Following consultation, the General Optical Council (“GOC”) announced new guidance on safeguarding against abuse, neglect and power imbalances. These two guidelines focus on the treatment of vulnerable patients and upholding professional sexual boundaries.
Understanding of these guidelines is essential for optometrists, opticians and businesses delivering optical services to comply with regulatory standards, minimise risk, and prevent claims.
The essentials of this new guidance are summarised below.
Vulnerable Patients Guidance
What is a Vulnerability?
It applies to all patients who may benefit from extra support or have a higher risk of neglect or abuse. That may be visible or apparent, such as where the patient
- has a physical health condition or disability,
- has a language barrier with the clinician,
- receives treatment in their own home.
Other vulnerabilities can be less obvious. Examples include
- poor mental health,
- neurodivergence or learning difficulties,
- bereavement,
- financial hardship,
- trauma or domestic abuse.
What Should Businesses Do?
The key steps for optical businesses are:
- Giving everyone visiting your premises notice of any access barriers, such as stairs;
- Ensuring vulnerabilities are accurately identified, securely recorded, and appropriately shared to ensure the best care is delivered;
- Supporting staff to adjust their practices to be accessible and adaptable to patient needs, providing training as required.
Circumstances creating vulnerability impact people differently and some are transient, so it may be unreliable to rely on a standard, one-off assessment of a patient, which may quickly be outdated or fail to capture the individual impact on a particular patient.
Businesses should review their policies and procedures to check these are compliant with the new guidance. The full guidance is available here.
Sexual Boundaries Guidance
Where are Sexual Boundaries Appropriate?
What is appropriate depends on type of relationship involved. In some cases, sexual contact is always inappropriate:
- Current patients – regular patients will build relationships, hand over to a colleague, cannot deliver care to current sexual partners, may infringe objectivity as a clinician and patient’s honesty about their health
- Vulnerable patients, including those under 18 years old: are always inappropriate and should be reported to minimise the risk of abuse, misconduct, or substandard care.
Other relationships may be permissible, depending on the circumstances:
- Former patients: only if the professional relationship is only long impacts the relationship and there is no risk of a future impact; for example, through the treatment of relatives or carers
- Colleagues, students and other professionals: may be permissible, so long as not impacting the delivery of care.
What Crosses a Sexual Boundary?
Behaviour which breaks a sexual boundary is much wider than conduct which is a criminal sexual assault. Examples of other inappropriate behaviour includes:
- Excessive compliments or comments on someone’s appearance, even if not about the recipient of the comment
- Discussion of someone’s sex life
- Innuendo
- Suggestive looks
- Building relationships to coerce someone to consent
These actions can be subtle and can vary with the power imbalance involved; so they will not always be easy to identify. Each person’s cultural or spiritual background can change their perception of appropriate boundaries too.
What Should Businesses Do?
An important step is ensuring all colleagues are aware of reporting mechanisms for sexual misconduct, against colleagues or patients, or a relative or carer of a patient. They should also be aware of when they must report sexual misconduct or inappropriate relationships. Fostering a culture in which colleagues are comfortable to report is key.
You should develop a similar culture and process for reports from patients or others about inappropriate behaviour in the delivery of care.
This professional, regulatory guidance should be considered alongside your employment policies and your duties on sexual harassment prevention under the Equality Act. The full guidance is available here.
Summary
Ensuring you are keeping up to date with relevant guidance is not only good for business, in terms of continually improving the care offered to patients but also assists businesses if and when a claim is made, whether by a patient or an employee. Being able to evidence compliance with guidelines can mitigate the risks faced by those providing optometric care.
If you have any queries on how this guidance may impact you or how to implement it, please contact our Lynn Livesey, Laura McMillan or your usual Brodies contact.
