ABDO advice on Covid-19

Vaccination update from ABDO

Many of you have been in touch to ask about the Covid-19 vaccination programme. All UK representative bodies are working together and will keep the sector up to date with developments. At this stage, it is important to note the following:

All optical practice staff are a priority group for Covid-19 vaccination

All UK governments are following JCVI guidance on prioritisation for the Covid-19 vaccination. It means all practice staff with patient-facing roles will be offered a vaccination along with all frontline healthcare workers, and it applies equally to NHS and non-NHS funded care.

Don’t worry if you have not yet heard from the NHS about vaccinations  

The MHRA approved the Pfizer/BioNTech vaccine on 2 December. Because of the vaccine’s complex storage requirements, the vaccination programme was unable to move at pace. The Oxford/AstraZeneca vaccine was only approved on 30 December and because it is easier to store and distribute we expect the programme to speed up over the next few weeks. The Moderna vaccine was also approved for use on 8 January and can be stored at -20C. However it may take a little time for stocks of this vaccine to arrive in the UK.

Expect some variation

The NHS will deliver the programme slightly differently across the UK, but you remain in a priority group in each UK country:

  • England will use hospital hubs to vaccinate frontline healthcare workers. Read more.  In some areas CCGs and Primary Care Networks (PCNs) may also offer vaccination to primary care staff. We are aware that this already happened in some areas where patients have not attended for their Pfizer/BioNtech vaccine therefore GPs have offered these to optical staff
  • Northern Ireland will also use hospitals for primary eye care staff. Read more
  • Scotland will be organising vaccinations through NHS Boards. They have already started the rollout. You should be contacted directly about the programme in due course, if you haven’t already. Read more
  • Wales is currently updating primary eye care via Optometry Wales (OW), so please keep up to date with communications from them.

The Covid-19 vaccination programme is the most extensive vaccination programme the UK has ever performed, so there are likely to be some unforeseen operational issues. You might notice variation at a local level, for example, with higher risk groups within your practice team prioritised in the event of temporary supply or capacity issues.

You might also hear colleagues near you have already been invited to have the vaccination and offered appointments at the last minute. This is more likely to be the case where the Pfizer vaccine is used as it needs to be used within an hour of being prepared for administration, because storage requirements mean that vaccination centres will want to ensure they maximise capacity on any given day and vaccine is not wasted.

As the weeks go on, we expect a more stable operating model to emerge. Meanwhile, please keep up to date with sector news and stay in touch with your LOC/ROC about local initiatives.

Do what you can to help practice teams prepare

It is helpful to consider how you might support informed decision making so that when colleagues are invited to have the Covid-19 vaccination, they are ready to act. Here are links to official guidance:

Non-NHS providers

The Covid-19 green book clarifies that frontline healthcare staff are in the same priority group for vaccination independently of how people pay for their care. If you do not provide NHS care but deliver face-to-face patient care, you should expect the local vaccination programme to contact you. Meanwhile, we recommend you contact your representative body to ensure that they can send you relevant vaccination information that might be shared with NHS contract holders.

If you have further queries about vaccines, please contact membership@abdo.org.uk.

Receiving the vaccine in England

Following published government guidance confirming that all optical practice staff and locums should be included in the priority group for Covid-19 vaccination, the Local Optical Committee Support Unit (LOCSU) is paving the way for practitioners to be included on local lists to receive their vaccination.

Non-NHS practice staff

The first port of call for non-NHS practitioners and staff is to check whether they can be included on a listing with their local optical committee (LOC).

LOCs are working across England to create lists of staff employed in GOS practices. As such, practitioners are advised to make contact with their LOC so that all practice staff may be included on its listing for the vaccination programme. Links to all LOCs in England with a web presence can be found on the LOC Online portal.

However, if none of the above applies, practitioners can complete LOCSU’s Non-NHS Practices Form to add themselves and their staff to a local vaccination list.

Locums

Locums are advised to check initially with any practices they work with, if they may be included on a practice staff list being submitted to its LOC (as above).

Locums may also be able to register directly with their clinical commissioning group or primary care network.

However, if none of the above is possible, locums may complete LOCSU’s Locum Form to ensure they are included on a local vaccination list.

Practitioners who have any further questions are advised to email info@locsu.co.uk

Receiving the vaccine in Scotland

Contact Optometry Scotland.

Website: www.optometryscotland.org.uk

Email: contact@optometryscotland.org.uk

Receiving the vaccine in Wales

Contact Optometry Wales.

Website: www.optometrywales.org.uk

Email: salidavis@optometrywales.com

Receiving the vaccine in Northern Ireland

Contact Optometry Northern Ireland.

