NHSE/I withdraws standard operating procedures

ABDO, the College of Optometrists, the Association of Optometrists and the Federation of Ophthalmic and Dispensing Opticians are advising that optical practices should continue to follow the College of Optometrists’ Amber phase Covid-19 guidance following the withdrawal of NHS England/Improvement (NHSE/I) standard operating procedures (SOP) for optical practices.

The optical bodies stated that self-isolation exemptions in England were unlikely to apply in primary eyecare settings at this stage of the pandemic, and that they would continue to monitor updates to public health advice and support eyecare service delivery as the situation evolved.

The optical sector bodies support the need to follow other existing guidance and maintain robust infection prevention and control (IPC) measures. This means that practices should continue to follow Amber phase Covid-19 guidance and the General Optical Council supporting statements for the Amber phase, including advice on patient face coverings. These are consistent with the existing Covid-19 IPC guidance, which will continue to apply in all healthcare settings.

Practices should:

• Maintain social distancing where possible
• Ensure all staff wear a face mask (FRFM) and follow the correct use of personal protective equipment (PPE)
• Recommend the public continue to wear a face-covering when on practice premises
• Ensure scrupulous hand washing
• Ensure good surface disinfection and frame sanitising after every patient episode
• Encourage all staff to use lateral flow tests and report the results regularly
• Maintain patient triage and prioritisation
• Maintain good ventilation throughout the practice
• Maintain high standards of infection controls, including hand-washing and wearing face masks is vital to protect practice teams and remain open to provide eyecare as people begin to move about more freely

Self-isolation exemption

In an announcement on 19 July 2021, the Department of Health and Social Care (DHSC) stated that fully vaccinated frontline health and care staff may continue to work rather than self-isolate when they have been identified as close contact of a Covid-19 positive case outside of the work setting. This has been introduced to help alleviate pressure on healthcare services. The DHSC is clear that the exemption only applies where frontline health and social care staff absence may lead to a significant risk of harm to patients.

NHS England has published a letter on the same date confirming that this exemption applied in all NHS settings, including primary eyecare, but was subject to strict conditions.

The optical sector bodies stated they supported the need to help prevent patient harm; that they had considered these conditions and concluded that this exemption was not likely to be available in primary care optical practices, except in genuinely exceptional circumstances.

To ensure appropriate application of this exemption, the optical sector bodies advise that practices must:

• Have a clear self-isolation risk assessment procedure, detailing how and when it should be conducted
• Identify and contact the public health authority involved in decision making and approval
• Have sufficient testing mitigations and safeguards in place to allow staff to return to work safely and in appropriate roles

This exemption must not be used as a general mechanism to prevent staff from self-isolating, the optical bodies stressed, or bring self-isolating staff back to work in the absence of exceptional circumstances.

The College and optical sector bodies added that they were working with NHSE/I and continually reviewing the guidance to ensure it remained comprehensive and up-to-date.

The College’s Amber phase guidance will be updated later this week to reflect changes in government advice.