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Opchat Magazine Professional Matters PagesProfessional Matters News, April to June 2020

Optometry/Dispensing

For Ophthalmology Section Page Click Here.

 

OFNC Update: NHS Funding for Optical Practices across England and in local lockdowns
AOP response to petition
AIO gets clarity from the GOC on what services practices could offer in lockdown
AIO meets with GOC Registrar to discuss The GOC's position on routine testing during the Lockdown by practices from March 23rd.
Is it really a turf war between independents and multiple staff or is that too simplistic?
ABDO comments on GOC/Specsavers Petition
GOC under immense pressure on apparent U-Turn after response to Specsavers infamous video
American Academy of Optometry Foundation Announces the 2020 Joe and Janet Barr Early Career Cornea and Contact Lens Research Award Recipient
Some more helpful tips on preparation for start up when the light changes to Amber
All primary care contractors (GPs, pharmacists, dentists and optometrists) are asked to take the following actions during "Test and Trace"
OFNC on the defence about rumoured cliff edge end to payments
ABDO position on GOC CET Consultation Stage
COVID19 – meeting the eye health needs of vulnerable individuals during the next stages of the pandemic
New AOP Infection control and prevention certificate
OFNC STATEMENT: Resumption of General Dentist Services – Implications for OPTICAL SERVICES IN ENGLAND
GOC launches consultation on Continuing Education and Training scheme
OFNC STATEMENT: Meeting essential eye care needs during the Pandemic
New PCA and road map for Scotland as Lockdown set to ease
GOC suspends Hampshire based optometrist
3706073 daily contributors' data is helping beat COVID-19, are you taking part?
Registered with GOC or have worked as clinician then: Join the Virtual Frontline as a Clinical Contact Caseworker
News from The General Council 13 May 2020
Give eyes essential care advise optometrists as lockdown takes its toll
Routine sight testing in the UK – statement from the OFNC, Optometry Northern Ireland, Optometry Scotland and Optometry Wales
FODO responds to the Health and Social Care Select Committee
NHS CC to run webinar (May 11th) titled: Troubleshooting the implementation of the COVID-19 Urgent Eyecare Service (CUES) specification
FODO takes a unified approach on sector Covid-19 guidance
ABDO considers exit phase approach to pandemic.
AOP reminds practitioners ‘ear for optics’ service open to all
GOC welcomes the Professional Standards Authority Performance Review
GOC erases Yorkshire based optometrist
College announces IP exam update
Primary eye care – urgent and emergency services. Scotland praised for emergency eyecare treatment centres
College provides support for remote consultations at patient's homes
OFNC STATEMENT ON GOS SUPPORT PAYMENTS
Tim Parkinson appointed to GOC Council
GOC erases Sheffield based student dispensing optician
Coronavirus testing extended to all essential workers in England who have symptoms
AIO releases Post-Covid-19 Manifesto
Covid Urgent Eyecare Services (CUES) and OFNC response
COVID-19 - How will you be insured for Optical Indemnity during the pandemic.
New guidance from Government is shown on our dedicated Covid Page including links to the new PPE Hub.
The OFNC has updated its FAQ resource
Updated PPE guidance published yesterday (Thursday 9th April) by College
There is a network of underground shoots below the surface waiting to sprout
GOC erases Cardiff based optometrist
Results of Annual GOS negotiations from OFNC.
LOCSU announce 4-month pause in levy payments
Updated guidance on PPE from College following Official Guidance
OFNC evaluates and sets out the requirements and its understanding of NHS Englands Optical Letter
OFNC Statement: COVID-19 – NHS guidance for optical practices in England: A response to letter below
Complete letter from Matt Neligan Director of Primary Care and System Transformation and Poonam Sharma Optometry Advisor NHS England
AOP fee reduction for members amidst coronavirus crisis
COVID-19 - Patient Care at Growing Risk as NHS ENGLAND ignores Optics
Promised further information and important links for help in finance in Covid Pandemic
News is just arriving on help for self-employed which will assist locums
OFNC updated guidance on opening arrangements for optical practices
AOP calls on Government to act faster for locums
OPTICAL PRACTICES – ESSENTIAL OPENING ARRANGEMENTS clarified this morning (24 March 2020)
Routine Eyecare to cease by order in Scotland
COVID-19 – SUPPORT FOR GOS CONTRACTORS IN ENGLAND
RCO and College publish joint Covid Statement
GOC response to the COVID-19 (coronavirus) emergency
Archived Professional Matters Janaury to March


OFNC Update: NHS Funding for Optical Practices across England and in local lockdowns

July 2020

In our recent discussions with NHS England on COVID-19 funding for optical practices in England, the OFNC has stressed the need for ongoing support in the event of local or regional lockdowns being introduced. This morning the OFNC met NHS England again and discussed the position in Leicester. We understand that NHS England is planning to shortly confirm the next steps for all primary care providers in Leicester, including optical practices.

Meanwhile our discussions with NHS England on future COVID-19 funding for all GOS contractors in England have continued.

The current arrangements end with effect from today, and contractors are understandably frustrated that NHS England has not clarified funding arrangements for the increased cost associated with NHS care from July onwards.

The OFNC continues to press NHS England for a decision on this so that practices and practitioners can focus on meeting the eye health needs of local people safely throughout the pandemic.

We have also clearly set out the additional challenges faced by domiciliary providers. We will provide more information on all these issues, and on the outstanding issue of agreed deductions as set out in NHS England’s 1 April letter to contractors, as soon as we can.

AOP response to petition

June 2020

AOP informs us that the Professional Standards Authority (PSA) will be looking into the matter regarding the GOC performance over Practitioners disobeying the lockdown requirements

The AOP is aware of the petition on Change.org asking the Professional Standards Authority to investigate alleged conflicts of interest in the General Optical Council’s governance structure.

The PSA has issued a statement to say that it is “seeking information about the matters raised from the GOC and will make a further statement in response to the petition within the next three weeks”.

Any regulatory body needs to be – and be perceived as – impartial in the positions it takes, and must treat all its registrants fairly and consistently. We are therefore pleased the PSA is looking into the matter.

The petition signatures stand at 7000 currently 500 short of the target for action.(June 23rd 15.00)


AIO gets clarity from the GOC on what services practices could offer in lockdown

June 2020

Independent body invites any breaches of lockdown rules to be reported

AIO today issued a Statement following recent controversy over apparent breaches of lockdown rules by opticians following a meeting with the GOC's CEO Lesley Longstone.

Following this meeting an agreed Statement (see following story) makes it clear that no routine eye examinations or sight tests should have been conducted between the period 23rd March 2020 and 15th June 2020. Any practice breaching the Rules should therefore be subject to Fitness to Practice proceedings.

AIO is aware that there may have been multiple breaches of the rules across the UK and is therefore inviting members and the wider optical community, Independent and Multiple alike, to report and provide evidence of such breaches to the GOC (or to AIO for onward submission) in order that Fitness to Practice proceedings can be commenced in each case.

Any breach reported through AIO will be treated in complete confidence and the reporting party will not be disclosed to the GOC or any other third party. Breaches can be reported to admin@aiovision.org or by telephone to 0800 1300 486 and ask for Mike or Lin

Dr Christian French, AIO Chairman said ‘we were appalled to see evidence of a blatant breach of lockdown rules by optical practices being circulated in the public domain. Against a backdrop of our members (and the Independent sector more widely) strictly observing present GOC rules, teamed with the stresses, uncertainties and hardship that the lockdown has occasioned, a cavalier and total disregard in some quarters is totally unacceptable and must dealt with appropriately. It should never be acceptable that a business goes against the direct advice of our regulatory body (whose rules are put in place for public safety). Such behaviour suggests severely misplaced priorities around public safety, going against the very principles of our profession.'

" Whilst we are aware of, and fully understand, the motivation of the Change.Org petition that has been circulating, our focus is on ensuring clarity regarding the Statements issued by our regulator, whilst bringing to account those who have broken those rules and denigrated our profession in such a blatant manner.’

AIO, as the only representative body in optics which represents Independents exclusively, and without any external influence, is determined that there can be no hiding place for those that have broken the rules against the backdrop.

AIO meets with GOC Registrar to discuss The GOC's position on routine testing during the Lockdown by practices from March 23rd.

June 2020


The AIO met with Lesley Longstone, Chief Executive and Registrar at the GOC on Thursday 18th June and agreed the following statement with them:

• The GOC position as laid out in their circular to all Registrants on 23rd March 2020, which stated ‘In light of concerns regarding the provision of eye services in England, we have issued a statement in support of suspending routine services and limiting registrants to only providing essential and urgent, emergency or acute care’ was confirmed as applying equally to NHS and privately provided care.

• That position, in support of professional guidance from The College of Optometrists, ABDO, AOP and OFNC remained unchanged until their further statement issued on the 12th June 2020.

• Paragraph 4 of the GOC statement issued on 12th June, which reads ‘in our view this means that registrants are able to deliver private eye care including private sight tests / eye examinations and aftercare appointments’ still has to be delivered in accordance with professional guidance including “amber phase” College guidance effective from 15th June

• The recommendation that private eye care services could be expanded beyond that which was urgent or essential, became effective from 15th June 2020 in England when the College changed from Red to Amber guidance. It did not change the position from 23rd March 2020 to 15th June 2020. It was accepted that this point could have been worded in more explicit terms.

• Fitness to Practice matters against individuals and businesses are always judged against the standards that were in place at the time of the alleged breach of GOC standards.

• The GOC is unable to make any public comment on any ongoing Fitness to Practice matter

Is it really a turf war between independents and multiple staff or is that too simplistic?

June 2020

ABDO’s response raises several questions about who is supporting the petition.

In Sir Tony Garrett’s statement as ABDO General Secretary, it assumes that the majority of signatures have come from those professionals working in the independent sector of primary care. This may be true, but we must remember that many locums work in both camps and there have been many a disgruntled optician who is prepared to resonate his or her feelings.

It is not just the Specsavers Video that has stirred over 6000 to sign and its still climbing by the minute but the feeling of imbalance between the multiples who now supply the major slice of sight tests and who have the weight to influence those who regulate us and those who commission optometry, just take the DVLA agreement for starters.

Yes, we need to get back to feeling part of one profession but that must start from those who assist us, the College, the membership bodies, and those who control us.

Please let us know your views on either side of the discussion, anonymously if you wish on mail@primaryhealthnet.com. Link to petition here

ABDO comments on GOC/Specsavers Petition

June 2020

ABDO General Secretary Tony Garrett has had a number of members contact him about the on line petition calling for the GOC to be investigated over a perceived conflict of interest as evidenced by two seemingly contradictory documents issued by the GOC.

Commenting on the petition Tony said “It is sad that our regulatory body has found itself in this position. I find it worrying that so many individual registrants feel so aggrieved that they are prepared to sign this petition. Clearly this has been largely supported by optometrists working in the independent sector but a number of ABDO members have added their support.

One of the serious outcomes of this is the potential for there to be conflict between registrants in both the independent and corporate sectors. This is both damaging and unhelpful.

At a time when we all need to be totally united in trying to bring the whole sector together and get practices open and looking after patients this is an unhealthy distraction. It also demonstrates, most acutely that the GOC needs to work closer with the sector and understand the different challenges being faced by all registrants to be able to provide statements that can be supportive to all and distinguish clearly the specifics for each country.

We welcome, therefore, the GOC’s commitment to reviewing its statement on reopening optical practices and hope that it does so without further delay.”

GOC under immense pressure on apparent U-Turn after response to Specsavers infamous video

June 2020

Petition for the General Optical Council to be investigated for conflict of interest now reaches 5425+, needing 7500 for action to be taken. Link to petition here

It includes the following statement

The General Optical Council is the regulatory body for Optometrists and Dispensing Opticians in the UK. Their role, as they say, is to protect the public and uphold standards within the profession.

Recently, there have been numerous concerns from members of the optical industry that the GOC is not fit for purpose and has a major conflict of interest.

When the COVID 19 lockdown came into force in March the GOC released a statement calling for all routine eye care to be suspended. Many companies followed this guidance and stopped providing routine sight tests and only opened for emergency/essential care. Some practices closed their doors completely.

Recently a video has gone viral, showing a Specsavers director boasting about how his store is keeping busy and stealing patients from competitors during the lockdown. Many people within the industry found this behaviour abhorrent and complained to the GOC, saying this was against their guidance.

Within the last few days, the GOC have released another statement, claiming that Opticians were always exempt from closing, and that private routine eye care could indeed have been provided during the lockdown. This goes against the guidance set out by the College of Optometrists. They have also deleted any trace of their original statement from their website.

For many people, it is clearly more than a coincidence that the GOC have done a U-turn and changed their stance so soon after the video of the Specsavers director gained significant attention. The fact that the GOC, as a regulator, also has Specsavers directors on its board is a clear conflict of interests and needs investigating. It is a disgrace that so many businesses have followed the initial rules set out by the GOC which has in turn hit them financially, whilst at the same time some Specsavers stores appear to be doing as they please. Deleting the original statement from the website amounts to dishonesty. If a GOC registrant had amended a patient's records following a complaint, they would (rightly) be sanctioned.

The GOC is not above the law and must also face the consequences of its actions. How can registrants be expected to show "duty of candour" as the GOC expects, when their governing body behaves in such a manner?

The petition also highlights the concerns around:

Overbooked clinics
Contact Lens sales online

Whilst it highlights the suspension of registrants for trivial matters e.g. Forgetting to pay for a packet of crisps.

The assertion that the GOC has redacted its original storyline and guidance does indeed seems to bare some truth when PHN investigates its original story reported in March after lockdown was announced.
A Reminder the petition says:

Within the last few days, the GOC have released another statement, claiming that Opticians were always exempt from closing, and that private routine eye care could indeed have been provided during the lockdown. This goes against the guidance set out by the College of Optometrists. They have also deleted any trace of their original statement from their website.
Our story in March found in our archives here https://www.primaryhealthnet.com/phnsubcontent.asp?id=93&subid=1096#31
It specifically says

“Today, 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 link has been removed following the statement of recent days reflecting a change of heart which is favourable to the Specsavers Debacle.

We published this story from an email received from the GOC on the 19th March 2020 and extract can be seen here:

GOC response to the COVID-19 (coronavirus) emergency

The General Optical Council (GOC) understands that many of its registrants and stakeholders will have questions about the impact of COVID-19 and wants to ensure that everyone in the optical professions is aware of the steps the GOC has taken in light of the emergency.

Support for registrants

The GOC has established a dedicated COVID-19 page on its public website where it is directing registrants to the latest Government guidance.
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 and will also be publishing a series of optical sector specific statements to reassure registrants that when they act in good conscience and exercise professional judgement for the public benefit, the GOC will support them.

Today, 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.

Furthermore we repeat the content of the OFNC statement which includes all organisations and the GOC:

Summary from OFNC in March

"We (OFNC) realise that so far there has been less clarity for the eye care sector from NHS England than in the other UK countries and that Government messaging about risk has changed significantly as the crisis has unfolded.

OFNC is therefore issuing this advice to the sector in England setting out

• that providers should no longer be offering or providing routine sight tests even as a matter of clinical judgement as previously
• that providers should be focusing on contingency plans to provide essential and urgent eye care to those who need throughout the crisis without putting staff at risk
• that this does not mean all practices should remain open if this is not possible and those that can may well operate on a remote consultation/advice only basis
• initial thoughts on the meaning of ‘essential’ and ‘urgent’ in this context which many change over time.

The national optical representative bodies (ABDO, AOP and FODO) have now issued/are issuing guidance for their members in line with this advice.

The OFNC (which is comprised of the national representative bodies) is in close touch with NHS England-NHS Improvement, DHSC, the College of Optometrists, the GOC and LOCSU, all of whom are sighted on this advice.

We also published urgent advice from NHS England here

Obviously having tracked back to the original story lines on Opchat News from March onwards and the CMO’s advice in February about triaging patients from abroad it would seem the assertion by the GOC that practices could make their own minds up about providing eye care is somewhat stretched.

We will reach out to other organsiations for their specific views but we must remember that many of their members work for the same company being mentioned in the petition and they too will be treading on eggshells.

Just part of the make up of how we have come to provide eye care in the UK.


American Academy of Optometry Foundation Announces the 2020 Joe and Janet Barr Early Career Cornea and Contact Lens Research Award Recipient

June 2020

Sidra Sarwat Sidra Sarwat is a first-year Ph.D. candidate at the School of Optometry and Vision Science, University of New South Wales.

Her research project entitled, “In Vivo Labelling and Bioimaging of the Tear Film Using Silicon Quantum Dots,” was chosen out of the six applicants who applied for the award. Sidra presented an impressive resume of experience in clinical research, volunteer service and lecture presentation.

