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The purpose of this paper is to assess if the GOC considers relevant factors at all stages of its deliberations into misconduct, as required by the determinations in the cases of Cohen, Zygmunt, and Azzam, and to assess whether those circumstances described in the Hearings Guidance and Indicative Sanctions as warranting removal of an optician from the relevant registers lead to that outcome.

The consideration of specific factors in determining impairment of fitness to practise was compared with their subsequent consideration when determining the severity of sanction. Additionally, cases that highlighted aggravating circumstances deemed as serious enough to warrant removal were monitored. Pearson’s χ² test was used to detect any variation from the expected distribution of data.

In total, 42 cases met the inclusion criteria. Each of the four factors considered was more likely to be heard when determining sanction having first been factored in to the consideration of impairment. Where risk of harm was identified as an aspect of an optician’s misconduct, the sanctions of suspension or removal were no more likely to be imposed. Where dishonesty was involved, they were more likely to result in suspension or removal.

The GOC do, in general, factor the rulings of High Court appeal cases into their deliberations on the impairment of fitness to practice and, where dishonesty is involved, consider their own guidance in determining which sanction to apply. The authors were unable to show that placing the safety of patients at risk was more likely to result in removal from the register.