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Equality and diversity

You must treat your colleagues fairly. You must not allow your personal views to adversely affect your relationship with them. You must not discriminate against colleagues on the grounds of one or more of the protected characteristics. These are:
  1. age
  2. disability
  3. gender reassignment
  4. marriage and civil partnership
  5. pregnancy and maternity
  6. race
  7. religion or belief
  8. sex
  9. sexual orientation.
Where possible, patients should be given a choice of which optometrist they wish to see.292  Patients may wish to see an optometrist of their own gender, or who speaks their first language. The reason for a patient’s choice is private to them and they should not feel pressured into disclosing it if they do not wish to. However, if it is apparent or disclosed that their choice derives from a discriminatory approach to any of the protected characteristics (listed in C171) you should exercise your professional judgement on what to do next. This could include informing the patient that choices made on the grounds they have expressed are not acceptable, and explaining how their eye health needs will need to be met elsewhere. See paragraph C173. In England, GOS contractors must keep a written record of a refusal to see a patient and the reason for the refusal.293
You will not be expected to examine a patient who makes an offensive or inappropriate comment about you or a member of staff, especially if it relates to a protected characteristic. If a patient makes such a comment before the consultation begins you may refuse to see them. If the comment is made during the consultation, you may stop the examination and bring this to the attention of an appropriate person, such as your practice manager. If you are concerned about the patient’s eye health, you should direct them to an alternative source of care. You should make a note in the patient record of why you refused to see the patient or stopped the examination.
If you are the practice owner or manager, you should make it clear to patients that offensive behaviour will not be tolerated, and they will not be seen for a consultation if they exhibit such behaviour. If you witness instances where offensive behaviour is tolerated within the practice, you should raise this with an appropriate person and escalate as necessary. If you no longer wish to see a patient who has displayed offensive behaviour, you should notify them in writing and explain that you will no longer be sending them recall reminders and that they should seek eyecare elsewhere. The reasons for this and what was notified to the patient should be recorded in the patient’s record. See section on Raising concerns.

You must take all reasonable steps to meet a patient’s language and communication needs. You should be aware of translation services available (remote and face –to face). You should ensure there is a suitably qualified medical translator who can ensure effective communication with your patient, when it can be accommodated as a reasonable adjustment.


292 In England, s.2A of Schedule 1 of the General Ophthalmic Services Contracts Regulations 2008 (as amended by the NHS (Miscellaneous Amendments Relating to Ophthalmic Services) Regulations 2010 ) says:

“(1) Where the contractor has agreed to provide services to a patient, it must notify the patient (or, in the case of a child or incapable adult, the person who made the application on their behalf) of the patient’s right to express a preference to receive services from a particular performer where more than one performer is available.

(2) The contractor must try to comply with any reasonable preference expressed under subparagraph (1) but need not do so if the preferred performer has reasonable grounds for refusing to provide services to the patient.”

293 Except if the reason for refusal was because the patient was not eligible for GOS services or because a sight test was not clinically necessary.