The award provides a first- or second-year M.S. or Ph.D. vision science or physiological optics student with a $2,000 research project seed fund in the area of cornea/ocular surface or contact lenses.

Sidra will be honored at the AAOF’s Annual Celebration Luncheon on Saturday, October 10, 2020 at Academy 2020 in Nashville, TN.

Some more helpful tips on preparation for start up when the light changes to Amber

June 2020

Whilst the infection rate 7-day rolling average continues to be stubbornly high (1419/day compared to 833/day on the day of lockdown) we are of course desperate to return to providing the services that are key to our Nation's eye health. In order to assist in preparation a number of professional bodies have provide further guidance.

ABDO has now issued guidance on dispensing and contact lens practice during Covid-19.

The guidance includes manufacturer guidance on frame cleaning and further guidance on dispensing spectacles and contact lenses. Not all frame materials are the same so care needs to be taken in the choice of cleaning fluids. See here

The College of Optometrists have made minor amendments to its traffic light (RAG) table earlier this week, adding a new row for contact lenses to align with ABDO guidance. Learn more about the College’s traffic light model here

The Welsh government has published Optometry recovery guidance. It provides a summary of key steps local practices and practitioners can take while they plan to reopen. The guidance includes tips on how to minimise the risk of virus transmission. Members in Wales should wait for official confirmation as to when the amber phase begins.

This is a handy check list on measures to be taken for all primary care settings.

All primary care contractors (GPs, pharmacists, dentists and optometrists) are asked to take the following actions during "Test and Trace"

June 2020

1. To prepare for potential staff absence, providers should review their existing business continuity plans and take actions as required. This includes ensuring that arrangements are in place within a primary care network or between buddies to maintain patient access to services.

2. Providers should inform their commissioner as soon as they consider that delivery of the full contracted service may be compromised by staff absence due to Test and Trace. The commissioner will work with the contractor to put business continuity arrangements in place and to maintain access to services for patients. The provider will need to update information on patient accessible websites and the impacted NHS 111 Directory of Services profiles will need to be updated.

3. The commissioner will inform the Regional Incident Coordination Centre without delay and work with the provider to implement appropriate business continuity measures. The Regional Team will notify the National Incident Coordination Centre.

In addition, Public Health England has launched SIREN, a new large-scale study to improve understanding of COVID-19 immunity and reinfection. Trusts will be asked to use their PCR and serology capability to monitor a cohort of healthcare workers fortnightly for up to 18 months for the purposes of this study. SIREN is aiming to determine whether a detectable antibody response protects against future infection in the short and medium term, which will help inform the public health response to COVID19.

Management of outbreaks

Ongoing and consistent implementation of national infection prevention and control guidance, including in staff areas, will be paramount in reducing healthcare associated infections. This includes all staff adhering to social distancing (2 metres) wherever possible in non-clinical areas.

Close contact between staff over prolonged periods should be minimised; for example, by avoiding congregating at central work stations, restricting the number of staff on ward rounds, conducting handover sessions in a setting where there is space for social distancing, moving to ‘virtual’ multi-disciplinary team meetings, and considering staggering staff breaks to limit the density of healthcare workers in specific areas.

Social distancing measures, where possible, are a critical part of maintaining IPC in clinical and non-clinical areas. However, where it isn’t always possible to maintain social distancing, public health advice is that wearing a face covering is an appropriate precautionary measure. As announced by the Secretary of State for Health and Social Care, from the 15 June, the recommendation will be that all staff in hospital wear a surgical face mask when not in PPE or in a part of the facility that is COVID-secure in line with the workplace definition set by the government.

The guidance will also apply to other NHS healthcare settings, including primary care, and will be published this week by Public Health England.

You are therefore asked that you make the necessary changes to implement that advice and help reduce any further risks of transmission, by 15 June at the latest.

To support this, trusts should continue to use additional available NHS testing capacity to routinely and strategically test asymptomatic frontline staff.

Local health systems should work together with their labs and regions to agree the use of available capacity. NHS labs should also be aiming to turnaround all COVID-19 tests within 24 hours, to ensure swift action can be taken to minimise the risk of nosocomial transmission and improve operational efficiency.

Matt Hancock confirmed at yesterday’s Downing Street conference (11th June) that if you are complying with Covid Secure standards, then one member of staff being asked to self-isolate by NHS Test and Trace would not result in the entire work team having to self-isolate.

This reconfirms the importance of ensuring compliance with infection prevention and control measures in your practice. You can do this by following our four stages to safer care, especially standard precautions in primary eye care settings

OFNC on the defence about rumoured cliff edge end to payments

June 2020

The OFNC has today written an open letter to the Health Secretary and optics minister at the Department of Health and Social Care (DHSC) about recent messaging from NHS England regional offices, suggesting that financial support to help optical practices deal with Covid-19 may stop at the end of June.

The OFNC letter points out that the sector is now preparing to resume care on a wider scale in the coming week, but will face reduced capacity because of social distancing, and that any cliff-edge end to financial support would make it impossible for practices to prioritise remote care and effectively respond to Covid-19.

The letter calls for urgent action to clarify funding arrangements and not to unnecessarily delay the resumption of regular NHS care.

ABDO position on GOC CET Consultation Stage

June 2020

The GOC is currently consulting on proposals to introduce changes to the Continuing Education and Training (CET) scheme to make it more flexible and less prescriptive, allowing registrants greater freedom to undertake learning and development which is relevant to their own personal scope of practice.

ABDO Head of CET Alex Webster says, "The changes proposed in the GOC CET consultation are overall a positive step towards building a broader approach to life-long learning for GOC registrants. Changing the scheme name to CPD will align optical professionals with other healthcare professions and reduce barriers to inter-professional working. Following the coronavirus pandemic, eyecare in the UK will never be the same again as we expect to see rapid developments in more hospital services within primary care. Having a professional education scheme that can be easily recognised should be one aspect of a swifter approach to these changes.

"I am disappointed that Peer Review is not being considered to be mandatory for all GOC registrants. Dispensing opticians fulfil an essential role as a healthcare professional in the many different settings of optical practice. I would like to see the GOC recognise now is the time to have an equal approach to continuing professional education for DOs. The original mandatory approach to peer review for optometrists and contact lens opticians was based on professional practice risk.

"However, this form of case-based learning is considered a highly effective form of education across healthcare professions and would be equally beneficial for dispensing opticians to help develop their patient care.

"The GOC has shown that the overwhelming majority of dispensing opticians already take part in this form of learning and as there is now the possibility of the GOC allowing a broader approach to online learning post-covid-19, access issues to peer review could be much less of a concern for those dispensing opticians who have yet to take part in peer review."

The consultation was live from 28 May and closes 20 August 2020. To take part, visit the GOC Consultation Hub

COVID19 – meeting the eye health needs of vulnerable individuals during the next stages of the pandemic

June 2020

A statement by the Optical Confederation Domiciliary Eyecare Committee (DEC) Domiciliary eye care is a specialised area of optometry and optics experienced in dealing with high risk patients (including those being barrier-nursed) and rigorous infection control. It provides eye care services to those who are unable to visit a high street practice unaccompanied due to a physical or mental illness or disability.

Within this group patients will have varying needs depending on the type of illness or disability. Some will have both sight and hearing loss as well as other long-term conditions or disabilities. Coronavirus Covid-19

Under the current Covid-19 public health measures, the UK health systems have identified shielded populations of ‘extremely clinically vulnerable adults’ comprising approximately 2.5 million people, currently

▪ 2.2 million England
▪ 40,000 Northern Ireland
▪ 170,000 Scotland
▪ 121,000 Wales

In addition, there are potentially over twice as many ‘clinically vulnerable’ adults who have been advised to physically isolate or who may have chosen to do so on their own risk assessment..

Nevertheless, the eye health needs of both groups, as well as of those unable to leave home for non-COVID reasons, continue and have, arguably, become even more crucial during this period of social isolation. A condition which may have been safe to postpone ten weeks ago may now have become acute, especially for chronic eye diseases which may not be immediately obvious to patients or carers or ongoing conditions which need regular support.

More than two million people in the UK live with sight loss that is severe enough to have a significant impact on their daily lives; around 79% of these people are over age 64, with one in every three people age 85 and over living with sight loss.

It is estimated that 8·43 million people in the UK are in the high-risk group, of whom 5·77 million are older than 70 years of age, and 2·66 million have one or more underlying condition and are 70 years or younger

Much more is now known about Covid19 and how it is spreads. As a result, eye care can now be safely provided in private homes and care home settings using ‘remote first’ and ‘safety first’ principles and where face-to-face care is required using personal protective equipment (PPE) and additional infection control procedures to safeguard patients, carers and eye care professionals.

Call to Action and Guidance As the UK governments ease lockdown restrictions and the health services moves in its second phase response in all four UK countries, the Optical Confederation Domiciliary Eyecare Committee calls upon governments, the NHS (including the Health and Social Care Board, Northern Ireland) local authorities and care home providers to work with skilled domiciliary eye care providers to ensure that clinically vulnerable and extremely clinically vulnerable patients are not denied the eye and vision care they need in these very challenging times.

To support this, the Optical Confederation’s Domiciliary Eyecare Committee has produced guidance for health and care providers and others, which links to essential government and public health advice and guidance produced by the General Optical Council, the College of Optometrists and the Association of British Dispensing Opticians. This can be accessed here

New AOP Infection control and prevention certificate

June 2020

On Wednesday 3 June, 12pm, The Association of Optometrists (AOP) will launch a new AOP Infection control and prevention certificate, in association with Optometry Today (OT).

The certificate has been designed by the expert clinical team to give optometrists and dispensing opticians, and patients, confidence and reassurance when practices open and they begin to see patients more regularly.

All UK practising and pre-registration AOP members are encouraged to take the certificate. Qualified optometrists and dispensing opticians can also earn 1 CET point with successful completion of the certificate.

In the pre-recorded lecture, AOP Clinical Director, Dr Peter Hampson, explains how to protect staff and patients in optometric practice during the coronavirus pandemic. He looks at how the virus is spread and how to control this, for example, by screening patients for symptoms, handwashing, social distancing, correct use of personal protective equipment (PPE), methods of cleaning, disinfection and sterilisation, and arranging the practice environment.

After watching the lecture in full, members will be directed to complete a series of related multiple-choice questions (MCQs). Upon successful completion , members will be able to download a paper certificate from MyAOP/CET, which they can personalise with a practice logo, to display on a practice wall or shown to an employer.

OFNC STATEMENT: Resumption of General Dentist Services – Implications for OPTICAL SERVICES IN ENGLAND

May 2020


On 28 May NHS England announced that it was asking all dental practices in England to commence opening from Monday 8 June for face-to-face care, subject to having the necessary infection control measures and PPE in place. The announcement makes it clear that the goal for patients and professionals is to resume the safe and effective provision of the full range of care in all practices, as rapidly as practicable.

Dentists are also being asked when scheduling treatment to take into account the urgency of patient need, the unmet needs of vulnerable groups, and the capacity available to provide care.

The OFNC continues to work urgently with NHS England to agree appropriate arrangements for optical practices to provide more face-to-face care as soon as possible. As with dentistry, the need for infection control and social distancing will reduce the number of patients that practices can safely see face-to-face.

The OFNC notes that the current temporary financial arrangements for dentistry are to be maintained initially and is similarly discussing with NHS England how the financial impact on optical practices of the necessary changes in the way care is delivered can be mitigated.

In the meantime, optical practices remain open to provide an inevitably widening scope of essential care as described in the OFNC statement issued on 27 May. We urge those practices that are open to continue to meet their patients’ evolving needs for essential care, and we encourage all practices to continue prepare for a wider resumption of face-to-face care in the near future.

GOC launches consultation on Continuing Education and Training scheme

May 2020

The General Optical Council (GOC) has launched a consultation on proposals to introduce changes to its Continuing Education and Training (CET) scheme.

The public consultation seeks views on how to make the scheme more flexible and less prescriptive, allowing optometrists and dispensing opticians greater freedom to undertake learning and development which is relevant to their own personal scope of practice.

The proposals are based on feedback from the GOC's 2018 public consultation: ‘Fit for the Future: A lifelong learning review’, and engagement with a diverse range of stakeholders including patients, the public, registrants, professional bodies within the optical sector and other stakeholders. Findings and discussions showed that there was strong appetite for change in five key areas which the new consultation will address:

• Replacing the current competencies of the scheme so that they are more flexible to help encourage and facilitate learning and development throughout a registrant’s professional life.
• Allowing optometrists and dispensing opticians more control over their learning and development and the ability to tailor it.
• Enhancing requirements for optometrists and dispensing opticians to reflect on their practice as a mechanism for embedding good practice and improving patient care.
• Changing the name of the scheme from CET to Continuing Professional Development (CPD).
• Introducing a new proportionate system of CPD approvals for efficiency.

Leonie Milliner, GOC Director of Education said: “We’ve listened to the views of our stakeholders and have taken this feedback into consideration when drafting our proposals. Our current scheme was introduced in 2013 and the type of work that optometrists and dispensing opticians carry out has expanded and diversified since then. The COVID-19 pandemic has also highlighted the importance of having a highly skilled and flexible work force, which is able to work effectively as part of multi-disciplinary teams across the healthcare sector. We must therefore ensure that our scheme is agile and able to support an optical workforce which is likely to see many more changes in the coming years.”

The consultation will take place from 28 May to 20 August. Feedback will then be considered, with a view to implement the changes at the beginning of the next CET cycle in January 2022.

Participation in the consultation is through the GOC's online consultation hub

OFNC STATEMENT: Meeting essential eye care needs during the Pandemic

May 2020

Today May 27th we received the following statement on the definition of essential eye care in NHS England’s letter of 1 April :

“this includes but is not limited to appointments for patients who would not normally be considered to be emergencies, but where, in the practitioner’s professional judgement, a delay in an examination may be detrimental to a patient’s sight or wellbeing. This may include where patients have broken or lost their glasses or contact lenses and need a replacement pair to function.”
This enables practitioners to exercise their professional judgement to determine whether a particular patient need falls under the heading of essential care.

As the pandemic has progressed and scheduled primary eye care services have remained suspended, inevitably there is now an expanded range of situations where individual patient needs are now likely to be essential.

Examples include:

• Patients who require an appointment due to clinical risk factors that are being monitored by the clinician. While in the initial stages of the pandemic deferring these appointments was acceptably low risk and justified when balanced against the risks of providing face-to-face care, the passage of time since the last examination may now have increased the risk to the point where the patient’s needs now fall within the definition of essential care

• Patients with a minor reduction in vision, and patients with broken spectacles that have been “making do” with older spectacles with an out-of-date prescription. In the initial stages of the pandemic, these patients may not have met the definition of essential eye care because their condition was not having a material effect on their sight or wellbeing. As lockdown conditions are starting to ease and patients are likely to undertake more vision-dependent tasks, such as working and driving, it is likely that more of these patients have needs which fall within the definition of essential care

• Patients who are anxious or concerned about their vision, in the absence of clear clinical indications. Some patients may be particularly susceptible to the effects of pandemic and lockdown on their wellbeing. This may lead to them developing mental health problems or exacerbating existing mental health problems. As such these patients’ need may now meet the definition of essential care

All patients should be considered on a case by case basis by the appropriate clinician, using remote triage in the first instance, to determine whether in their professional judgement the patient requires a face-to-face appointment.

ABDO Comment on reopening:

In response to the Prime Minister’s statement on Monday 25th May regarding retail premises opening again on 15th June, ABDO head of policy and public affairs Debbie McGill commented, “This is not relevant to optical practices as they are named as essential services within the definition of health and social care. Optical practices continue to provide only essential/ urgent/ emergency eyecare at this stage. We will advise of any updates as soon as the position changes.”
The ABDO Policy team is in continuing discussions with governments for each nation and members will be updated as soon as any developments are confirmed with regard to opening of practices for services beyond essential, urgent and emergency eyecare.

New PCA and road map for Scotland as Lockdown set to ease, plus predicted phase changes for both Scotland and Wales.

May 2020

New PCA

The Scottish government has published a new PCA, which includes an update on continued financial support for community optometry.

The update sets out how practices are crucial to the delivery of eye care in Scotland, and it is an “imperative therefore that, as far as possible, the current infrastructure and workforce are protected”. The government is committed to ensuring that the future recovery plan “prioritises the safety of patients and practice staff and that this is underpinned by an appropriate model for the provision of financial support to practices”.