Website: www.optometryni.co.uk

Email:  admin@optometryni.co.uk 

 

Delivering eye care during the current lockdown webinar

You can watch the Delivering eye care during the current lockdown webinar that took play on 14 January here.

A letter has been released to go to all optical professionals on behalf of the professional bodies and government bodies responsible for ophthalmic dispensing and optometry. The full text of the letter can be read here.

 

This page summarises the latest advice during the COVID-19 outbreak. Scroll down for advice by country and FAQs for practitioners and the public.

PPE suppliers
click here
Return to practice resources
click here
PPE advice and guidance
click here
Manufacturer frame cleaning advice
click here
NEW: further guidance on dispensing and contact lenses
click here
Domiciliary care
click here

Follow the links for information specific to each nation

England
click here
Northern Ireland
click here
Scotland
click here

More information

Clock here for the latest GOC updates and guidance related to the COVID-19 (coronavirus) emergency.

General Optical Council (GOC) statement on contact lens aftercare during COVID-19 emergency

The GOC statement can be found here.

General Optical Council (GOC) statement on Continuing Education and Training (CET) during COVID-19 emergency 3 April

1. Along with all other healthcare regulators, the GOC has signed a joint regulatory statement which acknowledges that registrants will need to act differently and deliver care in different ways during the COVID-19 emergency in line with Government and public health guidance. The GOC will take account of this in fulfilling its regulatory functions along with the following statement.

CET requirements
2. All registrants have requirements which must be completed by the end of the three-year CET cycle on 31 December 2021. The requirements can be found here.

3. All registrants are expected to complete a minimum of six points of CET on an annual basis (this may be reduced if a registrant has joined the register part way through the year).

Changes to CET expectations as a result of COVID-19
4. It is important for our registrants to maintain and develop their knowledge, skills and performance, even during this emergency. This is particularly the case if they are required to undertake activities that they do not normally undertake. While registrants are encouraged to work up to the limits of their competence, refresher training may be needed.
5. Given that we are not yet at the mid-point of the three-year CET cycle, the overall cycle requirements for CET will remain in place to be completed by 31 December 2021.
6. However, the GOC acknowledges the difficulty which registrants will experience in achieving the annual expectation of six CET points and will waive this requirement for 2020.

Peer review
7. To ensure that registrants do not put themselves at risk of contracting or spreading COVID-19, we will automatically allow all registrant-led peer reviews to be conducted using video-conferencing technologies. This includes video-conferencing via Microsoft Teams, Zoom and Skype, but other technologies may also be used.
8. All other requirements for registrant-led peer review remain in place, including the minimum period of one hour and the need to have this approved by the GOC in advance. Details can be found in the CET registrant guide 2019-21 here.

The GOC will keep this statement under review
9. Next routine review due: not later than 30 April 2020.

GOC statement on supply of spectacles and contact lenses

The GOC has published a new statement on the supply of spectacles and contact lenses, which allows registrants to use their professional judgement to decide whether it is necessary for a patient to attend for a sight test or contact lens fitting/check in order to supply spectacles and contact lenses. This follows the publication of a statement for education providers yesterday on the ability to adapt education delivery approaches during this time.

The GOC has also signed a joint regulatory statement on remote consultation and prescribing which is particularly relevant during this period of social distancing.

Further statements to support optometrists, dispensing opticians, optical students, optical businesses, the education sector and other stakeholders will be published over the coming days and weeks.

Consultation forms to download:

Spectacle lens telephone review form

Contact lens telephone review form

 

 

You can read all guidance from the College of Optometrists for the COVID-19 outbreak here.

The College of Optometrists and Royal College of Ophthalmologists joint statement on COVID-19 and viral conjunctivitis can be read here.

CCGs that commission MECS have agreed to proceed to offering remote consultations for MECS where possible within current contracts. Following all the announcements – Primary Eyecare Services have outlined that all MECS should have a telephone/video consultation in the first instance and face to face arranged where necessary.

Practices should note the triage form is in addition to the usual clinical triage forms used in various parts of the country.

ABDO can confirm that the professional indemnity we provide to our MECS accredited CLOs will cover the provision of MECS services in this way during the COVID-19 situation.  All record keeping should include information to support the decision made in how care is delivered.

An example of one telemedicine guide from the Primary Eyecare Company can be found here: Telemedicine Guidance

The Government has updated the list of essential workers which applies throughout the UK.

The exceptions in relation to optical practices and optical staff include the following:

Medical services (such as dental surgeries, opticians and audiology clinics, physiotherapy clinics, chiropody and podiatry clinics, and other professional vocational medical services).

