The Optical Confederation’s Domiciliary Eyecare Committee (DEC) has highlighted the importance of eye health and vision care in a statement today. It has also issued guidance to support the provision of eye care to adults who are ‘extremely clinically vulnerable’ and ‘clinically vulnerable’, as well as those who are unable to leave home owing to physical or mental ill-health or disability.
As well as patients who cannot leave home for non-Covid reasons, 2.5 million people in the UK are now shielding on medical advice. Many more people have been advised to physically isolate or have chosen to do so based on their risk assessments, because of the pandemic.
Vision is crucial for people in isolation for social functioning and mental health reasons. Such groups will also be highly vulnerable to eye disease because of age and other conditions, and they will have seen their eye health deteriorate during the past 10 weeks of lockdown.
Much more is now known about the disease and how it is spread than in March. Also, personal protective equipment (PPS) and rigorous infection prevention and control (IPC) are in place to protect patients, staff and the public. As a result, eye care can be safely provided in private homes and care-home settings using ‘remote-first’ and ‘safety first’ principles based on assessed risk for each patient and location.
Gordon Ilett, Co-chair of the DEC, said: “Vision and healthy eyes are critical to people who cannot leave home, may have other long-term conditions or who are isolating. Eye disease is insidious and can be catastrophic. We must not fail the most vulnerable in society by denying them the eye care they need to stay fit and well.”
Issued 5 June 2020
We are writing to update you on action that we have taken in response to COVID-19 at the highest-level to protect domiciliary patients, staff and providers in all four UK countries.
As we all know, domiciliary practice is similar to fixed-premises practice in that normal clinical, infection control and staff and patient health protection advice applies. You should have been receiving this advice through the NHS and the optical professional and representative organisations in all four countries.
In many ways however domiciliary practice is very different in the complexity, vulnerabilities, disabilities and co-morbidities of the cohorts of patients we care for and the fact that a lot of this care is provided to patients in care homes. We also depend on a highly skilled eye health professionals and clinical support staff who have additional training and knowledge in supporting this vulnerable population.
The cost of our skilled workforce however means that if a care home decides to isolate patients on precautionary grounds, which many have been doing, no patients in that location can receive care and the vital services we provide cannot function. Given the low margins in the sector, we are acutely aware that the current restrictions could easily result in domiciliary practices closing which would be in neither patients nor the NHS’s best interests.
To mitigate against this unacceptable outcome, we have been supporting the national bodies (OFNC, OW, OS and ONI) and partners (College of Optometrists, GOC and LOCSU in England) who have been working urgently with governments, health departments and the various NHS systems, to ensure that GOS and other NHS funding continues to flow to practices during the crisis. Domiciliary provision because of its particular and immediate vulnerabilities has been at the top of the agenda in all four countries.
So far Welsh Government has announced a package of measures, including continuing funding, to keep eye care services operating throughout the crisis whether or not normal service provision is possible
This is very welcome.
Negotiations are also underway in England, Scotland and Northern Ireland and further announcements are hoped for in the near future.
We are also exploring how business rates and other easements may be extended to head offices and other non-retail locations of mobile businesses which do not yet benefit from the business rates relief measures announced by the government in response to COVID-19.
We are also discussing with the four governments and NHS systems how our highly trained domiciliary professional staff might be able to respond to urgent cases in care homes, which may otherwise have restricted access, and how they and our facilities may potentially be redeployed during the next stages of the crisis. For example, we are also exploring how providers might be able to support care homes based on current government advice.
Meanwhile the General Optical Council (GOC), together with the other health and social care regulators, has made clear that we are now all working in highly challenging circumstances in which professionals may need to depart from established procedures. Where a concern is raised about a registered professional, those circumstances informed by any national guidance will be taken into account. Learn more.
The GOC is also due to issue further guidance shortly about using professional judgement to make eye care as safe as possible.
We will also support the College and ABDO who are developing Q&A guidance on clinical matters while the optical bodies are dealing with NHS contractual and business queries.
We will continue to keep you posted on development across the four countries. If you have any general queries, please contact Peter Fogarty DEC secretary firstname.lastname@example.org or Gary Robjent at email@example.com
Please also let us know personally if we can help you or your staff in any way to keep this crucial NHS service operating for the most vulnerable individuals in society during this very difficult time.