The PCA also confirms that the Community Eye Care website has been updated with Covid-19 emergency response clinical guidance for every condition. EyeHealth Scotland, NHS Board OAC and Optometry Scotland advise eye health professionals to use this website as their primary clinical source.

You can read the full PCA(0)2020(8). here

Dr Janet Pooley, Optometric Advisor, has also written to all eye care providers in Scotland: “I am writing to thank you for everything you have been doing so far during this crisis. Many of you have been conducting telephone triage and consultations, and referring patients onwards for face to face care; a service transformation that we could never have predicted just a few months ago.”

The letter also confirms the government’s position that Covid-19 will be present for the “foreseeable future” and that the skills in primary eye care will be “required during the next phase as we start to reopen practices”.

She added: “Plans for the recovery phase are being developed now, and these will be shared as soon as possible. We are also working with others to implement a robust NHS supply process to practices to ensure that you have access to the appropriate PPE at the right time.”

Route map

On Thursday 21 May, the Scottish government published Scotland’s route map through and out of the crisis’ – you can read a more detailed review of this route map here

The main points for primary eye care are:

• There will be a five-phased approached to easing the lockdown – phases 0 to 4
• To progress from phase 0 (lockdown) to phase 1, R must remain below 1 for at least three weeks
• Scotland will use the World Health Organization’s (WHO) six criteria for easing lockdown and will wait until R is consistently below 1 before moving from phase 2 to phase 3
• To progress from phase 3 to phase 4 the virus must “effectively have ceased to be a significant issue in Scotland”.
Scotland is currently in phase 0 and will move to phase 1, if the above conditions are met, from 28 May. The situation will then be reviewed every three weeks before deciding on the next phase of the route map.

What this means for eye care providers in Scotland:

• Phase 0 – lockdown (current phase). Emergency eye care in the community at a limited number of sites
• Phase 1 – Increased provision of emergency eye care in the community
• Phase 2 – Aim to expand the range of optometry and ophthalmology services
• Phase 3 – All community optometry will reopen with social distancing safeguards
• Phase 4 – Full range of health and social care services provided with greater use of technology to deliver improved services to citizens.

There will be an ongoing need for:

• Social distancing
• Regular hand washing
• Cough and sneeze etiquette
• Being aware of and acting on the symptoms of the virus – e.g. self-isolating based on official guidance at the time
• Engaging with the ‘test and protect’ system
• The use of PPE and other infection prevention and control measures.

Similarly in Wales in a letter sent last week sent to all NHS Wales Chief Executives for eye care, there is a phased plan:

• Lockdown – access to emergency or essential services only

• Red (Phase 1) – Urgent response structures in optometry will be retained. Preparations should start to de-escalate the Covid-19 action plan for all services progressively. Agree if and what level of usual funding practices receive

• Amber (Phase 2) – continue to roll out telephone/video consultations in primary eye care. Reinstate the optometry care that was “suspended during the outbreak and embed eye care closer to home pathways utilising optometry workforce in line with planned care programme for Glaucoma, cataract, AMD and urgent eye care”

• Green (Phase 3) – when the R rate is stable, and it’s safe to do so, retire optometry hubs established during the red phase.

Practices in Wales should have received a letter from NHS Wales on 22 May. asking them to complete a Covid-19 self-declaration form and return to NWSSP Primary Care Services ahead of any amendments to your current trading hours/closed status.

 

GOC suspends Hampshire based optometrist

May 2020

The General Optical Council (GOC), the UK regulator for optometrists and dispensing opticians, has decided to suspend Jagdip Dhariwal, an optometrist based in Hampshire, from its register for six months.

A GOC Fitness to Practise Committee found his fitness to practise impaired by reason of misconduct. This is in relation to failing to declare his conviction of indecent exposure to the GOC over the course of several years.

Mr Dhariwal has until 26 May 2020 to appeal his suspension.

3706073 daily contributors' data is helping beat COVID-19, are you taking part?

May 2020

The Covid Symptom Study has been developed by Health Science Company ZOE. Endorsed by the Welsh Government, NHS Wales, Scottish Government and NHS Scotland; it shares its data with King's College London.

The almost 4 million freely registered regular contributors allow ZOE to estimate the current infection rate across the UK and in district areas.

It estimates that currently there are 9900 new daily cases across England at present.

The regional current breakdown of new infected cases is as follows (May 26th)

South West 400-1000

London 800-1600

N East and Yorkshire 1300-2600

Midlands 1800-3200

East of England 700-1500

South East 900-1600

North West 1500-2900

Graphs and regular updates are available to those signed up at www.covid.joinzoe.com

Yours and other's continued use of the app is playing a critical role in helping us better understand COVID-19 and beat the virus.

Generous donations have helped them raise £860k in under two weeks, but we still need your help to reach our funding target of £1m. These funds will help support the scientists, researchers, engineers and data science experts running the app and producing the research we are sharing with you here.

The importance of more logging as we leave lockdown

As we emerge from lockdown, it is now more critical than ever that we are alert to emerging hotspots. The more people logging the earlier we will catch any new rise in infections in your area, so do please share the app with your friends and encourage them to spend a minute logging daily to help keep us all safe.

Latest data on daily new COVID cases

ZOE have just released brand new research this morning. For the first time, this gives a number on how many new COVID cases a day are occurring in England (we hope to have figures for the other nations as soon as they are able to provide testing capabilities). These results are based on data from 980,000 of you, including 18,000 who kindly carried out swab tests after an invitation from ZOE.

Detecting COVID sooner with new symptoms

This week, the UK government added loss of taste and smell (anosmia) to their official list of COVID-19 symptoms. This is much-welcomed news, as data collected from you and millions of other app users published in top medical journal Nature Medicine suggests that losing your sense of smell or taste is a stronger predictor of coronavirus infection than fever. In fact, we found that two-thirds of users who tested positive for coronavirus infection reported this symptom in our app.

Including this new symptom in official guidance will help us more easily identify coronavirus cases that would otherwise be missed. By detecting COVID-19 sooner and encouraging those with anosmia to self-isolate, even in the absence of fever or a cough, we can slow the spread of the virus.

New clinical trial

As countries around the world begin to ease lockdown restrictions, it is of utmost importance that we put measures in place to prevent a new wave of infections. Public health authorities and healthcare services are in greater need than ever of strategies that can help them more easily and quickly identify COVID-19 cases.

We are going to be supporting a clinical trial by King's College London on diagnosing coronavirus by using symptoms reported in the Covid Symptom Study app.

All adult UK-based users of the app reporting for themselves who have not previously reported a positive COVID-19 test will be offered the opportunity to participate in this study. You will see this communicated in the app soon. When we launch the trial we will share much more detail.

Watch our latest webinar

Watch Dr Claire Steves and me discuss the latest data around COVID risk factors. This week we talked through the hospitalisation data that looks at co-morbidities like type 2 diabetes, cardiovascular issues, obesity and lung disease." Professor Tim Spector, On behalf of ZOE

Registered with GOC or have worked as clinician then: Join the Virtual Frontline as a Clinical Contact Caseworker

May 2020

Why not use your clinical skills and expertise in order to help support the NHS – and all from your own home. By working as a Clinical Contact Caseworker, you will be responsible for liaising over the phone with Covid-19 patients, understanding their situation and assisting in the tracing and tracking of anyone they have been in contact with.

This crucial role has been developed as part of the Public Health England Contact Tracing Service programme and will allow you to further play your part in defeating the pandemic. This initiative is supported by Department of Health & Social Care, NHS England & NHS Improvement and the Cabinet Office.

Please note: the skills and experience required for this position are for those who are currently registered with an appropriate health or science related professional body and are working, or have worked at a Band 6 level. However we would also welcome applications from clinicians above this band who want to play their part on the virtual frontline. You can find the full role Job Description and Person Specification here, which includes working hours, pay rate and working from home requirements.

Key features and responsibilities of this role include:

Undertaking the initial interview of COVID-19 positive cases by phone
Conducting a public health risk assessment
Identifying contacts and providing public health advice (where appropriate)
Using your clinical knowledge to help escalate complex cases
Working within recognised procedures, scripts and structures, with support

Along with your public health experience, you will have the ability to work independently, problem solve, manage and prioritise your own workload and cope with competing demands.

As part of this role, you will be provided with appropriate training, onboarding and induction materials. Working as part of a wider team of experienced clinicians, you will be liaising with initial call handlers and escalating any in-depth queries to the Public Health England team.

This position also requires excellent communication skills, both verbal and written, including a good telephone manner and the ability to remain calm under pressure. Due to the homeworking and online nature of this role, you must be proficient in the use of Microsoft products, electronic systems and databases.

To find out more and register your interest in this position, please click through to our dedicated form, with Screening Questions, here.

News from The General Council 13 May 2020

May 2020

The General Optical Council (GOC) held its first remote Council meeting which considered the Education Strategic Review (ESR), fitness to practise (FTP) performance, new guidance on holding remote hearings, and its response to COVID-19.

COVID-19

Council noted and endorsed the steps the GOC has taken, including:

• GOC guidance statements on the emergency to remove unnecessary regulatory barriers to the provision of care
• Impact on healthcare and specifically the optical sector
• Collaborative working with the optical sector, NHS bodies and other regulators to consult on work and share information
• Regular communication with registrants and stakeholders to keep them informed about the latest information and guidance

Council will next meet to discuss the GOC’s strategy post-COVID-19, which will inform the future review of the business plan for 2020-21 and the ‘Fit for the Future’ Strategic Plan (2020-25).

The GOC will continue to monitor the situation and how it impacts on the optical sector and its regulatory work.

Education Strategic Review (ESR)

Council received an update on the ESR and discussed the progress of the key deliverables and the continuation of the review in light of the COVID-19 emergency.

Due to the emergency, some areas of work are progressing at a slower pace to enable continued engagement and consultation across the optical and education sectors.

The key deliverables are being developed in conjunction with two Expert Advisory Groups (EAGs) for optometrists and dispensing opticians, and include:

• Outcomes for registration, which describe the knowledge, skills and behaviour individuals must meet to register with the GOC
• Standards for approved qualifications, which outline the expected context for the delivery and assessment of the outcomes by a single point of accountability
• Assurance Method for Approved Qualifications, which explains how evidence will be gathered to decide whether qualifications leading to registration meet the GOC’s outcomes and standards

Council thanked all those involved in the co-production of the various strands of activity within the ESR, including members of the EAGs and the attendees of the GOC’s recent roundtable on the funding of optical education.


Fitness to practise (FTP) performance update

The GOC previously completed a four-month pilot of a revised triage process, which concluded in December 2019. As a result of this new process, the number of full investigations opened in triage decreased to 43% for Q2-Q4 2019-2020, compared to 83% for the same period last year.

Since January 2019, the GOC has also seen a 62% reduction in the number of open cases at the investigation stage and during 2019-2020, a 31% reduction in the overall number of open FTP cases.

The GOC has also focused on progressing more of the aged cases through to case examiners.

Guidance on remote hearings

Council approved the new process for holding remote hearings and guidance for panel members. Between 19 March and 1 May, the GOC has held 17 remote hearings.

The guidance will assist the hearings panel in taking a consistent approach when deciding whether a remote hearing is appropriate.

The guidance has been implemented with immediate effect and will be published on the GOC website later this month.

Give eyes essential care advise optometrists as lockdown takes its toll

May 2020

Why making time for eyecare has never been more important

From an increase in eye injuries due to DIY to buying sub-standard contact lenses online – coronavirus has brought some unexpected and worrying trends for our eye health. While routine eye care is currently suspended, the Association of Optometrists (AOP) is reminding the public that there’s never been a more important time to look after your eyes with essential advice to keep them healthy.

Optometrist and AOP spokesperson Henry Leonard, said: “Unfortunately, the shift in lifestyle is taking a toll on many people’s eye health. Oxford Eye Hospital was one of the first to report a spike in serious eye injuries as more people are doing DIY and gardening projects during lockdown, but this is something optical practices across the country are experiencing. Patients are needing to have foreign objects removed or chemical burns treated because they are not wearing safety googles. Other areas of concern include people buying contact lenses from unregulated suppliers online and a surge in people experiencing headaches and eye strain as they turn to television, mobile and computer screens for work and entertainment.”

Highlighting the warning signs to be aware of Mr Leonard explained: “Sudden changes to your vision such as flashes, floaters or blurry vision, or your eyes become red and painful, could be a sign of a more serious condition."

Commenting about eye care in the current crisis, Mr Leonard said: “At the moment people are unable to visit their optometrist for routine eyecare but that doesn’t mean you can’t access advice. Many practices are still open for essential and urgent care, such as if you get something lodged in your eye and may also be able to help if you have a problem with your contact lenses or you’ve broken your glasses. Optometrists are trained to identify visual problems and many conditions and will often be able to do this via a remote consultation or will ask you to come in, if needed. Call your usual practice to find out, they will direct you to another that’s near if they are closed.”

“There are many things people can still do to protect their vision – including making sure they have eye protection to do DIY, taking regular breaks from their screen and buying contact lenses from a reputable supplier – visit the AOP website for lots of helpful patient advice on keeping eyes healthy.” Mr Leonard added.

An estimated 30,000 eye injuries are caused by DIY accidents every year – Oxford Eye Hospital reported six in a week in April, where one in every two to three weeks would be typical.
To share essential eye health advice the AOP is launching a series of graphics and videos for social media www.aop.org.uk/eyecareessentials

Routine sight testing in the UK – statement from the OFNC, Optometry Northern Ireland, Optometry Scotland and Optometry Wales

May 2020

Opticians across the UK are essential services and continue to operate in accordance with College of Optometrists and local NHS guidance, as they have throughout the pandemic.

The current clinical advice on the delivery of essential, urgent and emergency eye care remains in place, as confirmed in a joint statement by the College of Optometrists and ABDO on 11 May. Routine sight testing currently remains suspended across the UK.

The UK Government has now confirmed that sectors of the economy that are allowed to open in England should be open and should continue to operate based on current national guidance and sector specific advice.

The Welsh Government have issued a letter from the Chief Optometric Adviser reiterating the advice to the public in Wales outlining the current situation, which is that for the next 3 weeks until further review, Wales remains in a state of lockdown until further notice.

The Northern Ireland Assembly has published a five-stage plan to ease Northern Ireland out of lockdown. The roadmap to loosening coronavirus restrictions does not include target dates. The situation in Northern Ireland remains unchanged and will be reviewed in three weeks.

The OFNC, Optometry Northern Ireland, Optometry Scotland and Optometry Wales are working closely with governments and the NHS and will provide more information on the next steps as soon as we can.

OFNC, Optometry Northern Ireland, Optometry Scotland and Optometry Wales

FODO responds to the Health and Social Care Select Committee

May 2020

FODO responds to the Health and Social Care Select Committee’s inquiry into ‘Delivering core NHS and care services during the pandemic and beyond’.

The response sets out how there is an urgent need to plan how and where we see patients for non-Covid-19 health issues during the pandemic rather than simply not seeing them because of Covid-19. It sets out how this would help to mitigate the risk of sensory-related harms and costs and reduce the risk of cross-infection.

The response also explains how there is a considerable risk that the lower priority traditionally accorded to long-term conditions, disability and quality of life issues will be perpetuated during the move out of lockdown, resulting in lifelong harmful consequences for the most vulnerable and isolated in our society.

Read the full response.

NHS CC to run webinar (May 11th) titled: Troubleshooting the implementation of the COVID-19 Urgent Eyecare Service (CUES) specification

May 2020

Background

In April 2020, NHS England and NHS Improvement, The College of Optometrists, the Royal College of Ophthalmologists, LOCSU, and the Clinical Council for Eye Health Commissioning (CCEHC) jointly issued a service specification for a COVID-19 Urgent Eyecare Service (CUES). This was developed in close consultation with clinical experts.

A CUES provider will offer initial patient contact, telephone triage, remote consultations, and (where necessary) face-to-face assessments and management of recent-onset symptomatic or urgent ocular presentations. This framework aims to preserve capacity in other areas of primary care (such as GPs and pharmacies), as well as hospital eye facilities, for patients who genuinely need to be there.

While many CCGs are about to begin implementing this service, we know that some are facing significant local barriers.

This solutions-focused webinar, aimed at CCG primary care leads, will:

Provide examples of how CCGs have implemented a CUES service or a similar service in their local area;

Share examples of how CCGs have overcome barriers to implementation, such as funding and contracting;

Give attendees the opportunity to ask questions during an extended Q&A session.

This webinar will be chaired by Julie Wood, chief executive of NHS Clinical Commissioners.

