NHS & Legal Requirements

R2.1.1 Professional practice – local NHS requirements

Registrants working within NHS services must be aware of and comply with relevant local NHS and Integrated Care Board (ICB) / Integrated Care Group (ICG) protocols applicable to the service they are delivering.

Registrants should familiarise themselves with local referral pathways, clinical governance arrangements and contractual requirements within their practising nation.

Information on local Integrated Care Boards in England can be found here.

R2.2.1 Professional practice – accurate NHS claims

It is a criminal offence to defraud the National Health Service (NHS) by submitting false, misleading or inaccurate claims.

Registrants must ensure that all NHS claims are accurate, complete and supported by appropriate clinical records.

Registered dispensing opticians, as trustees of NHS funds, have a professional duty to handle payments appropriately, effectively and honestly. Abuse of NHS procedures constitutes a serious breach of trust and may result in criminal prosecution and/or investigation by the General Optical Council (GOC), with potential fitness to practise consequences.

Nation-specific guidance on making accurate claims can be found at:
England – MACE Guide

Scotland

Wales

Northern Ireland
References – R2.2.1
Fraud Act 2006
National Health Service Act 2006
General Optical Council Standards of Practice 

R2.3.1 Professional practice – fraud prevention

ABDO and the Department of Health are signatories to a Counter Fraud Charter, committing to reduce fraud and corruption within NHS services and to promote awareness among professionals and patients.

Registrants must co-operate with counter-fraud measures and report suspected fraud through appropriate local or national channels.

Further information is available from:
NHS Business Services Authority – Loss and Fraud Prevention
NHS England Counter Fraud
NHS Scotland Counter Fraud Services
NHS Wales Counter Fraud Service
Northern Ireland – Reporting Health and Social Care Fraud

R2.4.1 Professional practice – equality obligations

The Equality Act 2010 protects individuals from discrimination in healthcare settings.

Registrants must treat patients and colleagues fairly, respectfully and without unlawful discrimination.

The Act protects the following characteristics:
– Age
– Disability
– Gender reassignment
– Marriage and civil partnership
– Pregnancy and maternity
– Race
– Religion or belief
– Sex
– Sexual orientation

Registrants must:
– Provide equitable access to services
– Make reasonable adjustments for disabled patients
– Challenge and escalate discriminatory behaviour appropriately
– Maintain a safe and inclusive environment

Indirect discrimination, harassment and victimisation are unlawful unless objectively justified under the Act.

Practices holding NHS contracts must accept eligible NHS patients. Services may be refused where a patient poses a genuine risk to safety or behaves abusively; any refusal must be proportionate, documented and accompanied by appropriate signposting where urgent care is required.

References – R2.4.1
Equality Act 2010
General Optical Council Standards of Practice

R2.5.1 Professional practice – adults who may lack capacity

The Mental Capacity Act 2005 (MCA) sets out the legal framework for decision-making on behalf of adults who may lack capacity.

Registrants must follow the MCA’s five statutory principles, including the presumption that every adult has capacity unless established otherwise.

Capacity is decision-specific and time-specific. A patient has capacity if they can:
– Understand relevant information
– Retain it long enough to decide
– Use or weigh that information
– Communicate their decision

Registrants must document clearly their assessment and reasoning.

If a patient lacks capacity to decide about an optical appliance, registrants may proceed only if:
– They have a reasonable belief that the patient lacks capacity for that decision;
and
– Provision of the appliance is in the patient’s best interests.

Carers or family members cannot consent on behalf of an adult unless they hold valid Health and Welfare Lasting Power of Attorney or Court of Protection authority.

Registrants must communicate sensitively, support autonomy as far as possible and maintain dignity and respect throughout the consultation.

References – R2.5.1
Mental Capacity Act 2005
General Optical Council Standards of Practice 

R2.6.1 Professional practice – use of chaperones

Registrants should follow recognised guidance on the use of chaperones during consultations where appropriate, ensuring patient comfort, dignity and protection.

ABDO’s Model Chaperone Framework for Optometry & Opticians is available here.

R2.7.1 Professional practice – maintaining professional boundaries

Dispensing opticians hold a position of trust. A professional relationship may involve an inherent power imbalance.

Registrants must maintain clear professional boundaries and must not pursue or engage in sexual or intimate relationships with current patients or carers.

If a registrant experiences personal feelings that could affect professional judgement, they should seek confidential advice from a senior colleague, employer or professional body at an early stage.

If a patient displays inappropriate behaviour, registrants should maintain professional boundaries, document concerns where appropriate and seek advice.

Concerns about sexual misconduct by another professional must be escalated in line with safeguarding and regulatory obligations.

Relationships with former patients may remain inappropriate depending on:
– The duration and nature of the prior professional relationship
– Whether vulnerability or power imbalance persists
– The potential for professional knowledge to influence the relationship

Registrants must be able to justify their actions if concerns arise. The responsibility to maintain professional standards rests with the practitioner.

References – R2.7.1
General Optical Council Standards of Practice
Safeguarding Vulnerable Groups Act 2006 (where applicable)