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GOC Standard 6: Working Within Your Limits of Competence in Optical Practice

Protecting Patients Through Safe and Responsible Practice

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GOC Standard 6 - Working Within
Why Competence Matters
Defining Competence
Clinical Limits
Legal & Professional Framework
Safe Escalation & Referral
Communication & Cultural Competence
Expanding Competence Safely
Professional Boundaries
Reflection & Growth
Exam Pass Notes: GOC Std 6
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Scenarios: Communication and Cultural Competence

Scenario 3: D/deaf Patient Requiring Interpreter

Scenario

You are consulting with a patient who is D/deaf; a family member is present and offering to interpret. The patient appears engaged but relies on the family member to relay questions and explanations. You are aware that the discussion will include clinical risks and consent for a proposed intervention.

How should you ensure communication is accurate and consent valid?

Use a professional interpreter or approved communication service wherever possible. ^[1]
Address the patient directly, maintaining eye contact and using appropriate language for the patient (e.g., sign language, written or visual aids). ^[1]^[3]
Supplement spoken explanations with written information, diagrams, or other visual materials to support understanding. ^[3]^[4]
Avoid relying solely on family members to interpret to protect confidentiality and reduce risk of miscommunication. ^[1]^[2]
Check understanding using teach-back (ask the patient to summarise key points and risks). ^[4]
Document the communication methods used, interpreter identity or service, and the steps taken to confirm understanding and valid consent. ^[2]^[1]

Scenario 4: Neurodiverse Patient with Complex Needs

Scenario

A patient with autism is unable to complete standard visual field testing in the usual way; they become anxious and disengaged during the procedure. A carer is present and offers support, but the standard protocol is not yielding reliable results. You are uncertain how best to adapt the examination while staying within your competence.

How should you respond while respecting your limits of competence?

Attempt reasonable in-session adaptations within your skills: shorten sequences, give clear simple instructions, allow breaks, use consistent routines, and minimise sensory triggers. ^[3]
Enlist carers to help with reassurance and practical support where appropriate, ensuring the patient remains the primary focus of communication. ^[3]
If adaptations produce unreliable results, explain the limitations to the patient/carer and document what was attempted and why results are not valid. ^[2]^[6]
Refer to a specialised service or clinician with expertise in adapted visual field testing when testing remains unreliable or beyond your competence. ^[6]^[5]
Record the adaptations made, patient response, and rationale for referral. ^[2]^[3]

References (numbered in text)

Accessible Information Standard – implementation guidance; NHS England. Find (opens in a new tab)
Decision making and consent - professional standards; General Medical Council (came into effect 9 November 2020; updated 13 December 2024). Find (opens in a new tab)
Clinical guide for front line staff to support the management of patients with a learning disability and autistic people – relevant to all clinical specialties; NHS England. Find (opens in a new tab)
Teach-back: A systematic review of implementation and impacts; Jason Talevski, Anna Wong Shee, Bodil Rasmussen, Georgie Kemp, Alison Beauchamp; PLoS One; 2020. Find (opens in a new tab)
Study of Optimal Perimetric Testing In Children (OPTIC): Normative Visual Field Values in Children; Dipesh E Patel et al.; Ophthalmology; 2015. Find (opens in a new tab)
Develop and maintain knowledge and skills (work within your competence) guidance; The College of Optometrists. Find (opens in a new tab)

Key Points

Please take a moment to review these points, reflect on their significance and consider how they apply to your own experiences.

Tick to confirm (optional):

Use professional interpreters for D/deaf patients and address the patient directly.
Supplement spoken explanations with written or visual aids to support understanding.
Avoid relying on family members as interpreters to protect confidentiality and accuracy.
Document the communication steps taken and confirm consent is informed and valid.
Adapt examinations for neurodiverse patients (shorten tests, use clear instructions, allow breaks).
Involve carers appropriately to support the patient while maintaining autonomy.
If results remain unreliable, explain limits and refer to specialist services with adapted testing.
Record adaptations attempted, rationale for decisions, and reasons for any referral or escalation.

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Safe Escalation & Referral Expanding Competence Safely

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Course Snapshot

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Length: 45 minutes CPD (0.75 CE Credits)
Appropriate for: Optometrists, Dispensing Opticians, Optical Assistants, Practice Managers, Trainee optical staff and supervisors in UK optical practices.
Course Price: Free
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Harvard

Mecourse Lifelong Learning (2025) ‘Scenario Page 2: Communication and Cultural Competence’. Mecourse Lifelong Learning [Online]. Available at: https://www.mecourse.com/scenario-page-2-communication-and-cultural-competence [Accessed 12 May 2026].

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Mecourse Lifelong Learning. Scenario Page 2: Communication and Cultural Competence [Internet]. Mecourse Lifelong Learning; 2025 Aug 22 [cited 2026 May 12]. Available from: https://www.mecourse.com/scenario-page-2-communication-and-cultural-competence.

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Mecourse Lifelong Learning. “Scenario Page 2: Communication and Cultural Competence.” 2025. https://www.mecourse.com/scenario-page-2-communication-and-cultural-competence. Accessed May 12, 2026.

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Mecourse Lifelong Learning. (2025, August 22). Scenario Page 2: Communication and Cultural Competence. https://www.mecourse.com/scenario-page-2-communication-and-cultural-competence

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Mecourse Lifelong Learning, “Scenario Page 2: Communication and Cultural Competence.” Mecourse Lifelong Learning. https://www.mecourse.com/scenario-page-2-communication-and-cultural-competence (Accessed: May 12, 2026).

AMA

Mecourse Lifelong Learning. Scenario Page 2: Communication and Cultural Competence. Mecourse Lifelong Learning. Published August 22, 2025. Accessed May 12, 2026. https://www.mecourse.com/scenario-page-2-communication-and-cultural-competence.

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GOC Standard 6: Working Within Your Limits of Competence in Optical Practice

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Scenarios: Communication and Cultural Competence

Scenario 3: D/deaf Patient Requiring Interpreter

Scenario 4: Neurodiverse Patient with Complex Needs

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