COUNCIL Survey of contact lens wearers: research findings Meeting: 10 February 2016 Lead responsibility: Alistair Bridge (Director of Strategy) Status: for noting Project manager/paper author: Marie Bunby (Policy Manager) Purpose 1. The purpose of the paper is to update Council on the findings from our recent survey of contact lens wearers, which was commissioned as part of the implementation of our illegal practice strategy. Recommendations 2. Council is asked to note and discuss the findings of the research and how we intend to use it. Strategic objective 3. The specific purpose of the illegal practice strategy project is to develop a clear strategy for preventing and addressing illegal practice. 4. This project contributes to our mission of protecting and promoting public health and safety by helping to achieve our strategic objectives in the 2014-17 Strategic Plan to raise public trust and awareness, handle complaints more effectively and implement a targeted and proportionate system of regulation. 5. Alistair Bridge, Director of Strategy, is the Project Sponsor for this work. Marie Bunby, Policy Manager, is the Project Manager. Risks 6. There is a risk that our illegal practice strategy will be less effective in protecting and promoting the public s health and safety if we do not act on the findings of the contact lens research, particularly in developing the planned consumer awareness campaign to ensure that the public knows how to purchase and wear contact lenses safely. Background 7. We held a consultation on our strategy for tackling illegal practice between March and June 2014. Following the consultation Council approved a 3 February 2016 Page 1 of 5
proactive, multi-pronged approach to reducing public harm based on the following five areas: 7.1 continuing to handle complaints in line with our prosecution protocol for all types of illegal practice (workstream 1); 7.2 collaboration with other enforcement bodies to address high-risk areas of illegal practice (workstream 2); 7.3 guidance for the public on the safe purchase and use of contact lenses (prescription and cosmetic) (workstream 3); 7.4 development of a voluntary code of practice on the supply of contact lenses (prescription and cosmetic) online that would address the risks to the public identified by the Europe Economics research (workstream 4); and 7.5 further research and intelligence-gathering (workstream 5). 8. As part of our work on further research and intelligence-gathering (workstream 5), in September 2015 we commissioned BMG Research to carry out some research with contact lens wearers to: 8.1 provide us with data to establish a benchmark from which to evaluate the impact of the planned code of practice; and 8.2 develop and target consumer information messages effectively. 9. Focus groups with contact lens wearers took place in September 2015 to inform the development of the survey questions, with an online survey of over 2,000 UK contact lens wearers then taking place in October 2015. The research agency also included questions on a national omnibus survey of the general public to obtain data on the supply of cosmetic contact lenses. These findings are also included in the research report. Analysis 10. BMG Research will be presenting the findings of the research at the Council meeting in February 2016. 11. We refer you to the executive summary of the report and draw your attention to the following findings in particular in relation to contact lens wearers: 11.1 77 per cent primarily purchase contact lenses in-store and 21 per cent primarily purchase contact lenses online; 11.2 those who primarily buy their contact lenses in-store are much more likely to have more frequent contact lens check-ups (79 per cent at least once a year) when compared to those who primarily buy online (60 per cent); 11.3 81 per cent of survey respondents were provided with their spectacles prescription at their most recent eye test, while 11 per cent said that they were not, and 8 per cent said they were not provided with one at their most recent eye test but had a copy from a previous test; 3 February 2016 Page 2 of 5
11.4 59 per cent of survey respondents were provided with their contact lens specification at their most recent check-up, 26 per cent said that they were not provided with one and 15 per cent said they were not provided with one at their most recent check-up but had a copy from a previous check-up; 11.5 48 per cent of respondents said that they were provided with advice on how to wear and look after their lenses (i.e. aftercare advice) at their most recent contact lens check-up; 35 per cent said they were not provided with any advice and 17 per cent said they could not recall whether any advice was given; 11.6 there appears to be a relationship between respondents experience of wearing contact lenses and the likelihood of receiving advice those who have been wearing contact lenses for more than 20 years are significantly less likely to have been provided with aftercare advice (33 per cent) compared to those who have worn them for five years or less (56 per cent) or six to 20 years (50 per cent); and 11.7 there was fairly high awareness of the contact lens aftercare advice dos and don ts, provided by the British Contact Lens Association (BCLA). In terms of compliance with the advice, fewer than one in five contact lens wearers do not follow each of piece of advice despite being aware of it. The advice with the highest level of non-compliance is replacing the lens case at least monthly (21 per cent aware but do not follow), followed by using lenses for swimming, hot tubs or water sports without goggles (17 per cent), not following the advised method of cleaning the lens case (16 per cent), not discarding lenses and solutions that are past their expiry date (16 per cent) and wearing lenses when showering (15 per cent). 