Confirmed speakers include:

Mike Burdon, President, The Royal College of Ophthalmologists

Colin Davidson, President, The College of Optometrists

Zoe Richmond, Interim Clinical Director, Local Optical Committee Support Unit (LOCSU)

Richard Everitt, Programme Manager: Optical Services Commissioning, NHS England and NHS Improvement

Cheryl Harding-Trestrail, Senior Commissioning Manager – Acute Transformation (South West Hampshire Directorate), Hampshire and Isle of Wight CCG

Simon King, Project Manager – PMO, Cambridgeshire and Peterborough CCG

Alison Lask, Clinical Commissioning and Governance Lead, Cambridgeshire Local Optical Committee

Dan Hornan, Consultant Ophthalmologist Surgeon, North West Anglia NHS Foundation Trust

How to register
Please register for the webinar here.

Date : 11 May 2020
Event Time : 2-3pm

FODO takes a unified approach on sector Covid-19 guidance

May 2020

Statement from FODO:

We know this is an incredibly difficult time for all practice owners, practitioners and other staff in the sector. Feedback from FODO members reveals they found the OFNC and College of Optometrists’ FAQs very helpful.

What is needed now is a similar single set of sector-wide guidance on ’coming out of lockdown and recovery planning’, which includes essential steps to consider alongside duties to patients, public and staff. Such advice will be crucial as the balance of public health risks changes as the pandemic moves on.

FODO fully supports this call to action and will continue to do all it can to back a unified approach across the sector on Covid-19, recovery and other issues. It resonates with the FODO approach throughout the crisis where we have avoided duplication and instead focused on facts and supporting and signposting to the College of Optometrists’ resources, OFNC FAQs and official government, public health and NHS guidance.

As we move into the next phase of pandemic planning, we remain committed to taking a ‘do it once for all’ approach, and have been sharing our thinking with sector partners to ensure all advice/guidance is aligned.

ABDO considers exit phase approach to pandemic.

May 2020

The Association of British Dispensing Opticians has a new working group to discuss the exit phase from the Covid-19 lockdown and beyond. The group will provide members with guidance and recommendations on protocol during the exit phase and when practices open again to provide routine eyecare.

The working group consists of Jo Holmes (President), Daryl Newsome (Vice President and Chair of the National Clinical Committee (NCC)), Debbie McGill (Head of Policy and Public Affairs), Clive Marchant (Past President), Josh Smith (NCC Member), Kevin Gutsell (NCC Member), and Tony Harvey (NCC Member).

The group has worked through major and minor issues including the patient journey, practice structure, the PPE which will be required in the immediate exit phase and what PPE will be necessary moving forward.

It has looked closely at guidance on adaptations that members can make to their practices to allow for social distancing, disinfection and sterilisation and equipment in between patients, as well as ideas on how to structure appointment systems for example providing specific days for shielded groups.

Debbie says, "We hope to release guidance and recommendations on exit phase protocols imminently, depending on the updated government and public health advice”.

{see also Green Shoots story and possible preparations here}

AOP reminds practitioners ‘ear for optics’ service open to all

May 2020

The Association of Optometrists (AOP) Peer Support Line (PSL) marks its three-year anniversary this week, and the Association wants to remind the profession that the service is open to anyone working in optics, member or non-member.

The Peer Support Line is designed to help health and wellbeing in the sector and has seen an increase in calls since the coronavirus outbreak, with many practitioners now facing unprecedented challenges. Callers can use the listening service for a range of issues including stress and mental health, financial worries and problems in the workplace.

A PSL volunteer explained: “The free service is open to anyone who is finding it hard to cope, or simply having a bad day, and would like to talk to someone confidentially. Simply talking through an issue can be an enormous help. In these uncertain times, individuals are understandably feeling anxious and worried and we’re encouraging people affected by the coronavirus pandemic, or any other issue, to get in touch. We’re here to listen, empathise and, where needed, point to other services where you can get advice.”

Henrietta Alderman, Chief Executive of the AOP, took the opportunity to explain the importance of the service and thank the volunteers who make it possible: “The Peer Support Line has been an extremely valued service since its launch but now more than ever, we all need to be making sure we’re taking good care of our health and wellbeing. Our volunteers are keen to help and it’s their dedication that ensures we can provide a listening ear 365 days a year.”

To celebrate the PSL’s anniversary, and encourage all practitioners to access support when they need it, the AOP is launching new social media graphics to share using the hashtag #AnEarForAnOptic.

The AOP’s PSL can be reached by calling, 0800 870 8401. Calls will be answered 24 hours a day, by an external answering service, with volunteers on duty to return calls between 8am and 8pm.

GOC welcomes the Professional Standards Authority Performance Review

May 2020

The General Optical Council (GOC) has today welcomed the publication of the Professional Standards Authority’s (‘the Authority’) annual review of our performance for 2018/19. The GOC has met 22 of the 24 Standards of Good Regulation.

The GOC met all the relevant standards for Guidance and Standards, Education and Training, and Registration. Eight out of the ten standards for Fitness to Practise (FTP) were met – the two standards not met related to the timeliness of FTP cases and communication of FTP decisions.

The Authority’s report notes the GOC’s commitment to improve the timeliness of FTP cases as part of its Strategic Plan for 2020-25, which includes upgrading its case management system, improving communication with NHS regional contacts and businesses, and introducing case management hearings.

The Authority also noted the improvements the GOC made to ensure information on its register is easily accessible in order to meet the third Registration standard, which the GOC had not met last year.

Lesley Longstone, GOC Chief Executive and Registrar said: “We welcome the Authority’s report and are pleased that they have recognised our commitment to improving our FTP processes. We know this is an area which requires continuous improvement and we have put several measures in place in our ‘Fit for the future’ Strategic Plan for 2020-25 to address this.

These measures will take some time to have an impact, but we have already seen shorter times for FTP cases to be heard due to removal of the cap on hearings panel members, which has allowed us to hold more hearings simultaneously.

We have also made improvements to the quality of data on our register of optometrists and dispensing opticians which has been recognised by the Authority.

We look forward to continuing to make progress with our FTP processes so we can fulfil our regulatory role of protecting the public to the best of our ability.”

The full report is available here

GOC erases Yorkshire based optometrist

April 2020

The General Optical Council (GOC), the UK regulator for optometrists and dispensing opticians, has decided to erase Alister Blockley, an optometrist based in Yorkshire, from its register.

He will now be unable to practise as an optometrist in the UK.

A GOC Fitness to Practise Committee found his fitness to practise impaired by reason of conviction.

This is in relation to making an indecent photograph of a child and possession of extreme pornographic images involving animals.

Mr Blockley has until 29 April 2020 to appeal his erasure, during which time he is suspended from the register under an immediate suspension order.

College announces IP exam update

April 2020

Optometrists waiting to sit their IP examination on 1 April can now sit the exam online in May.

Candidates that originally planned to sit the exam on 1 April should email education.help@college-optometrists.org now.

Primary eye care – urgent and emergency services. Scotland praised for emergency eyecare treatment centres

April 2020

In Scotland, the government has praised the new emergency eyecare treatment centres set up by Scottish health boards which will help reduce the need for patients to attend hospital during the Covid-19 pandemic.

Scottish Health Secretary Jeane Freeman thanked optometry and ophthalmology professions “for their excellent collaboration in establishing, at pace, more than 50 Emergency Eyecare Treatment Centres across Scotland to manage patients without Covid-19 symptoms who need an emergency face-to-face consultation”.

She also welcomed the use of innovative tele-ophthalmology, adding: “This means that more patients can be immediately diagnosed and treated in a community setting while gaining an expert opinion from the secondary care ophthalmology team.” Read more here .

In England, as reported in our 17 April update, a new Covid-19 urgent eyecare service (CUES) framework is being implemented primarily in the 50 per cent of CCGs and was published on PHN here

In Wales, the Welsh government, Optometry Wales and other stakeholders have produced a Covid-19 toolkit for optical practices. The 23-page toolkit includes advice on: working in clusters, what to do if your practice is closed, education and training, an overview of financial support, examining patients, PPE and more. Access the toolkit.

College provides support for remote consultations at patient's homes

April 2020

Are you conducting consultations over the phone or via video call? If so, the College has put together some temporary guidelines to help you.

Firstly they have provided a Home visual acuity (VA) chart, to be used by your patients at a distance of 3 Metres.

For those who are unable to create that testing distance the College has provided a conversion chart for tests carried out at 1M and 4M.

The new, easy-to-use home visual acuity (VA) chart and instructional video, featuring Clinical Adviser Daniel Hardiman-McCartney FCOptom, allows patients with printer access to provide an approximate measurement of their visual acuity ahead of a remote consultation.

Sight Test chart distance converter

Patients can find these resources, alongside other COVID-19 guidance, on lookafteryoureyes.org. or you can send them the links to assess the information directly from your practice.

OFNC STATEMENT ON GOS SUPPORT PAYMENTS

April 2020

We are aware that contractors across England are receiving various communications from NHS England area teams about the GOS support grants for practices that are open to provide essential care to patients, and that some contractors have already received payments in respect of their actual GOS claims for March.

We have confirmed with NHS England today that the first support payments - which will top up GOS claims submitted for March to the value of average monthly GOS claims - are being paid in line with normal payment schedules, and that the calculations of average claims have been provided to PCSE this week.

Contractors should therefore receive the March top-up payment in May, along with their April payment which will be the value of their average monthly GOS claims.

The OFNC reminds contractors in England that are open to provide essential care to ensure that their websites and any other information for patients, including phone messages, accurately reflect their open status (as set out in the OFNC FAQs updated on 18 April) to avoid any risk of confusion for patients or NHS England area teams.

Tim Parkinson appointed to GOC Council

April 2020

Tim Parkinson appointed to GOC
Tim Parkinson has been appointed as the newest lay member of the General Optical Council (GOC) as of 16 April 2020 for a period of four years.

Tim will replace Deborah Bowman, who resigned on 8 February 2020.

Tim is the Director of his own board-level consultancy business. He has over 20 years of senior leadership experience in highly regulated service industries such as water and green energy from waste, with over half of this time spent leading the provision of outsourced operations services entailing complex contractual, commercial and stakeholder relationship aspects.

Previously, Tim was an executive board director of Kelda Water Services Limited and a non-executive director of multiple of its subsidiary companies. As an executive board director, he held several specific positions including being the Managing Director of the subsidiary business that produced roughly half of Northern Ireland’s drinking water.

He also held several other executive roles which include leading a 24/7 service producing and distributing drinking water to about half a million people and leading all customer-facing functions of a business supplying water to around 100,000 people.

GOC Chair Gareth Hadley said, “I am pleased to welcome Tim to the Council. He brings to us a wide range of corporate experience gained within regulated 24/7 service businesses. I am sure that he will prove to be a major asset to our Council and the challenges that we will face in the coming years in our core task of protecting the public in the rapidly changing field of healthcare professional service delivery.”

GOC erases Sheffield based student dispensing optician

April 2020

The General Optical Council (GOC), the UK regulator for optometrists and dispensing opticians, has decided to erase Bradley Burke, a student dispensing optician based in Sheffield, from its register. He will now be unable to undertake training as a student dispensing optician in the UK.

A GOC Fitness to Practise Committee found his fitness to practise impaired by reason of conviction and misconduct.

The conviction is in relation to his conviction of the production of a controlled drug.

The misconduct is in relation to failing to engage and respond to the Council on three occasions and using abusive language in an email to an employee of the Council.

Mr Burke had until 22 April 2020 to appeal his erasure, during which time he was suspended from the register under an immediate suspension order.

Coronavirus testing extended to all essential workers in England who have symptoms

April 2020

All essential workers in England and members of their households who are showing symptoms of coronavirus will now be able to get tested. This will assist all key workers including optical staff.

The biggest widening of access to coronavirus testing made possible due to substantially increased testing capacity

Essential workers with coronavirus symptoms can get tested, helping them return to work if test is negative

Broad range of testing methods being rolled-out to increase accessibility, including home testing kits, mobile testing sites and satellite testing kits

New campaign to provide clear information for essential workers on how to get a test

All essential workers in England, and members of their households who are showing symptoms of coronavirus will now be able to get tested, the government has announced.

This will mean individuals and people they live with will have the reassurance of knowing whether their symptoms are caused by coronavirus and can decide whether they are well enough to return to work.

A new campaign will help essential workers in England - including NHS and care staff, teachers, hospital cleaners, public servants, the emergency services, supermarket staff, delivery drivers, and other critical infrastructure staff - to access testing.

Booking the test has been made simpler via a new online system. From today, employers can register and refer self-isolating staff, and from tomorrow employees will be able to book a test directly for themselves or members of their household who are experiencing symptoms – a high temperature or new continuous cough.

This will speed up the process of getting an appointment and take the burden off employers, helping reach everyone who has symptoms at the earliest opportunity.
You can read more on our daily updated Covid-19 page

AIO releases Post-Covid-19 Manifesto

April 2020

Independent Opticians body calls for a complete overhaul of eyecare in England triggered by the impact of Coronavirus


The Association for Independent Optometrists and Dispensing Opticians (AIO) has today released a Post Covid-19 Manifesto that proposes radical change to the way that eye health care is delivered in England. The Manifesto calls for all eye health care to be structured on a national level in keeping with Dentistry and Pharmacy. The current fractured way of working with Clinical Commissioning Groups (CCGs) in England (which is not the case in Scotland and Wales) has resulted in a complete post code lottery for patients which has undoubtedly led to unnecessary sight loss and blindness.

Dr Christian French, AIO Chairman said ‘The awful Covid-19 epidemic and the disparate NHS England handling of emergency eyecare provision by optometrists (who are being asked to offer emergency care in regions where they have been campaigning to establish such schemes for years) has been a catalyst for AIO to consider a radical new approach to eye care provision. The NHS will emerge from the current pandemic stretched, exhausted, and ill-equipped to deal with a significant backlog of patient cases in Hospital Eye Services. Primary Care Optometry can play a full and active role in helping to relieve this pressure and is something already within their clinical capabilities. The time for all parties to come together to make change happen is now.’

AIO is sharing the Manifesto with all other optical representative bodies and calling for their support in a direct approach to Health Secretary of State Matt Hancock. There has been much talk about how the country will most effectively recover from the effects of the pandemic and delivering the AIO Manifesto can play an important and positive part in taking significant pressure off the NHS.

Christian added ‘it is well known that the provision of eye health care in Scotland and Wales is far better developed and more efficient than it is in England, and it is time that patients in England are treated on a similar footing.’

Both a Summary and the Full Manifesto document are attached and can also be accessed on the AIO website

Covid Urgent Eyecare Services (CUES) and OFNC response

April 2020

The OFNC welcomes the publication of the COVID-19 Urgent Eyecare Service (CUES) to provide urgent and emergency services in primary care settings during the pandemic. The new service framework will be particularly helpful in those areas of England where there are currently no locally commissioned urgent eyecare services in primary care. It must be commissioned rapidly in those areas, so that patients with urgent eyecare needs can receive care without having to visit a GP or hospital.

The OFNC has today issued an updated set of FAQs on primary eyecare services during the COVID-19 crisis, including information on the key features of CUES. Contractors and practitioners should direct further questions to their representative bodies, using the contact details in the FAQs.

OFNC Guidance on Changes to Primary Eye Care in England

As set out in our statement of 1 April, this document addresses the main questions raised by our members so far about the NHS England optical letter of 1 April 2020 (001559) and other recent developments.

This OFNC FAQs has been endorsed by the NHS England-Improvement optical commissioning team. If you have any difficulty in explaining your arrangements to your area team, please refer them to this FAQs.

We will update this guidance as the situation develops, and as we receive more information from NHS England and queries from the members of the OFNC bodies. Please always check that you are accessing the most recent version.

This version of the FAQs was updated on 18 April 2020. New questions are marked ‘[NEW]’ for ease of reference.

PROVIDING ESSENTIAL CARE

All routine care is suspended – am I required to close my practice?

No, you do not have to close.

You should not offer routine sight-testing and dispensing (to avoid all unnecessary travel and person-to-person contact) but you may stay open so that your clinical team can provide:
essential eye care as defined in the NHS England letter, and/or
urgent / emergency care.

This includes providing remote advice, reviews, consultations, dispensing and contact lens supply, including to patients not entitled to GOS, in line with the College of Optometrists’ guidance on providing care during the crisis and the GOC’s guidance on the provision of spectacles and contact lenses.

