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Statement on updated professional standards on refractive surgery

10 July 2020

Remote consultations have been given additional impetus by the COVID emergency and are almost certainly one of the changes in practice that is here to stay. The advantages for the patient in terms of access are obvious, and video meeting platforms are now part of our daily lives. Video calls add emotional cues that are missing from telephone conversations. But how far can they substitute for traditional face-to-face consultations in procedure choice and consent?

This is a hot topic in refractive surgery. The GMC has emphasised that higher standards of consent apply to self-pay, elective, lifestyle procedures, including refractive surgery; and has recently issued guidance on the appropriate use of remote consultations. Responding to this guidance, and a step change in access to remote consultation technologies, we have changed our guidance on consent in an update to the 2018 Professional Standards for Refractive Surgery.

Where previously a conventional face-to-face consultation was required to advise on procedure choice in advance of the day of surgery, video consultations may now be used. But there are some important boundaries. Surgeons must have access to healthcare records and up-to-date examination findings at the time of the video consultation, which should still take place at least one week before the day of surgery to allow adequate time for cooling-off. The healthcare professional supplying examination data and the surgeon interpreting it must have adequate medical indemnity cover, and the option of a conventional face-to-face consultation should remain available.

We would strongly recommend that ophthalmologists and healthcare professionals engaged in refractive surgery review the updated Professional Standards for Refractive surgery for further detail on video consultations in relation to their practice. The key changes to our recommendations are in the new clause 5.8.