Please note this is to provide essential/urgent care only.

ABDO has developed a form for employers to complete if staff require their child/children to attend school as they will be providing or supporting essential eye care in practice. 

Dear Sir/Madam,

RE: ESSENTIAL WORKERS & SCHOOL ATTENDANCE

I appreciate that the current situation relating to school closures is creating challenges that are new and difficult to manage in this unprecedented time.

There is a child/children attending your school [INSERT NAME(S)] whose parent [INSERT NAME] work for [INSERT NAME OF COMPANY].

The Company is a provider of eye health care, working as part of the NHS primary care provision to maintain the delivery of essential and urgent eyecare to the public during the COVID-19 pandemic. Essential eye health care provided in practice removes the need for patients to attend GP surgeries and hospitals for eye health care. Therefore as a result, we have a ‘duty of care’ to maintain service. Without our support, the provision of eye health care would be effected.

As the company provides care in optical practices, in the community, it is not possible for essential work tasks to be done from home.

As an essential worker, providing and supporting essential NHS eyecare services, could you please enrol the child’s/children’s attendance at school during the closure period.

Please make contact if you require further information. I have provided the link to the Government website below as well as the abstract where opticians are listed within the exceptions:

https://www.gov.uk/government/publications/further-businesses-and-premises-to-close/further-businesses-and-premises-to-close-guidance


“Exceptions:
Medical services (such as dental surgeries, opticians and audiology clinics, physiotherapy clinics, chiropody and podiatry clinics, and other professional vocational medical services)”

Yours sincerely

[Insert company name]

Copy and paste above or download template.  

Frequently asked questions – COVID-19

The Association of British Dispensing Opticians (ABDO) has provided this advice and guidance for members on situations they may encounter during the COVID-19 pandemic. These FAQs were written on 17 March (am) and will be updated where necessary as the situation evolves. 

Patients who attend optical practices and who subsequently test positive for COVID-19 are not generally considered contacts for NHS Test and Trace/Test and Protect purposes when the practice has been following IPC procedures and practitioners have been wearing PPE properly when they were in contact with the patient.

Each Test and Trace/Test and Protect call handler is a clinician who will make a clinical judgment about the risk of each person’s interaction but may not fully understand the nature of primary eye care and how IPC in our sector operates.

If you are contacted by NHS Test and Trace/ Test and Protect call handler, it is essential you explain to them that the contact was within a healthcare setting and to describe the PPE you were using and the IPC procedures you were following.

If you are asked how long you spent with the contact, make sure you let the call handler know BOTH the total duration of the sight test/dispense AND how long the Optom/DO were in close proximity to the patient. For many contacts, proximity will be a relatively short period of time. (Such as the time at the slit lamp, behind the slit lamp Perspex screen, fitting/adjusting of frames with the rest of the consultation performed at two meters or more.)

If you believe the call handler has incorrectly assessed the risk of the interaction, you should escalate the decision by requesting a second opinion.  This is an accepted part of the internal process at NHS Test and Trace/ Test and Protect and will not cause offence.

If, after the escalation request and further discussion, it is decided you did not have a close contact and can return to work, you can then do so. However, it is a legal requirement to follow the advice of the call handler, including isolation for 14 days, even if you believe this to be an incorrect decision.

If you had to escalate a decision, or believe the advice was incorrect, please contact our ABDO Head of Policy dmcgill@abdo.org.uk so we can collectively collate examples to feedback to the relevant NHS tracing service.

Updated: 2 December 2020”

The advice to practices is to ask any patient that feels unwell, in any way, to not present to the practice at all. The Government advice provided to the public is to self-isolate if they are showing symptoms that could be COVID-19 therefore patients attending optical practices for eye care should not be a risk. Practices should not deliver care to patients who have COVID-19 as they are not in supply of PPE. OFNC advises that cleaning of practices is carried out more regularly at this time and it is not unreasonable to ask patients who attend to wash their hands on entering or use hand sanitiser. The usual formal sanitising procedures should be adhered to as stated in the ABDO advice and guidelines on our website:

Principles of Cleaning, Sterilisation & Disinfection

4.4.1 There are numerous pieces of equipment that regularly come into contact with patients e.g. trial frames, chin rests, refractor heads, hand held occluders and rulers, as well as ophthalmic devices which come into direct contact with ocular tissues e.g. tonometer heads, gonioscope and other contact lenses. It is essential that they are all appropriately decontaminated, for example by wiping headrests and/or chin rests with a disinfectant wipe, to reduce the risk of transmission of infection.

