Professional and Legal Accountability

GOC standards

General Optical Council (GOC) Standard 3 requires registrants to obtain valid consent before providing care. This involves ensuring capacity, adequate information, and voluntary decision-making free from pressure. Documentation-whether verbal, written, or implied-should be clear and proportionate to the procedure. Failure to comply may result in fitness-to-practise proceedings and sanctions.^[1]

GMC parallels and NHS guidance

The General Medical Council (GMC) offers guidance closely aligned with GOC expectations, emphasising that informed consent is a process rather than a single event.^[2] NHS consent policies likewise promote patient-centred communication, accessible information, and the right to refuse treatment even where clinicians disagree. Optical professionals working in NHS settings are expected to follow these policies alongside GOC requirements.^[3]

Statutory frameworks

Key frameworks underpin valid consent in the UK:

• The Children Act 1989 and Gillick competence, guiding decisions for minors.^[5][8]
• The Mental Capacity Act 2005, establishing principles for assessing capacity and making best-interests decisions where adults cannot consent.^[4]
• The Human Rights Act 1998, protecting autonomy, dignity, and the right to private and family life.^[6]

Case law examples

Courts have reinforced the need for properly informed and documented consent:

• Montgomery v Lanarkshire Health Board (2015) - clinicians must disclose material risks and reasonable alternatives, judged from the patient's perspective.^[7]
• Re C (1994) - adults with mental illness may still have capacity if they can understand, retain, and weigh up information.^[9]
• Gillick v West Norfolk (1985) - minors may give valid consent if sufficiently mature and competent.^[8]

Aligning everyday practice with GOC standards, NHS policy, and case law helps uphold patient rights and maintain professional accountability.^[1][3][7]

Consent across the UK nations

The principles of capacity, voluntariness, and adequate information apply throughout the UK, but each nation has distinct legal frameworks:

• England & Wales – Governed mainly by the Mental Capacity Act 2005. Adults are presumed to have capacity unless shown otherwise, and decisions for those lacking capacity must follow best-interests principles. Consent for children follows the Gillick competence test and the Children Act 1989.

• Scotland – Capacity law is set by the Adults with Incapacity (Scotland) Act 2000. Children’s consent is determined by the Age of Legal Capacity (Scotland) Act 1991, which allows anyone aged 16 or over to consent independently; under 16s may consent if judged capable of understanding the treatment.

• Northern Ireland – The Mental Capacity Act (Northern Ireland) 2016 is being implemented in stages; meanwhile, common law principles continue to apply. Consent for children follows the Children (Northern Ireland) Order 1995 and Gillick competence.

• Wales – The Mental Capacity Act 2005 applies (as in England), alongside Welsh Government health guidance and NHS Wales consent policy.

For registrants who practise in more than one nation, it is essential to check the applicable statutory framework and local safeguarding policy. This ensures consent remains both valid and lawful across jurisdictions.

References (numbered in text) Why we include references

1. Standards of practice for optometrists and dispensing opticians — General Optical Council Find (opens in a new tab)
2. Decision making and consent — General Medical Council (2020) Find (opens in a new tab)
3. Reference guide to consent for examination or treatment (second edition) — Department of Health and Social Care (2009) Find (opens in a new tab)
4. Mental Capacity Act Code of Practice — Office of the Public Guardian (2013) Find (opens in a new tab)
5. Children Act 1989 — legislation.gov.uk Find (opens in a new tab)
6. Human Rights Act 1998 — legislation.gov.uk Find (opens in a new tab)
7. Montgomery v Lanarkshire Health Board [2015] UKSC 11 — Supreme Court Find (opens in a new tab)
8. Gillick v West Norfolk and Wisbech Area Health Authority [1985] — House of Lords Find (opens in a new tab)
9. Re C (Refusal of Medical Treatment) [1994] 1 WLR 290 — Family Division / High Court Find (opens in a new tab)