Do I need someone to be physically present in my practice throughout my normal opening hours to qualify as ‘open’ and receive NHS England financial support? [updated 18 April]

No, you do not need to be physically present in the practice. Government advice is that all unnecessary travel should be avoided and person to person interaction (even if social distancing) minimised to help reduce risk for patients, staff and the wide public. ‘Open’ in these circumstances means providing essential eye care in accordance with College of Optometrists and government Covid-19 guidance. These services can be provided from home locations wherever possible.
The key to being ‘open’ is that patients must be able to contact the practice during normal opening hours, but this can be by phone or email – for instance you could divert your practice landline to an alternative number, or provide an answerphone message asking patients to contact a mobile phone or to send you an email. Calls and emails should be managed promptly and efficiently in line with the importance of providing an essential service.

Please see FAQ 3 below for more on meeting patients’ needs during the crisis. Direct input from practitioners may require scheduling in order to accommodate demand and practitioner availability. Appropriate clinicians should be available to deliver face-to-face services where clinically necessary, subject to confirming the patient and other household members have no COVID-19 symptoms, and following College of

Optometrists guidance including on the use of PPE. Face-to-face consultations should take place at the patient’s normal practice unless:
there are reasons preventing this in a particular case (such as lack of PPE), or in the particular circumstances another location is requested by the patient.

How should I meet my patients’ essential eyecare needs during the crisis? [updated 18 April]

NHSE has advised that where possible remote reviews and consultations (via phone or video) should be available to prevent the need for patients to attend the practice in person. The College of Optometrists guidance on providing care during the crisis advises that you should operate a locked-door policy and admit patients for pre-booked appointments only. The College has published guidance on conducting remote consultations.

If practice attendance is required, you should double-check whether the patient or any household member has symptoms of COVID 19. If they have, the patient should be treated via alterative local pathways as appropriate.

If they have not, the face-to-face consultation should take place at the patient’s normal practice unless:

there are reasons preventing this in a particular case (such as lack of PPE), or

in the particular circumstances another location is requested by the patient.

Practices may need to exercise flexibility around opening hours in response to patient demand, staff availability, self-isolating, infection control and PPE availability during the course of the crisis, especially those practices that might otherwise operate extended hours.

Contractors are required to deliver their total contracted hours and should maintain up to date details on their practice website, so that patients know when and how to contact them. Practices should keep their local area team informed of any temporary changes.

You also have the option of changing your standard NHS contractual opening hours via the formal contract variation process. However, this is unlikely to be necessary throughout the crisis unless you plan to do so permanently.

If a contractor chooses to cease operations entirely, they should notify their regional commissioner, and support payments will stop for this period.

I cannot get access to PPE – what should I do and what does this mean in terms of NHS support? [NEW]

The Department of Health and Social Care (DHSC) and NHS England-Improvement are aware that it is difficult to access all necessary supplies of PPE at the present time. If you cannot access the correct PPE for the services you offer at any point, you should temporarily stop face-to-face contacts in line with College of Optometrists guidelines which state:

“if you are unable to get the PPE to enable you to see patients according to national guidance, you should not conduct face-to-face consultations at a distance of less than 2m. We realise that this means that in most cases you will be unable to see patients. However, you can provide other services that do not require face-to-face contact, such as supplying spectacles or contact lenses by post, or offering telephone or video advice.” Updated: 9 April 2020

The safety of patients and staff should be your top priorities during the crisis. If you cannot access the correct PPE you should continue to offer essential care remotely, and work with other providers with PPE for face-to-face consultations where it is clinically necessary and safe to do so.

The NHS will recognise that your practice remains open if you are working to official and best practice Covid-19 guidelines, and you will continue to receive GOS grant funding provided you provide essential care remotely during normal hours.

The government is working to improve supplies and distribution of PPE. It is important that when you do get access to PPE that you follow DHSC advice and use it “only where there is a clinical need to do so”.

Learn more in the DHSC PPE plan.

What should I do if my area team queries whether I’m open to provide essential care?[NEW]

We are aware that NHS England area teams have issued requests for information about practices’ opening arrangements in different formats. These OFNC FAQs have been endorsed by the NHS England optical commissioning team. If you have any difficulty in explaining your arrangements to your area team, please refer them to these FAQs.

For the avoidance of doubt, you are open to provide essential care if you meet the requirements set out in FAQ 2, 3 and 4 above. In particular:

You do not need to be physically present in the practice during your normal opening hours for GOS services, but patients must be able to contact the practice during those hours – this can be by phone or email.

Appropriate clinicians should be available to deliver face-to-face services where clinically necessary, in line with College of Optometrists guidance including on the use of PPE. Face-to-face consultations should take place at the patient’s normal practice unless there are reasons preventing this in a particular case (such as lack of PPE), or in the particular circumstances another location is requested by the patient.

Where possible you should use remote reviews and consultations rather than face-to-face, in line with official public health, NHS and College of Optometrists guidance

All consultations must be conducted by an appropriately qualified member of staff.

The GOS support covers essential eye care. It does not cover urgent and emergency care and therefore the hours in which you provide urgent and emergency services will not have any impact on your eligibility for GOS support

It is accepted that you may need to exercise flexibility around opening hours during the crisis. You are required to deliver your total contracted hours and keep the local area team informed of any temporary changes

Will I be forced to open?

NHS England has no plans either to force practices to close or to remain open. The aim is to direct all patients who need essential eye care to optical practices during the crisis, to meet their care needs and keep pressure off other parts of the NHS. If undersupply occurs, NHS England or CCGs may work through LOCs to ask practices to volunteer to reopen if they can. In most cases, we expect practices will continue to offer essential eye care and support their own patients.

The NHS has also now developed a Covid-19 urgent and emergency eye service, see CUES below.

Do I need permission to continue to provide essential care?

No, you do not need to get permission to stay open or to inform your NHS England regional team.

I am a DO and own my practice, can the practice remain open to provide essential eye care? [NEW]

Yes, as long as your practice is open during your contracted hours and able to provide essential eye care through deploying the skills of the appropriate member of the team as required.

What happens if I’ve already completely closed my practice, or want to close it now or in future?

If your practice is completely closed and you are not providing any essential care (e.g. remotely), you will not receive GOS support payments for the duration of the closure. You will be able to claim any general Government business support for which you are eligible, such as business grants and payments under the Coronavirus Job Retention Scheme and the Self-Employment Income Support Scheme.

I initially closed my practice but now we have more guidance I would like to reopen, what do I do? [NEW]

Some practices closed when the government introduced a general lockdown, and others postponed all activity because of the uncertainty around PPE and changing public health advice during the initial escalation phase. If you closed for these reasons this does not mean you have to remain closed. See question 7, you do not need to seek permission to re-open.


You should notify your NHS area team of the date you re-opened, and log the period in which you were closed so that period can be deducted from your GOS support payment.

Why does the NHS England letter of 1 April talk about delivering services from only a limited number of practices?

Depending on the progress of the COVID-19 crisis, NHS England regional teams may need to work with optical practices, LOCs, and CCGs to ensure that practice opening arrangements continue to protect public health and ensure appropriate and adequate levels of care – particularly urgent and emergency care. See the FAQs on urgent and emergency care below.

DOMICILIARY SERVICES

I have a domiciliary practice, how does the NHS England letter apply to me?

In the same way as any other practice as above. People who cannot leave home unaided will need essential eye care during the crisis the same way as everyone else.

What if a non-COVID positive patient in a care home needs essential (GOS), or urgent/emergency care (CUES), but their care home is locked down or they are being sheltered or self-isolating?

Remote essential care (including symptom relief) should be provided. This may involve advising and working with and through other clinicians (e.g. nurses, visiting GPs), trained care workers or carers who are admitted into thehome. In the case of lost or broken glasses, consider using any available evidence such as broken glasses, old prescriptions and previous records to enable emergency replacements to be supplied.

Where there is an urgent or emergency eye care issue, you should coordinate the best possible response for each individual by working collaboratively with ophthalmology and the patient’s GP.

GOS SUPPORT FOR PRACTICES PROVIDING ESSENTIAL CARE DURING THE CRISIS

I wish to continue to provide essential NHS services – what payment will I receive?

If you continue to provide essential care in line with official public health advice and College of Optometrists guidance, you will receive a monthly payment based on your average monthly GOS claims for the period from March 2019 to February 2020. This will include voucher claims. Where your actual GOS claims during the crisis exceed this level, you will be paid the additional claims in the usual way.

This is a grant payment, not a loan. It will be subject to a reduction for variable costs associated with service delivery, which will be agreed with the OFNC. We will provide more information about this process as soon as we can.

The GOS grant is not for COVID-19 urgent and emergency care provided under (CUES), which is funded separately.

My practice has been open less than a year, how will average fees be calculated?

NHS England has said average fees will be calculated on a fair and reasonable basis taking into account your average monthly GOS claims during the period your practice has been open.

When will I know how much will be deducted for variable costs?

The OFNC will agree this with NHS England. We will provide further information as soon as we can.

How do I apply for the new NHS England financial support?

You do not need to apply for the support and will receive it automatically as long as your NHS England area team knows you are open for the purpose of providing essential care.
If your NHS England area team knows you are open, it will write to you shortly with the calculated value of your monthly payment. You will then be automatically paid this amount by PCSE in line with your normal payment schedule. Your area team will have your GOS claims payment history and will be able to deal with any queries about the value of the payment.

The first support payment will cover March 2020, and will top up any GOS claims you submitted for March to the value of your average monthly claims. You will then receive the same payment each month until further notice. During this period, PCSE have requested that contractors continue to submit GOS claims as normal. This will not affect the value of the monthly payments, except in the unlikely event that your claims exceed the value of the monthly payment.

RELATIONSHIP BETWEEN GOS SUPPORT AND GENERAL GOVERNMENT SUPPORT

How do I ensure that claims for additional Government support schemes only relate to my proportion of private revenue?

NHS England wants to ensure that where it continues to pay contractors to provide essential care during the crisis, those contractors do not also receive a separate contribution from general Government financial support which directly covers the cost of providing essential GOS – in other words, they do not want the Government to pay twice for the same thing.
If you receive general Government support while providing essential care under these arrangements, which will likely be the situation for most practice owners, you should keep records to show that the general support is not being used to fund the costs of providing essential care, which will be separately funded through GOS. Other FAQs in this section set out the OFNC’s understanding of how the NHS England support relates to different forms of general Government support.

Can I provide essential care and claim NHS England support while furloughing staff?

You can furlough any staff on PAYE who are not involved in providing essential care. Staff who are involved in providing essential care – even on a voluntary or part-time basis – cannot be furloughed under the rules of the Coronavirus Job Retention Scheme.

Can I provide essential care and claim NHSE support while also claiming a business grant?

Business grants are linked to premises and applied automatically, so this grant does not have to be claimed. Business grants are provided because of the general impact of the crisis on qualifying businesses and are not linked to essential NHS care.

NHS funding is for essential NHS eye care and to ensure the primary eye care infrastructure is maintained after the crisis period. NHS England has said it intends to run a reconciliation process to check practices have only received an appropriate level of support during the crisis, and that it will work with the OFNC to agree a proportionate and workable process.

Given how the vast majority of optical practices operate, it is clear that any business rates relief and/or grants will be support for the impact of the crisis on their general business activities and not clinical care, in the same way as for other businesses receiving the support. In the OFNC’s view there will therefore be no overlap between the NHS support and the general business grant support, except in the unlikely event that your income during the crisis, from the NHS support for essential eye care and business grants combined, is greater than it would have been under normal circumstances.

Can I provide essential care and claim NHSE support while also claiming self-employment support?

The general government income support scheme for the self-employed is new and complex, and the rules are still evolving, so the OFNC cannot yet give firm guidance on this question. The sector representative bodies will provide further guidance as the rules are clarified.

In principle we think self-employed practice owners who are providing essential care and receiving NHS England financial support may also be able to claim for support under the self-employed scheme, provided that (i) they meet all the eligibility criteria for the scheme, and (ii) they can show they have suffered ‘lost profits’ relating to private sales and services, including non-voucher dispensing, private sight tests and contact lens appointments, and any other sources of income that are not from GOS.

Anyone claiming self-employed support in these circumstances should satisfy themselves that they can show the support has not been used to cover the costs of providing essential care, and may wish to seek accountancy advice.

USING GOS FORMS DURING THE CRISIS

Do I still need to get the patient to sign GOS forms before I submit them?

For GOS 1, we recommend that where you provide a remote consultation (and where necessary, a dispense) but don’t perform a sight test, you should not submit a GOS 1 claim but should maintain records and make a note of the activity. If you do perform a sight test, you should submit a signed GOS 1 claim in the usual way, using social distancing and hygiene procedures.

For GOS 3 and 4 claims, NHS England has advised the OFNC that during the crisis claims can be submitted without a patient signature provided the form is annotated ‘COVID-19’ wherever a patient signature is needed.GOS 4 claims for adults should be pre-authorised by the NHS Business Services Authority (see below).

Where I am dispensing spectacles without performing a sight test, which GOS form should I submit? [NEW]

If you are dispensing spectacles to a patient eligible for GOS 3 but you have not performed a sight test, you should submit a GOS 4 form rather than a GOS 3. During the crisis GOS 4 authorisation has been extended to cover any adult (not just those with illness-related loss as previously) meeting the following criteria:

Adults who are clinically deemed by a qualified clinician to require the dispensing of a spectacle prescription, determined without a face-to-face consultation

Adults who would have otherwise been eligible for a GOS3

The damaged or lost spectacles to have been older than 2 years if issuing exactly the same prescription as before.

The form should not be signed by the patient but annotated ‘COVID-19’. If the dispense is for an adult, the GOS 4 form will also need pre-authorisation from the NHS Business Services Authority. You should contact them on nhsbsa.paos@nhs.net or on 0300 330 9403, and they will give you a unique claim code to enter on the GOS 4 form.

URGENT AND EMERGENCY CARE

If I provide essential NHS care, do I also need to provide urgent or emergency care?

No. The GOS grant is for essential care only. You only need to provide urgent or emergency NHS care if you have an existing or new contract to do so.

How can I provide urgent or emergency NHS care during the crisis? [NEW]

NHS England, LOCSU and the Clinical Council for Eye Health Commissioning have developed a new framework for urgent primary eye care during the crisis, the COVID-19 Urgent Eye Care Service (CUES).

This will be commissioned through CCGs. NHS England regional teams will work with CCGs, LOCs and optical practices to ensure the availability of appropriate levels of eye care across England.

I already provide care through a Minor Eye Conditions Service (MECS), what will happen to that? [NEW]

The new CUES framework is not a MECS service. Where MECS services are already commissioned by CCGs, they are already being changed to support the delivery of urgent eye care from optical practices.

Do I have to provide face-to-face consultations in order to offer CUES? [NEW]

No. The CUES framework is based on risk stratification. Many patients will still only need a remote telephone or video consultation by a suitably qualified GOC registrant to assess and manage patients.

This may lead to further steps including remote advice from an optometrist, Independent Prescriber or ophthalmologist, to remote prescribing or follow-up, or to a face-to-face consultation in an optical practice where appropriate. The CUES face-to-face consultation need not be provided by the practice that provided the initial CUES remote consultation.

What is the difference between remote review and a remote consultation? [NEW]

A remote review is part of essential care. A patient contacts the practice with concerns about their vision or eye health and an appropriately qualified member of staff asks a series of questions to assess whether the patient has an essential, urgent or emergency eye problem which requires a remote consultation.

Remote consultation can be part of essential care or urgent and emergency care, depending on clinical need and risks to sight and health. This is provided by a suitably qualified GOC registrant and will involve all the elements of a normal consultation, except that face-to-face tests and procedures cannot be performed.

Can a MECS accredited Contact Lens Optician (CLO) deliver CUES? [NEW]

Yes, CLOs with MECS accreditation can deliver remote reviews, remote consultations and face-to-face consultations in line with their accreditation.

Will face-to-face urgent care only be provided in a limited number of ‘hub’ practices? [NEW]

At times there may be a need to concentrate face-to-face care in a limited number of hub practices, for both practical and public health reasons. These include access to suitable PPE, the presence of sufficient clinical staff (who may need to be drawn from a range of local practices to work in a single hub if the crisis affects staff availability), and premises that enable the required level of social distancing and infection control protocols at that time in the pandemic. The locations used for these hubs may need to change as the pandemic progresses.

How will hub practices be selected? [NEW]

If it is decided that a hub practice is needed in a given area, the location would be identified by the relevant CCG in consultation with LOCs. Hub locations should be selected bearing in mind local patient demographics, and local volumes and channels of service delivery.

What fees will be paid to practices that provide CUES? [NEW]

CUES will be contracted locally by CCGs, and fees will be agreed between CCGs and LOCs. The OFNC has asked NHS England-Improvement which developed the CUES framework to make recommendations on the urgency of commissioning CUES and support CCGs with an indication of the factors to be taken into account in agreeing fees.