There are three levels of decontamination:

Cleaning – The removal of organic and inorganic debris from a surface which might support micro-organisms and provide insulation that reduces the efficiency of disinfecting or sterilisation procedures. Detergents and ultrasonic cleaners are frequently used for cleaning purposes.

Disinfection  A treatment that reduces the number of viable micro-organisms but not necessarily bacterial spores or some viruses. Disinfection can be achieved by physical methods such as heat or by the use of chemical disinfecting agents. Chemical disinfection can be an uncertain procedure as it involves an integration between the chemical used, the micro-organism and exposure time.

Sterilisation – A treatment, which completely kills or removes all kind of micro-organisms including spores. Sterilisation can be achieved by ionising radiation, by gaseous ethylene oxide, by gaseous hydrogen peroxide, by low pressure steam and formaldehyde, by filtration, by dry heat (hot air oven) or by moist heat (autoclave).

4.4.2 To be effective all items must be physically clean before being exposed to any sterilisation or disinfection process.

4.4.3 Not all equipment, however, needs to be sterile before use and the following is a general guideline:

Sterile – Equipment introduced into a sterile body area or in contact with a break in the skin or mucous membrane.

Disinfected – Equipment in close contact with body surfaces or intact mucous membranes, such as the ocular surface e.g. tonometer heads, gonioscope and other contact lenses.

Clean – Equipment not coming into close contact with mucous membranes or sterile body areas e.g. trial frames, refractor heads.

4.4.4 Surfaces in the consulting room should be cleaned after every patient with detergent and water unless contaminated with body fluids. If contaminated with body fluids a chlorine-based disinfectant should be used. All consulting rooms should have access to a wash hand basin and it is good practice for this to be within the consulting room

This is a personal decision. Member, staff and patient safety is our priority. We would advise members to follow the Government’s advice and inform the necessary NHS primary care teams and commissioners, if you deliver enhanced services, as well as LOCSU, of your temporary closure. If ABDO can provide any further support during this time please contact our membership department. Our policy lead is working with the Optical Confederation partners to try and agree a financial support package from the NHS for optical practices who will be forced to close during this time.

Covid-19 support for business.

 

 

The advice up until 17 (am) March from the Royal College of Obstetricians and Gynaecologists (RCOG) was, if you are pregnant you are more vulnerable to getting infections than a woman who is not pregnant. You should wash your hands regularly, going to and from home, from and to work etc. Due to this advice and the latest Government advice on social distancing, we would recommend pregnant members take precautions as those with underling health problems, have been advised to do and monitor the updates provided on the RCOG.

 

Patients booking in by telephone or online who meet the case definition should be directed to NHS 111.

An unwell patient with a relevant travel history should be identified when they book in at reception and immediately placed in a room away from other patients and staff. If COVID-19 is considered possible when a consultation is already in progress, withdraw from the room, close the door and wash your hands thoroughly with soap and water.

Avoid physical examination of a suspected case. The patient should remain in the room with the door closed. Belongings and waste should remain in the room. The patient and any accompanying family should remain in the room with the door closed.

Advise others not to enter the room. If a clinical history still needs to be obtained or completed, do this by telephone.

If entry to the room or contact with the patient is unavoidable in an emergency, wear personal protective equipment (PPE) in line with standard infection control precautions, such as gloves, apron and fluid resistant surgical mask (FRSM) and keep exposure to a minimum. All PPE in full should be disposed of as clinical waste.

Should the patient need to use the toilet, they should be allocated a WC for their sole use. Instruct the patient to wash their hands thoroughly after toileting, and return directly to the room they have been isolated in and close the door. The toilet should be taken out of use until cleaned and disinfected following the decontamination guidance.

Ask the patient to call NHS 111 from their room, on their mobile.

Once a possible case has been transferred from the primary care premises, the room where the patient was placed should not be used, the room door should remain shut, with windows opened and the air conditioning switched off, until it has been cleaned with detergent and disinfectant, as should all of the practice. Once this process has been completed in line with the procedures within the practice can be put back in use immediately.

 

 

The GOC has relaxed the regulations on these points during the COVID-19 situation, to enable practitioners to use their clinical judgement to be able to post spectacles and contact lenses to patients unable to attend practices due to self-isolation. ABDO, AOP, CoO, and FODO have designed a telephone review form (for both CLs and Spectacles) to assist with providing services this way.

The Royal College of Ophthalmologists and College of Optometrists have confirmed that the information in relation to the AAO advice should be disregarded.  Please refer to the advice issued.

The Government has provided advice for the self-employed.

COVID-19: guidance for employees, employers and businesses