GOC consultation on Disclosing confidential information about patients guidance
The College has responded to a consultation on disclosing confidential information about patients (June 2019).
The College has responded to a consultation on disclosing confidential information about patients (June 2019).
Yes
Yes
Please see our answer to question 18 below.
Not sure
The most common situation in which optometrists are likely to need to consider breaching patient confidentiality is when a patient consults an optometrist and indicates that they are driving when they may be unfit to do so. Optometrists often worry about disclosing information about their patient to the DVLA, even when the patient has indicated to the optometrist that they are still driving when they are unfit to do so, and the patient themselves should have notified the DVLA already.
We welcome paragraph 25 of the GOC guidance, which says ‘In cases where a patient who drives and is unfit to do so either will not or cannot notify the DVLA/DVA, you should notify the DVLA/DVA yourself if you are concerned about road safety, in relation to both the patient and the wider public.’ We agree with this guidance, which is clear. Optometrists can then refer to College Guidance which encourages optometrists to consider the consequences of not raising this (paragraph A222) when asking themselves whether they should act.
We agree with paragraphs 29-31, which are similar to College Guidance, paragraph A223.
We note that paragraph 33 of the GOC guidance states that optometrists should notify the patient’s GP ‘if possible’, whereas College Guidance (A223e) says this should be done ‘if appropriate, with the patient’s consent’. As part of our forthcoming guidance review we will be considering whether to retain this sub paragraph, as part of a discussion as to whether notifying the patient’s GP is necessary.
We agree with the AOP that paragraph 35 of the GOC guidance is not clear and should be phrased in more definite terms, as is paragraph 25. We also agree with the AOP, that it is not a matter of professional judgement for the optometrist as to whether or not the patient will not or cannot notify the DVLA/DVA themselves. The professional judgement should relate to whether or not the patient meets the vision standards for driving, as the nature of the subjective tests involved will always cause some variation, and so decisions around the borderline are not clear cut. We agree with the AOP’s suggestion that it would be better if the GOC guidance said ‘if it appears that the patient would not meet’ the visual standards for driving. Paragraph 25 could then read ‘If a patient drives and you consider they do not meet the visual standards for driving and they will not or cannot notify the DVLA/DVA, you should notify the DVLA/DVA yourself if you are concerned about road safety, in relation to both the patient and the wider public’.
We agree with the structured approach as laid out by the AOP.
Yes
We feel it is helpful for the GOC to clarify that patient confidentiality, although an important part of optometric practice, is not absolute, and to discuss situations in which this can be breached. We largely agree with the guidance, but we have seen the AOP’s working paper on this and agree with them that section 2, which is by far the most likely situation that optometrists are likely to experience, could be made clearer.
Please see our answer to question 18 above.
Yes
Yes
Please see our answer to question 18 above.
Yes
We feel that some sort of decision tree, as laid out by the AOP, would be helpful. Alternatively, an online decision aid as on the GMC website could be useful. We also feel it would be helpful if the GOC could reference to College Guidance, which covers this issue.
Yes
Yes
Yes
It gives greater clarity for optometrists and patients in this difficult area.
Yes
Yes
There is a danger that patients with correctable poor vision may be deterred from seeking optometric services if they are worried that their vision is not up to standard and they feel that the optometrist may inform the DVLA of this. This may happen even if the patient’s vision may be correctable to the standard with a change of spectacles, for example. The consequence of such patients not seeking optometric advice is that they will continue driving with poor vision when this could be improved if they visited the optometrist.
No
Yes
Submitted: June 2019