OPTICAL STAFF TAKING OTHER ROLES DURING THE CRISIS

What plans are in place to redeploy people from the optical workforce to other roles during the crisis? [NEW]

The NHS has published guidance on deploying the clinical and non-clinical optical workforce to support the NHS clinical delivery plan for COVID-19. This sets out the scope for members of the optical workforce who are not providing NHS eye care during the crisis to take on other optical or non-optical roles. There will be no obligation on anyone to take on another NHS role – it is a matter of personal choice.

Will people who take on another role during the crisis be paid? [NEW]

Self-employed members of the optical workforce who are not engaged to provide essential or urgent eye care services can volunteer for temporary roles during the crisis:
on a remunerated basis (rates to be agreed by locally) e.g. in eye casualty or other clinical roles on a non-remunerated basis under the NHS Volunteer Responders or other schemes, where they will receive compensation such as travel and subsistence without affecting their access to the Self-Employment Income Support Scheme entitlements.

Employed members of the non-NHS optical workforce, including people who are furloughed, can volunteer for temporary roles:
on a remunerated basis in line with their contract of employment (checking with their employer) and the rules of the furlough scheme where relevant.
on a non-remunerated basis under the NHS Volunteer Responders or other schemes, where they will receive compensation such as travel and subsistence. This will not affect the income of furloughed staff.

If people take on another role during the crisis, what indemnity cover will they need? [NEW]

The main optical sector indemnity cover providers (ABDO, AOP and FODO) have prepared separate Q&A to explain the insurance arrangements for the roles performed by the optical workforce during the COVID-19 crisis. You can download the Q&A here.

Will the NHS provide people who take on another role during the crisis with Death in Service cover? [NEW]

The NHS guidance on deploying the optical workforce acknowledges that Death in Service cover would need to be provided. Our understanding is that the Government is considering the arrangements for this and expects to provide more information soon.

Will taking on another role affect any existing life cover or other insurance that people hold, for instance through their employer or in connection with a mortgage? [NEW]

This will depend on the terms of the existing cover. Anyone who has such cover and is considering taking on another role for the duration of the crisis should review the terms of their cover and talk to their cover provider if necessary.

PRACTICAL ISSUES

For guidance on the other practical issues raised by the NHS England letter, including:

How do I provide remote consultations?
How do I provide emergency dispensing and supply?
Where can I find out more about infection control to maintain my practice environment?
Where do I find the latest information and recommendations on Personal Protective Equipment (PPE)?
How can I obtain PPE?

Please see the COVID-19 guidance of the College of Optometrists, the General Optical Council and official PPE hub.

FURTHER QUESTIONS

Contractors and practitioners should direct further questions to their representative bodies, using the email addresses below, so that the bodies can consolidate queries to inform more detailed guidance and FAQ resources as required:

ABDO general@abdo.org.uk
AOP policy@aop.org.uk
FODO info@fodo.com

COVID-19 - How will you be insured for Optical Indemnity during the pandemic.

April 2020

This Q&A has been prepared by the main optical sector indemnity cover providers (ABDO, AOP and FODO) to explain the insurance arrangements for the roles performed by optical workforce during the COVID-19 crisis.

I work in an optical practice that is open to provide essential and/or urgent and emergency care

You will be covered by your existing indemnity arrangements, as long as you remain GOC registered and your work is within the scope of normal optometric, dispensing and contact lens practice. If your role or duties have changed and you have concerns about the scope of your work, you should discuss this with your line manager or contact your indemnity provider.

I am being furloughed from my role in an optical practice but have been told I may need to leave the furlough scheme and return to work to provide essential and/or urgent and emergency care

You will continue to be covered by your existing indemnity arrangements, as long as your work is within the scope of normal optometric dispensing and contact lens practice. If your role or duties have changed and you have concerns about the scope of your work, you should discuss this with your line manager/practice manager/practice owner or contact your indemnity provider.

I am taking on a temporary optical role in the NHS (such as working in a Hospital Eye Service casualty or outpatient department)

Indemnity cover for any temporary optical role in the NHS should be arranged by the NHS1.
Before taking on the role you need to obtain confirmation from the organisation in which you are due to begin work that your work is covered by the relevant scheme. This will ensure that you are indemnified for all the work you do in your temporary role.

I am taking on a temporary non-optical role in an NHS trust (such as keeping medical records, phlebotomy etc)

Since you will not be working as an optometrist/dispensing optician, you will not be covered by your existing indemnity arrangements. You will therefore need to be covered by NHS indemnity arrangements. You should: • Obtain confirmation from the organisation in which you are working that your work is covered by the relevant scheme • Not be identified or describe yourself to patients or colleagues in your new role as an optometrist or dispensing optician, to avoid any confusion or misunderstanding.

1 The arrangements for this will vary across the UK. Relevant indemnity schemes include the Clinical Negligence Scheme for Trusts in England, and the Clinical Negligence and Other Risk Indemnity Scheme in Scotland. In Wales indemnity will be arranged through the health body in command and control of the activities performed. In Northern Ireland [TBC]
18 April 2020

I am taking on a temporary non-optical role in another NHS setting (such as working in community pharmacy)

Since you will not be working as an optometrist/dispensing optician, you will not be covered by your existing indemnity arrangements. You should: • Obtain confirmation from the organisation in which you are working that your work is covered by suitable indemnity arrangements • Not be identified or describe yourself to patients or colleagues in your new role as an optometrist or dispensing optician, to avoid confusion or misunderstanding

New guidance from Government is shown on our dedicated Covid Page including links to the new PPE Hub.

April 2020

This guidance contains information on personal protective equipment (PPE), and infection prevention and control (IPC).

The UK is currently experiencing sustained transmission of COVID-19 across the country

More guidance on coronavirus (COVID-19) can be found on our regularly updated Covid 19 page including daily infection rates and sadly the announcements of daily deaths in hospitals. There are also links to health district individual stats

The OFNC has updated its FAQ resource

April 2020

Guidance on changes to primary care in England. Published yesterday 9th April includes more detail on financial support.

“How do I apply for the new NHS England financial support?

You do not need to apply for the support. If your NHS England area team knows you are open, it will write to you shortly after 17 April with the calculated value of your monthly payment. You will then be automatically paid this amount by PCSE in line with your normal payment schedule. Your area team will have your GOS claims payment history and will be able to deal with any queries about the value of the payment.

The first support payment will cover March 2020, and will top up any GOS claims you submitted for March to the value of your average monthly claims. You will then receive the same payment each month until further notice. During this period, PCSE have requested that contractors continue to submit GOS claims as normal. This will not affect the value of the monthly payments, except in the unlikely event that your claims exceed the value of the monthly payment.”

Read the full updated financial guidance from the OFNC Here

Updated PPE guidance published yesterday (Thursday 9th April) by College

April 2020

The College of Optometrists has updated its guidance on personal protective equipment (PPE). This includes updated Covid-19 guidance for optometrists and detailed FAQs specifically about PPE.

Here are some key messages from a list of FAQs that they have published.

We suggest that all working practices reappraise themselves on these updated guidelines here Detailed FAQs specifically about PPE 

We draw all members’ attention to the following key extracts from FAQ, ‘What PPE should I wear?’

• “It is now recommended that, for direct patient care at less than 2m, even if the patient is not currently a possible or confirmed case of COVID-19, clinicians should wear single use disposable aprons and gloves (changed for each patient).

“In addition to gloves and aprons, practitioners are advised to risk assess whether they feel they need to wear a fluid-resistant surgical face mask (type IIR) and/or eye/face protection if there is an anticipated or likely risk of contamination with splashes, droplets of blood or body fluids. If masks and/or eye/face protection are worn they can be worn for the whole session (‘sessional use’) rather than changed for each patient, unless they become soiled, damaged or uncomfortable.

“Optometrists who are seeing patients should follow the same advice and we recommend that all optometrists working within 2m of a patient should choose to wear a surgical mask.”
Members should read this College guidance in full:
You can also read the College's detailed Pandemic Guidance here

There is a network of underground shoots below the surface waiting to sprout

April 2020

A look at the Covid 19 hiatus that the Optical Sector is currently bearing by the PHN Editor. {Bob Hutchinson}

Two- and a-bit week’s into lockdown and there is beginning to feel a similarity about the days and the weeks. For one who has spent the last 10 years or so working 50% of my time at home, there is no great change. Bar of course the regular trips to London and to clients usually by train for those many meetings. Courtesy of the lockdown and Zoom that has no longer been a distraction. I wonder if we will ever return to the same work patterns.

But of course, we will inevitably do so. We are social animals and we miss standing around the coffee machine or the water fountain for a chat and as clinicians we miss our patients and customers.

Bob Hutchinson CEO Primary Health Net Ltd and Immediate Past President of the Section RSM
At Opchat News we continue to publish the news as it comes in daily and in fact now break a rule and review news at the weekends. Our page visits have increased particularly on our Covid dedicated pages, as well as general news and professional pages.

The conversations we are having with industry and the profession have proven that many conscientious optometrists especially in the independent sector are providing essential and urgent care to those who need it.

And to provide back up and support at least 80 manufacturing and service companies are remaining open to make sure the goods and services practices need are available at the end of a phone call or email.

To assist those companies, we have published a dedicated directory listing; with the support of the FMO who provided us with the names and contact details of their members and non-members who can provide these services.

This is an open list and if your company should be on the list under your chosen product or service category then just let PHN know. (mail@primaryhealthnet.com)

Lockdown has tended to make us regard that the world has stopped. It definitely has not, and the news of our continuing sector’s work has raised the thoughts of what else can we do to ready our businesses for the eventual return to normality.

The industrial world is full of stories about how even in the midst of the deepest recession those leaders who gained in later and better times were those who invested in their companies. With capital, planning and design of new processes.



Having more time for consideration than usual is a plus if we use it to our businesses’ advantage.


Capital? I hear you say and yes, not in cash terms; that we need to safeguard, but in finance brokerage and lending.

This is the way that all optical businesses should grow their business because it flattens out the spending over future years and does not breach the de minimus terms of partial exemption.

Our research has shown that many of the companies providing instrumentation and manufacturing machinery are open for business and finance is available. .

Whilst some finance companies seem to be suspending their operations (hopefully temporarily) others are very much open for business and have the full support of their backers all of whom are often major international banking operators.

One leading broker quoted “we are here to help both our existing and new customers as well as suppliers who utilise the benefits of finance in assisting with the sale of equipment. Our funders have shown their commitment to the optical profession, are all open for business and there is absolutely no scarcity in liquidity and funding”

Whether your practice is open or not this is an opportunity to process re-engineer and plan for the future. Plan, budget and discuss with the optical suppliers that are still up for business from you, so you are ready for the returning market ahead of the relaxation or completion of the current situation.

Optics provides so many opportunities in a downturn, even plan a refurb, new instrumentation, tidy up the PMS system and learn how to better market from its information, or maybe even get some of those redundant spectacle frames glazed as sunglasses.

Stay in touch with your business, keep a dialogue with your suppliers and order when you can, with the assistance of finance where necessary.

We must keep the cogs turning so our sector can return with its normal keen tenacity.

The article was written by Bob Hutchinson is the editor and owner of PHN’s Opchat News, the Immediate Past Section President of the Royal Society of Medicine and a management consultant for Eros Business Consulting Ltd after many discussions with industry and practices.

GOC erases Cardiff based optometrist

April 2020

The General Optical Council (GOC), the UK regulator for optometrists and dispensing opticians, has decided to erase Vikash Kumar, an optometrist based in Cardiff, from its register. He will now be unable to practise as an optometrist in the UK.

A GOC Fitness to Practise Committee found his fitness to practise impaired by reason of misconduct. This is in relation to dishonestly submitting documents to a County Court and his attempt to persuade a witness in GOC fitness to practise proceedings against him to not give evidence or to influence the evidence given.

Mr Kumar has until 2 April 2020 to appeal his erasure, during which time he is suspended from the register under an immediate suspension order.

Results of Annual GOS negotiations from OFNC. NIL!

April 2020

The Optical sector has rejected for a fifth year of freeze in GOS fees The Government has announced that there will be no increase in GOS fees in England for a fifth successive year.

The Department of Health and Social Care described this as “a difficult decision” which reflected “the lack of available evidence about any impact on NHS sight test numbers or optical businesses” as a result of fees being frozen since 2016.

CET fees and pre-registration grants will rise by 2%, as they did last year.

The OFNC has told the Government that, while the sector’s priority at present is to support patients, eye care providers and the wider NHS through the COVID-19 crisis, the decision to freeze fees is not justified on the evidence. Eye care providers deliver an essential health service and have been under just as much pressure as other parts of primary care. Consequently, the freeze will have to be imposed by the Department without OFNC agreement.

The OFNC had bid for a reasonable and affordable increase of at least 2.5% in GOS fees this year in line with wider investment in NHS care. Paul Carroll, OFNC Chair, said: “Although everyone is rightly focusing on the COVID-19 crisis at the moment and the optical sector is working hard to protect patients and support the NHS through this difficult time, we have written back to the Department of Health and Social Care about the offhand treatment of primary eye care services.

The OFNC made absolutely clear to NHS England that the ongoing freeze in GOS fees is not in patients' best long term interests, with an even greater risk that NHS eye care will be unviable for some communities.

“The Government’s fee letter does not bear any relation to discussions the OFNC has had with NHS England and our response sets out to correct the record. In the meantime, a serious injustice has been done to the primary eye care sector and eye care patients. The trust and goodwill of a loyal workforce, who will be key to delivering the Outpatient Transformation Programme and relieving long term pressures on hospitals, has been further eroded.

“The OFNC bid for 2020/21 highlighted the growing importance of sight testing and preliminary case finding in meeting growing eye health needs, and the pressures optical practices were under whilst they fought hard to continue meeting more complex patient needs, as well as the growing cost pressures on optical practices while providers have generated efficiencies for the NHS.

“The OFNC also offered to open discussions about how the skills, facilities and capacity of the primary care optical sector can be deployed through the Primary Ophthalmic Services framework to deliver the NHS Long Term Plan and Outpatient Transformation programme, by enabling more eye care to be delivered in primary care settings under the Clinical Council for Eye Health Commissioning SAFE system. The OFNC and NHS England have agreed to continue those discussions. “In thanking the sector for its continued work to prepare for and handle the COVID19 crisis, NHS England has expressed gratitude for the commitment and effort that colleagues are investing in providing care for patients as part of this unprecedented national effort. We trust that this insight will remain front of mind when we next commence fee discussions”.

LOCSU announce 4-month pause in levy payments

April 2020

LOCSU is very aware of the impact that the measures to combat COVID-19 are having across the sector.

While the measures to combat COVID-19 are in place, including the ceasing of routine eye examinations, very minimal income relating to sight examination will be generated by optical practices.

This will impact on LOC income and consequently LOCSU income.

To help LOCs through this difficult time the decision has been taken to halt LOCSU levy payments entirely in respect of the four-month period April-July 2020.

Whilst there may be a small amount of activity generating levy payments to LOCs during this period, there is no expectation that the LOCSU levy will be paid on this activity income, the GOS grant or any payments made in relation of Covid-19 support for the four months outlined.

The position will be reviewed in July in line with the COVID-19 situation.

Please be assured that the support and guidance provided by LOCSU to LOCs will remain unaffected during this period. Currently we are focused on support as we move through the COVID-19 crisis with emphasis on national policy work, regional forum sessions and local support as needed by LOCs.

Alongside this, once the situation is more settled, it is hoped that during this four-month period we will also be able to proceed with other initiatives, including progressing with solutions to the issues raised at the NOC in 2019.

Updated guidance on PPE from College following Official Guidance

April 2020

The College of Optometrists has updated its PPE guidance in response to this official guidance.

The College guidance explains:

• Primary eye care practices should not be seeing patients with signs or symptoms, or confirmed cases, of Covid-19
• Social distancing and scrupulous hand-washing remain essential
• You should assess the risk of infection to patients and colleagues in practice. This risk assessment will help you ensure you use the appropriate level of PPE based on official advice (more below).
This is important because PPE is in addition to:
• Other official public health advice and sector guidance
• Social distancing
• Best practice handwashing and best practice use of hand rub.

PPE does not replace these core principles of infection control.

