our standards. The stakeholder conversations were open to all registrants (student and qualified) and professional bodies. We have engaged separately with education providers, business registrants, and others. In June, we commissioned a piece of research to explore patient and public perceptions of our standards of practice, and we expect this work to conclude in September.

The stakeholder conversations gave us excellent insight into the opportunities, challenges and concerns faced by stakeholders, which will help us to make more informed decisions about revisions to the standards. We have summarised a few headlines for each topic below.

Social media and online conduct

We heard that social media is being used for educational purposes, research, facilitating communities of practice, peer to peer support, professional promotion, and raising awareness of eye care and health.

Current issues mainly relate to the blurring of boundaries between personal and professional conduct online, and the context and intent of online communications are important considerations. Another issue raised was the sharing of patient’s retinal images via social media, for clinical support and/or educational purposes, and whether patient consent is needed.

Supervision and delegation

There is some uncertainty around the requirements of supervision. In general stakeholders felt that the requirements for a supervisor to be on the premises should remain, but further clarity is needed around what it means to be in a ‘position to intervene’.

In terms of delegation, there was broad agreement that the registrant who delegates activities should remain responsible. However, there is a need to consider the role of businesses, in ensuring that staff are appropriately trained, and processes and procedures are in place, to facilitate effective delegation.

Leadership

Stakeholders agreed that all registrants should demonstrate leadership skills to some extent. There was recognition that culture is important, as registrants need to feel enabled to exercise leadership and confident to step forward and address issues.

It was felt that some leadership skills and attributes are embedded in the existing standards but may not be recognised by registrants as “leadership”.

Technology, AI, and Digital Literacy

We heard that technology and AI have already changed the delivery of optical care and will continue to do so, however, the speed with which these technologies are being adopted may differ.

Technology and AI used to support diagnosis could give greater opportunities for clinicians to engage with and support patients, however, it is important that professionals understand the technology they are using to inform their decision making, so patients can be confident in the quality of care.

Professional boundaries

Registrants are aware of the need to maintain professional boundaries between themselves and patients, however, there may be less awareness of the need to maintain professional boundaries between themselves and other colleagues. Social media is blurring the lines of professional relationships.

Maintaining professional boundaries with patients can be more challenging in specific types of practice, e.g., domiciliary care, and some registrants have experienced boundary crossing by patients. Failure to maintain boundaries can have a significant impact on all parties, e.g., patient trust can be damaged, and registrants’ willingness to remain in the profession can be impacted.

We are grateful to all the stakeholders who have engaged in the review thus far.

What’s next?

Our focus for the next few months will be reflecting on what we have heard, and making draft amendments to the standards, in preparation for a full public consultation in January 2024. The consultation will be live until April 2024, and we would encourage as many stakeholders as possible to contribute to the consultation. Once the consultation closes, we will consider all responses thoroughly, before drafting the final sets of standards. We will publish the revised standards in autumn 2024.