12. We will use the results of the research in working with our stakeholder groups to develop our consumer information messages and the most appropriate communication methods. We have also shared the research findings with our Companies Committee to obtain their feedback. In discussion on the findings from the contact lens research, the Committee noted the following points: 12.1 while some of the findings might be surprising, the findings did in the main outline risks around consumer awareness on contact lens usage that the sector had already identified; 12.2 from a commercial perspective, the research pointed to the potential advantages for commercial organisations to focus further on advertising the public health benefits of optical products, as it appeared from the research that consumer awareness in this area might be stronger than suggested by anecdotal evidence; 12.3 the findings indicated a generally high awareness of, and compliance with, aftercare advice. The results could point to further work within the industry on ensuring that registrants presented aftercare advice to 3 February 2016 Page 3 of 5
patients in a way that was more likely to be fully comprehended and retained; 12.4 there was evidence in the survey findings to suggest that zero-powered contact lenses (ZPLs) were being purchased through a range of suppliers, many of whom were not legally entitled to be supplying such products. This suggested that there was additional work to be done across the optical sector in raising consumer awareness on ZPLs; the GOC would also work with the General Pharmaceutical Council in respect of the findings that a sizeable proportion of respondents had purchased ZPLs in pharmacies; and 12.5 differing views were expressed around the speed with which the online market for contact lenses supply was growing; the Committee however agreed that it would be beneficial to repeat the research on a regular basis to allow for trends to be identified. This would help in both assessing changes in the market and in ensuring that the GOC as the regulator responded to, and remained in touch with, the market. The Committee viewed the development of the voluntary code of practice as an example of how the GOC was proactively responding to changing markets. 13. We also need to take account of section 25(5) of the Opticians Act 1989, which requires registrants to provide an individual with a signed written specification on completion of a contact lens fitting, sufficient to enable the lens to be replicated, and to provide the individual with instructions and information on the care, wearing, treatment, cleaning and maintenance of the lens. 14. The research findings suggest that we need to consider how to improve awareness among registrants of their legal obligations in respect of issuing contact lens specifications and providing aftercare advice. Initial discussions suggest that this could be in the form of supportive material supplementary to our new Standards of Practice for Optometrists and Dispensing Opticians and/or through Continuing Education and Training (CET) modules. Impacts 15. Likely impact of the proposed research findings: 15.1 Reserves none; 15.2 Budget we have funds for research and consultancy in the budget for 2016/17 to cover the work we will need to do in the next year; 15.3 Resources none; 15.4 Equality and diversity none; and 15.5 Human Rights Act none. 3 February 2016 Page 4 of 5
Devolved nations 16. We will engage with stakeholders in all four nations as we consider the research findings and will respond to any issues that may subsequently arise. 17. The research included a representative sample of all four nations of the UK. Communications 18. We have ensured that our key stakeholders are represented on our stakeholder steering and working groups. The research has been shared with the stakeholder steering and working groups to obtain their feedback. 19. The optical press are also likely to take an interest, and at certain times of the year the issue of cosmetic contact lenses can attract national media attention. In October 2015 we proactively raised awareness of the dangers of incorrectly sold zero-powered contact lenses (ZPLs), achieving national media coverage. We used the hook of Halloween as people often wear ZPLs at this time for fancy dress. We worked jointly with the Trading Standards Institute and publications covering the issue included Radio 1 Newsbeat, The Daily Mail, The Daily Mirror and RNIB s Insight Radio, along with the optical trade journals. 20. We note the concerns of individual registrants in respect of illegal practice and online contact lens supply and will communicate with them directly e.g. through our regular bulletin. 21. We have also contacted the General Pharmaceutical Council to highlight the issue of cosmetic contact lenses being supplied by pharmacies. They have agreed to work with us to identify ways of addressing this problem, including raising awareness among their registrants of the fact that such lenses should be supplied only by or under the supervision of a GOC registrant or medical practitioner. Timeline for future work 22. We will consider the findings of the contact lens research as part of our overall implementation of our illegal practice strategy. A further update about progress and timing of implementation of the strategy will be given at a Council meeting in May 2016. 3 February 2016 Page 5 of 5