For example:

• You should continue to screen patients before they attend practice and place information notices on your practice door to minimise the risk of somebody with a possible or confirmed case of Covid-19 attending
• If you can provide care remotely or while maintaining a 2m distance this is better than using PPE to carry out those tasks at a closer distance
• In addition, you should use the correct PPE as instructed.

read the College’s new PPE guidance in full 

OFNC evaluates and sets out the requirements and its understanding of NHS Englands Optical Letter

April 2020

As set out in our statement of 1 April, this document addresses the main questions raised by our members so far about the NHS England optical letter of 1 April 2020. It is based on our understanding of the information NHS England has shared to date. We will update this guidance as the situation develops, and as we receive more information from NHS England and queries from the members of the OFNC bodies.

Provision of services

1. All routine care is suspended – am I required to close my practice?

No, you do not have to close. You should not offer routine sight-testing and dispensing (to avoid all unnecessary travel and person-to-person contact) but you may stay open so that your clinical team can provide:

• essential eye care as defined in the NHS England letter, and/or
• urgent / emergency care.

This includes providing remote care and dispensing, and meeting the needs of those patients not entitled to GOS, in line with the College of Optometrists’ guidance on providing care during the crisis and the GOC’s guidance on the provision of spectacles and contact lenses.

2. Will I be forced to open?

NHS England has no plans either to force practices to close or to remain open. The aim is to direct all patients who need essential, urgent or emergency NHS eye care to optical practices during the crisis, to meet their care needs and keep pressure off other parts of the NHS. If undersupply occurs, NHS England or CCGs may work through LOCs to ask practices to volunteer to reopen if they can. In most cases, we expect practices will continue to offer essential eye care and support their own patients.

3.Why does the NHS England letter talk about delivering services from only a limited number of practices?

Depending on the progress of the COVID-19 crisis, NHS England regional teams may need to work with optical practices, LOCs, and CCGs to ensure that practice opening arrangements continue to protect public health and ensure appropriate and adequate levels of care – particularly urgent and emergency care. The OFNC will monitor this closely and provide further advice if necessary.

4. Do I need permission to continue to provide essential care?

No, you do not need to get permission to stay open or to inform your NHS England regional team.

5. If I provide essential NHS care, do I also need to provide urgent or emergency care?

You only need to provide urgent or emergency NHS care if you have a contract to do so.

6. I don’t currently provide urgent or emergency care under a MECS or similar contract, how can I start doing that?

The OFNC, LOCSU and others are working with NHS England to put in place local urgent and emergency care services where these do not already exist. LOCSU will work with all LOCs to communicate these arrangements as soon as possible.

7. What happens if I’ve already completely closed my practice, or want to close it now or in future?

If your practice is completely closed and you are not providing any essential care (e.g. remotely), you will not receive GOS support payments for the duration of the closure. You will be able to claim any general Government business support for which you are eligible, such as business grants and payments under the Coronavirus Job Retention Scheme and the Self-Employment Income Support Scheme.

Domiciliary services

8. I have a domiciliary practice, how does the letter apply to me?

In the same way as any other practice as above. People who cannot leave home unaided will need essential and urgent eye care during the crisis the same way as everyone else.

9. What if a non-COVID positive patient in a care home needs essential or urgent care, but their care home is locked down or they are being sheltered or self-isolating?

Remote care (including symptom relief) should be provided. This may involve advising and working with and through other clinicians (e.g. nurses, visiting GPs), trained care workers or carers who are admitted into the home. In the case of lost or broken glasses, consider using any available evidence such as broken glasses, old prescriptions and previous records to enable emergency replacements to be supplied.

Support for services that remain open

10. I wish to continue to provide essential services – what payment will I receive?

If you continue to provide essential care in line with official public health advice and College of Optometrists guidance, you will receive a monthly payment based on your average monthly GOS claims for the period from March 2019 to February 2020. This will include voucher claims. Where your actual GOS claims during the crisis exceed this level, you will be paid the additional claims in the usual way. This is a grant payment, not a loan. It will be subject to a reduction for variable costs associated with service delivery, which will be agreed with the OFNC. We will provide more information about this process as soon as we can.

11. My practice has been open less than a year, how will average fees be calculated?

NHS England has said average fees will be calculated on a fair and reasonable basis taking into account your average monthly GOS claims during the period your practice has been open.

12. When will I know how much will be deducted for variable costs?

The OFNC will agree this with NHS England. We will provide further information as soon as we can.

13. How do I ensure that claims for additional Government support schemes only relate to my proportion of private revenue?

NHS England wants to ensure that where it continues to pay contractors to provide essential care during the crisis, those contractors do not also receive a separate contribution from general Government financial support which directly covers the cost of providing essential GOS – in other words, they do not want the Government to pay twice for the same thing.

If you receive general Government support while providing essential care under these arrangements, which will likely be the situation for most practice owners, you should keep records to show that the general support is not being used to fund the costs of providing essential care, which will be separately funded through GOS.

For instance, if you are receiving payments under the Coronavirus Job Retention Scheme, those payments would relate to staff who are currently furloughed and therefore unable to contribute to providing essential care. Similarly, if you receive a grant under the Small Business Grant Fund or the Retail, Hospitality and Leisure Grant Fund, that would relate to the retail business element of your practice and not to providing essential care.

Practical issues

For guidance on the practical issues raised by the NHS England letter, including:

• How do I provide remote consultations?
• How do I provide emergency dispensing and supply?
• Where can I find out more about infection control to maintain my practice environment?
• Where do I find the latest information and recommendations on Personal Protective Equipment (PPE)?
• How can I obtain PPE?

Please see the COVID-19 guidance of the College of Optometrists and the General Optical Council.

Further questions

Contractors and practitioners should direct further questions to their representative bodies, using the email addresses below, so that the bodies can consolidate queries to inform more detailed guidance and FAQ resources as required:

• ABDO general@abdo.org.uk
• AOP policy@aop.org.uk
• FODO info@fodo.com

LOCs can also raise LOC matters via LOCSU by emailing info@locsu.co.uk where they will be fed into the central process.

OFNC Statement: COVID-19 – NHS guidance for optical practices in England: A response to letter below

April 2020

The Letter from NHS England includes details of support payments for practices which continue to provide essential care for patients during the COVID-19 crisis. These practices will be expected to follow guidance from the General Optical Council and the optical sector bodies on how to provide this care safely. The support payments will be based on average past General Ophthalmic Services (GOS) payments between March 2019 and February 2020.

The OFNC, LOCSU and others are now working urgently with NHS England to put in place local urgent and emergency care services where these do not already exist in primary eye care.

Read the letter here

The OFNC has repeatedly called for urgent financial support to offset the catastrophic impact the crisis continues to have on optical practices, with all routine sight testing suspended in line with public health guidance and many practices being forced to close their doors.

The primary eye care community in England has stood ready to play its full part in supporting people with essential, urgent and emergency eye care needs throughout this crisis. Today’s announcement should provide a vital lifeline so that patients continue to benefit from eye health services. We are seeing the detail for the first time today, and the proposed stability funding appears to differ from that available in other parts of the UK in a number of ways. The OFNC will work with stakeholders to support all practices that are able to continue to offer care to their local population during the crisis. We will provide more guidance this week.

OFNC Chair Paul Carroll said: "“The crisis has placed a great burden on frontline practitioners and practices across England. Today’s announcement throws the sector a lifeline even though there is a lot of detail to work through. The new support must be used to help more practices keep running through this very difficult time, and to reduce pressure on GPs and hospitals."

“We look forward to working together with the primary care optical team at NHS England to make sure practices can access support as quickly as possible.”

The OFNC will work with NHS England to clarify these arrangements and provide further guidance as needed throughout the crisis. Contractors and practitioners should direct questions to their representative bodies, using the email addresses below, so that the bodies can consolidate queries to inform more detailed guidance and FAQ resources as required:

Complete letter from Matt Neligan Director of Primary Care and System Transformation and Poonam Sharma Optometry Advisor NHS England

April 2020


Thank you again for your continued work to prepare for and handle the COVID-19 pandemic. We are grateful for the commitment and effort that is going into providing care for patients.

In light of the most recent public health control measures and in recognition of the difficulties that practices are facing including continuing concerns about staff safety, we are making a number of immediate changes to the delivery and operation of our optometry services.

A. Changes to optometry services delivered outside hospital


The following changes to the provision of services will take immediate effect:

All routine optical services are suspended until advised otherwise. For this communication, the definition of a routine service is when the patient is not complaining of any new symptoms or loss of sight.

Urgent and essential eye care should be delivered from a limited number of optical practices only. This includes:

• Essential eye care currently delivered under General Ophthalmic Services (GOS). This includes but is not limited to appointments for patients who would not normally be considered to be emergencies, but where, in the practitioner’s professional judgement, a delay in an examination may be detrimental to a patient’s sight or wellbeing. This may include where patients have broken or lost their glasses or contact lenses and need a replacement pair to function.

• Urgent or emergency eye care where a contract is held with a CCG to deliver urgent clinical advice or intervention e.g. for red eye, contact lens discomfort, foreign object, sudden change in vision, flashes and floaters which might suggest detachment etc., or where the patient has been advised to attend a practice by NHS 111 or another healthcare professional for urgent eye care.

NHSE/I regional teams will work with CCGs and optical practices locally to ensure that appropriate and adequate levels of urgent and essential eye care are available across populations.

We support the guidance released by the College of Optometrists that sets out ways in which practice should be adapted in the current circumstances.

This is included here:


Where possible remote consultations should be available to triage symptoms and prevent the need for patients to attend the practice in person. This triage should establish whether any potential patient or anyone in their household has symptoms, prior to any visit should that be required. Further information will follow on new support measures for practices to enable remote consultations.

NHS England is also working with the Department of Health and Social Care to develop practical workaround solutions that aid remote service delivery through review of existing GOS regulations such as the requirement for patient signatures on GOS 3 forms.

Should emergency dispensing be required, please follow the General Optical Council statement on supply of spectacles and contact lenses during COVID-19:


Where contractors are unable to provide urgent and essential care services, or elect not to do so, they should notify their regional commissioner of their intention to cease operations.

B. Infection control

All services that continue to be delivered must use robust infection control procedures, including:

• Using a cough guard on slit lamps. The Royal College of Ophthalmologists has advice on how temporary cough guards can be made here;
• Wiping clinical equipment and door handles after every patient, as well as other surfaces that may have been contaminated with body fluids using a suitable disinfectant such as an alcohol wipe. All surfaces must be clean before they are disinfected; • Sanitising frames before patients try them on. If a focimeter needs to be used on patients’ spectacles, the patient should be asked to take them off and should be provided with a wipe to sanitise their frames before these are touched by the professional;
• Supporting good tissue practice (catch it, kill it, bin it) for patients and staff by having tissues and covered bins readily available; and
• Ensuring that thorough hand washing techniques are adhered to.


C. Further advice and guidance

NHS England has recently published standard operating procedures for primary care: https://www.england.nhs.uk/coronavirus/primary-care/. These will continue to be updated regularly. These pages also include interim advice for primary care from Public Health England.

Professional regulators have issued guidance to support health professionals in these challenging circumstances, you can read the statement here:


D. Personal Protective Equipment (PPE)

We recognise that the issue of staff safety and confidence in PPE guidance is very important for staff engaged in direct patient care.

We will continue to be led by the emerging evidence and will update the Standard Operating Procedure available on our website at https://www.england.nhs.uk/coronavirus/primary-care/optical-setting/ to reflect updated advice through our NHS Infection Prevention Control (IPC) colleagues and Public Health England.


E. 2020-21 contracts and finance

We will take immediate steps to revise the operation of the 2020-21 contract requirements to reflect service disruption due to COVID-19. The approach will aim to achieve the following:

• Maintaining cash flow and immediate stability and certainty for optometry practices who are providing urgent and essential eye care services in a consolidated and temporary service model locally;

• Fairly recompensing practices for GOS costs incurred;

• Enabling practices to cease provision of GOS services for the period of the COVID-19 response where appropriate; and • Ensuring that appropriate capacity exists locally for patients to access urgent and essential eye care.

We will therefore take the following steps:

For practices seeking to cease operations entirely:

• The contractor should notify their NHS England and Improvement regional commissioner of the dates on which provision of services stops and re-starts;
• Agreement to service cessation will be given by the commissioner, on the condition that provision of appropriate eye care is in place in the local area;
• Payments will stop for the period of service cessation and resume once the regional commissioner has been notified that services have been recommenced; and
• Most practices will be able to take advantage of government support already announced in this period.

For practices continuing to provide essential eye care:

• We will support cashflow by maintaining monthly payments based on the average monthly reimbursement to the practice generated from GOS fees during the period March 2019 to February 2020;

• Where a larger volume of essential care takes place, this will be funded in the normal manner through the reconciliation of processed vouchers for that activity on a monthly basis;

• We will progress work with the Optical Fees Negotiating Committee (OFNC) to determine a fair and reasonable approach to reconciliation of payments that would take place after the COVID-19 response upon return to normal operations; and

• We will encourage practices to support efforts to offer any surplus and available staff capacity to other areas as outlined in section F, “Workforce” below, where practicable;

• We expect practices to ensure that all appropriate staff continue to be paid at previous levels;

• An agreed and fair reduction for any variable costs associated with service delivery (e.g. in recognition of reduced consumable costs associated with dispensing of frames and lenses) will be applied to all reimbursements. This will be discussed and agreed with the OFNC; and

• These arrangements will operate over a fixed number of months with an agreed end date.

Additional government support

Contract holders wishing to claim against additional Government support schemes should ensure that claims are made only in relation to their proportion of private revenue.

We expect that as part of the 2020/2021 reconciliation process practices will be expected to declare that they have not applied for any duplicative Government funding and provide evidence of the portion of NHS/ private income used in any applications for additional support. We will work with the OFNC to agree a proportionate and workable process in this regard.

F. Workforce

We recognise the impact that self-isolation and social distancing is having on the optical workforce. We also realise that the changes to GOS outlined above will mean that there is freed capacity within a highly skilled workforce, and we appreciate the offers that have come in from the profession to contribute to the wider COVID-19 response.

We would like to encourage the freed-up workforce capacity to support:

• ongoing provision of urgent and essential eye care;

• NHS colleagues working in wider primary care;

• NHS colleagues working in the acute COVID-19 response; and

• Local authority and voluntary services COVID-19 response.

We would ask that where possible staff contact details are made available rapidly and that practices actively support any national or local calls for help.

The most up to date information on how to register to provide services in other parts of the NHS will be made available through our workforce landing page:


Conclusion

We are working with professional bodies and optical practices across the country to keep you and your patients safe, to produce information and guidance, and to listen to your concerns and suggestions as the situation progresses.

Thank you again for your commitment and engagement as part of this unprecedented national effort.

With very best wishes

Matt Neligan Director of Primary Care and System Transformation

Poonam Sharma Optometry Adviser NHS England and NHS Improvement

AOP fee reduction for members amidst coronavirus crisis

April 2020

The Association of Optometrists (AOP) Board announce a 20% reduction in membership fees for UK practising members, which is the equivalent of two monthly direct debit payments.

The fee reduction is designed to provide immediate financial support to members during the coronavirus crisis. The scheme will be rolled out automatically and there is no action needed by members to benefit.

AOP Chief Executive, Henrietta Alderman said: “The AOP Board is acutely aware of the cashflow difficulties many of our members are having at this unprecedented time. We are keen to do all that we can to support our members which is why we have taken this step with immediate effect.
“We hope it will go in some way to alleviate the financial strain members are currently facing and that it also encourages other optical bodies to consider how they may further reduce the burden on practitioners.”

Ms Alderman also reminded members that support via the Optical Benevolent Fund might be available to them for additional help during this time.

The fee reduction will be a significant cost to the AOP using a large portion of its reserves. The full details on what it will mean for upcoming payments is available on the AOP website,

The reduction does not apply to the AOP Career Break grade.

The fee reduction is in addition to all other areas of support the AOP is currently providing in relation to the COVID-19 outbreak, including guidance and resources to assist members through legal, employment and practical issues.

COVID-19 - Patient Care at Growing Risk as NHS ENGLAND ignores Optics

March 2020

NHS England’s failure to act is forcing hundreds of optical practices to close, with a direct and dangerous impact on the eye healthcare of patients in England during the COVID-19 crisis, the OFNC warned today.

Optical practices in other parts of the UK, as well as pharmacists and dentists across the UK, have already been offered emergency NHS funding to enable them to continue providing urgent and essential care during the COVID-19 crisis. But NHS England has given no guidance to practices in England on their role during the crisis, despite constant pressure from the OFNC.

The OFNC and its member bodies, along with others in the optical sector across the UK, have stepped in to fill the gap where we can, issuing guidance on what services practices should provide during the crisis. However, we cannot fill the void the NHS has left on the problem of funding.

Optical practices have had to stop routine sight testing in line with public health guidance. That means the vast majority of their income has vanished overnight. Like other NHS providers, they need a financial lifeline to help patients and the public – who will otherwise be forced down higher-risk pathways to A&E.

The NHS in all parts of the UK except England has recognised the vital role optical practices can play in providing urgent and essential eye care to patients during this crisis, and keeping patients away from overstretched GPs and hospitals. This is even more vital now that the Royal College of Ophthalmologists has recommended hospital eye departments reduce their clinical activity by 80-90%.

With no certainty of NHS funding during the crisis, hundreds of optical practices have already closed their doors and many more will follow in the next few days. On Wednesday OFNC wrote to Ministers and NHS England warning that “many optical practices in England are now in complete despair”. We have published the letter here.

Today OFNC Chair Paul Carroll said “Eye care patients are now at serious risk because of blockages somewhere in the NHS England system. We are now asking Ministers to intervene urgently to sort this out, so we can help the public with eye and vision problems during this national crisis.”

Promised further information and important links for help in finance in Covid Pandemic


March 2020

The Chancellor, last night announced a new Self-employment Income Support Scheme to support self-employed people who have been adversely affected by COVID-19.

GOV‌.UK has further details about who is eligible for the scheme and how it will work

Self-employed people do not need to get in touch with HMRC as the scheme isn’t yet open for applications.

HMRC will contact eligible customers by the beginning of June, inviting them to apply.

Unfortunately, we are aware of an increase in scam emails, calls and texts. If someone gets in touch claiming to be from HMRC, saying that financial help can be claimed or that a tax refund is owed, and asks you to click on a link or to give information such as your name, credit card or bank details, please do not respond.

HMRC will never contact you out of the blue to ask for these details.

The government has also introduced the following help for the self-employed:


We will continue to share the most up to date information as it is sent to us from HMRC and other legitimate governmental organisations with you as it becomes available.

News is just arriving (5pm 26 march) on help for self-employed which will assist locums

March 2020


Rishi Sunak Chancellor
Self-employed workers will be able to apply for a grant of up to £2,500 a month to help them cope with the financial impact of coronavirus, the chancellor has announced.

The money will be paid in a single lump sum, but will not begin to arrive until the start of June at the earliest.



Rishi Sunak
told the self-employed: "You have not been forgotten."

The total number of people in the UK to die with Covid-19, the disease caused by coronavirus, reached 475.

What help will the self-employed get?

Mr Sunak said the steps taken so far were "already making a difference" but it was right to go further "in the economic fight against the coronavirus".

Self-employed people will be able to apply for a grant worth 80% of their average monthly profits over the last three years, up to £2,500 a month.

It is acceptable to provide only 1 or 2 years average monthly profits if your are recent to the marketplace but 3 years is also possible in case you have suffered a downturn in any one year.

Mr Sunak said the grants would be available to people across the UK for at least three months, and longer if necessary.

In all, 95% of people who earn most of their income as self-employed would be covered, the chancellor added.

We will bring you more precise information and links as we receive further news

OFNC updated guidance on opening arrangements for optical practices

March 2020


Joint statement from the Optometric Fees Negotiating Committee (OFNC), Optometry Scotland, Optometry Wales and Optometry Northern Ireland

The UK Government has now published further guidance clarifying that opticians are exempt from the general requirement for retail businesses and premises to close.

Optical practices may therefore continue to provide urgent and essential eye care to the extent that they can, including remote care, while managing COVID-19 risk to keep patients, staff and the public as safe as possible.

This is a key health service to meet urgent eye care needs during the crisis, especially for isolating elderly people and key workers, and to divert patients from GPs, A&E and hospital emergency eye departments.

Optical staff involved in offering urgent and essential eye care meet the Government definition of a key worker for the purpose of access to transport and schools.

ABDO has published an ‘essential workers’ template letter for optical practices to help their staff demonstrate this to schools, and the sector is working on further resources covering transport etc. Key workers should only place children in school where absolutely necessary because they cannot safely be cared for at home.

Meaning of ‘urgent’ and ‘essential’ care

The Welsh, Scottish and Northern Ireland governments have all issued advice on the care that optical practices should continue to provide during the COVID-19 crisis. NHS England has yet to provide guidance but is expected to do so very soon.

On 23 March the College of Optometrists, OFNC and the UK optical bodies all issued statements advising optical practices to stop providing routine sight tests and care in the current circumstances. Optical practices should only remain open to provide urgent and essential care.

Our current view is that:

Urgent or emergency care would include urgent clinical advice or intervention eg for red eye, contact lens discomfort, foreign object, sudden change in vision, flashes and floaters which might suggest detachment etc.

Scottish Government guidance for practices in Scotland states that as is already the case, it is up to the professional judgement of an optometrist or ophthalmic medical practitioner to determine whether or not the circumstances in which a patient presents constitutes an emergency. Professional guidance already exists to help practitioners in this regard, such as the College of Optometrists Guidance for Professional Practice

Essential eye care would include appointments for patients who would not normally be considered to be emergencies, but where, in the practitioner’s professional judgement, a delay in an examination may be detrimental to a patient’s sight or wellbeing.

This definition is from the Scottish Government guidance for practices in Scotland. Optometry Scotland takes the view that a sight test is highly unlikely to meet the definition of essential care. In other parts of the UK, practices may consider a sight test as essential care if for instance a key worker needs a sight test and new spectacle prescription in order to continue to work. Other examples of essential care could include a visually impaired person or child who needs eye care where a delay in care may be detrimental.

Managing COVID-19 risk

Practices that remain open to provide urgent and essential care must have in place appropriate measures to manage COVID-19 risk. These should include:

• Displaying the College of Optometrists or equivalent poster at the entrance of the practice
• Using remote consultations wherever possible, closing for routine sight testing, and only admitting patients on appointment for essential and urgent eye care which cannot be provided by phone, video or email
• Keeping up to date with and following Public Health England guidance on limiting the spread of COVID-19 in workplaces, including:
• maintaining a distance of at least 2 metres from others where possible
• regular hand-washing and cleaning - ABDO has published an FAQ on the cleaning of practices, equipment and spectacles to manage COVID-19 risks.

Personal Protective Equipment (PPE)

The optical sector bodies are in constant contact with government, public health and NHS authorities about PPE. The situation is fast-moving and we recommend that you check the College of Optometrists website for regular updates using the link below.

The College has provided the following guidance (as of midday on 25 March) for optometrists providing urgent and essential care:

“We understand the growing concern about the potential for tears to lead to COVID-19 infection and are waiting for more information on this. In the meantime, optometrists should not put themselves at unnecessary risk and we are asking the UK governments to provide appropriate PPE for optometrists who are providing essential services. If you need to use personal protective equipment, it is important that you use the correct type and are trained in how to use it.

“Current guidance is that face masks are only needed for those who are dealing with patients with confirmed or suspected cases of COVID-19. The Royal College of Ophthalmologists advises that patients with no known risk, should be seen as normal - with the ophthalmologist using scrupulous standard infection control as for any patient (e.g. hand hygiene, clean instruments). They recommend that there is no known need for using face masks or gloves for every patient but that discretion is to be used. Ophthalmologists should use normal surgical masks for specific situations or patients, especially prolonged slit lamp exposure time or patients with watery, discharging eyes. They should balance mask use with the possibility of supplies running low if the pandemic is prolonged.

“We have guidance on how to adapt your practice to minimise prolonged close contact in our FAQ 'Should I continue with business as normal?”

If a practitioner has concerns about any procedure (especially aerosol effects) when carrying out urgent or essential care on an asymptomatic patient, they should apply their professional judgement when deciding whether to perform it. If they decide not to, they should inform the patient and note the reason in the patient record (annotating COVID-19) and where necessary rearranging care. In recent statements, the GOC has acknowledged that “registrants may be called upon to …vary their practice …. in challenging circumstances (and that) registrants should act in good conscience, for the public benefit, exercising professional judgement in all of the circumstances that apply”.

AOP calls on Government to act faster for locums

March 2020

The Association of Optometrists (AOP) is calling on the Government to redouble its efforts to provide essential support for self-employed people, such as locum optometrists.

Within the last week, the Government has announced the Coronavirus Job Retention Scheme for the employed, guaranteeing 80% of their monthly earnings, up to £2,500, alongside a package of supportive measures for public services and businesses.

The Treasury is currently working on income support measures for self-employed people, but today said these are likely to take time to introduce because of the complexities involved in delivering a brand new service.

In response, the AOP is highlighting the need for the Government to drive this forward more quickly, because thousands of our locum optometrist members, like other self-employed people, are now in a desperate financial situation through no fault of their own.

AOP Councillor and locum optometrist, Alison McClune said: “We understand the Government faces huge challenges in supporting people during this unprecedented disruption. But the self-employed workforce, who play a key role in supporting our healthcare system, must be given the same help as others, and at the same time. Locums make up a massive part of the UK’s optical workforce, providing essential eye care in the community. They are rightly angry and deeply worried that the Government can’t yet assure them they will be given the same level of help as others.”

The AOP today issued specific guidance for locum optometrists.

OPTICAL PRACTICES – ESSENTIAL OPENING ARRANGEMENTS clarified this morning (24 March 2020)

March 2020

Following the initial statement posted yesterday evening and published by us (see news story) we now have further clarification that Optical Practices following strict rules can and are expected to stay open for key workers as well as those with ongoing essential and emergency care.

In a Joint statement from the Optometric Fees Negotiating Committee (OFNC), Optometry Scotland, Optometry Wales and Optometry Northern Ireland

On 23 March the UK Government published a revised list of business and premises required to close. This included retail premises, with exceptions for a range of premises including pharmacies and health shops. The list does not mention optical practices.

Our understanding is that the four UK governments intend optical practices providing NHS services to continue to provide essential and urgent eye healthcare services during the COVID-19 crisis, subject to suitable risk management measures both to meet essential health needs, especially for isolating elderly people and key workers, and to keep pressure off GPs, A&E and hospital emergency eye departments.

The OFNC in consultation with the other UK optical bodies has confirmed that optical practices in the UK providing urgent and essential eye healthcare are key health services and should continue to function where possible during the COVID-19 crisis. This means that NHS primary care premises are exempt from general closure requirements for retail premises.

The condition is that those which are able to open have in place appropriate measures to manage COVID-19 risk. These should include remote consultations wherever possible, closing for routine sight testing and only admitting patients on appointment for essential and urgent eye care which cannot be provided by phone, video or email.

The Welsh, Scottish and Northern Ireland governments have all issued advice on this as has OFNC for England. NHS England has yet to provide guidance on this but is expected to do so very soon.

On 23 March the College of Optometrists, OFNC and the UK optical bodies all issued statements advising optical practices to stop providing routine sight tests and care in the current circumstances. Optical practices should only remain open to provide essential and urgent services.

Currently:

• Essential eye care would for be instance where a key worker or elderly person needed a sight and new spectacle prescription, had broken their glasses, where a contact lens wearer needed more lenses, or where a visually impaired person or child needed eye care.
• Urgent care would include urgent clinical advice or intervention e.g. for red eye, contact lens discomfort, foreign object, sudden change in vision, flashes and floaters which might suggest detachment etc.
Scottish Government guidance for practices in Scotland on these issues is:

Emergency care

As is already the case, it is up to the professional judgement of an optometrist or ophthalmic medical practitioner to determine whether or not the circumstances in which a patient presents constitutes an emergency. Professional guidance already exists to help practitioners in this regard, such as the College of Optometrists Guidance for Professional Practice

Essential care

As these measures will likely be in place for some month, essential care is to be interpreted as meaning appointments for patients who would not normally be considered to be emergencies, but where, in the practitioner’s professional judgement, a delay in an examination may be detrimental to a patient’s sight or wellbeing.

Statement made by OFNC, Optometry Scotland, Optometry Wales, Optometry Northern Ireland

Routine Eyecare to cease by order in Scotland from March 23rd

March 2020

CORONAVIRUS/COVID-19: GOS and EYE CARE Continuity in Scotland

A Memorandum providing an important update to all community optometry practices and staff regarding the provision of community eye care services during the COVID-19 pandemic is available in full here as a pdf . Read full memo here


A summary of the memoranda includes:


Instruction to all General Ophthalmic Services (GOS) providers to cease providing routine eye care and to move to providing only essential and emergency eye care in Scotland from Monday 23 March 2020

A package of financial measures to help support community optometry practices in Scotland during the COVID-19 pandemic - all practices will receive a monthly payment equating to their average monthly item of service income across the 2019/20 financial year

Information about emergency eye care pathways within NHS Board areas
infection control measures

Revised Health Protection Scotland guidance for optometrists and opticians

Details of the temporary suspension of the requirement for patient or patient representative signatures on GOS(S)1 ‘cheque book’ slip and GOS(S)3, GOS(S)4, HES(S)1, HES(S)3 and HES(S)4 forms
information about notifying Health Boards of changes in permanent practice opening hours or of practice closures as a result of COVID-19.
and other information.

1. This Memorandum provides an important update to all community optometry practices and staff regarding the provision of community eye care services during the COVID-19 pandemic.

It includes:

 an instruction to all General Ophthalmic Services (GOS) providers to cease the provision of routine eye care services in Scotland from Monday 23 March 2020,

and move to providing only emergency and essential eye care;

 details of a package of financial measures to help support community optometry practices in Scotland during the COVID-19 pandemic;

 information about the development of emergency eye care pathways within NHS Board areas;

 infection control measures;

 information about revised Health Protection Scotland guidance for optometrists and opticians;

 information about new General Optical Council guidance for COVID-19;

 details of the temporary suspension of the requirement for patient or patient representative signatures on GOS(S)1 ‘cheque book’ slip and GOS(S)3, GOS(S)4, HES(S)1, HES(S)3 and HES(S)4 forms;

 information about notifying Health Boards of changes in practice opening hours or of practice closures as a result of COVID-19.

Suspension of all routine eye examinations, and arrangements for continuation of emergency and essential eye care

3. In line with wider guidance on social distancing to reduce the transmission of COVID-19, all providers of GOS in Scotland are instructed to cease the provision of routine eye care services from Monday 23 March 2020 until further notice. Routine existing appointments on or after this date should therefore be postponed with immediate effect.

4. From Monday 23 March 2020, community eye care services provision will change to supporting only patients who need emergency or essential eye care.

As set out in paragraphs 8 to 25, financial support measures are being put in place to complement the continuation of this care.

5. Practitioners and practice staff are reminded that, where applicable, they are required to follow the advice issued in relation to self-isolating and social
Read full memo here

COVID-19 – SUPPORT FOR GOS CONTRACTORS IN ENGLAND

March 2020

OFNC

 

The Optometric Fees Negotiating Committee (OFNC) and its members (ABDO, AOP, BMA and FODO) are working closely with NHS England on supporting GOS contractors in England through the coronavirus crisis. NHS England has confirmed that eye care is an essential part of the NHS and primary care service, both of itself and in keeping pressure off other NHS services such as GPs and A&E. NHS England’s aim is to keep essential eye care operating as far as possible to ensure essential and urgent eye health needs are met whist protecting patients, staff and the public. 

Issues that the OFNC and NHS England are urgently working on with the aim of supporting optical practices in England, include:

  • The financial implications for practices of a downturn in GOS fee income because of the crisis 
  • More flexibility around GOS contractual requirements, to help practices and domiciliary providers give patients the care they need as quickly and safely as possible, and to support practices who may not have the staff available to provide services, due to illness or self-isolation 
  • Guidance to help patients, optical practices and other parts of the NHS understand the GOS services that optical practices in England will continue to provide during the crisis and to direct patients to them 
  • How the whole sector can work together to mobilise new services in optical practices as quickly as possible, to meet essential and urgent eye care needs during the crisis and reduce demand on GP and hospital services. 
OFNC and its member bodies are working very closely with LOCSU, which is co-ordinating the sector-wide work on new services, and with the General Optical Council, College of Optometrists, Optometry Wales, Optometry Scotland and Optometry Northern Ireland and government to streamline communications and provide evidence-based advice to the front-line throughout this crisis.

We and the NHS in all countries thank you for your support to the population at this difficult time. We will share more information about these measures as soon as we can. 

RCO and College publish joint Covid Statement

March 2020

Viral conjunctivitis and COVID-19 – a joint statement from The Royal College of Ophthalmologists and The College of Optometrists

Recent reports have suggested that COVID-19 may cause conjunctivitis, and it is known that viral particles can be found in tears, which has caused some concern amongst eye health professionals. It is recognised that any upper respiratory tract infection may result in viral conjunctivitis as a secondary complication, and this is also the case with COVID-19. However, it is unlikely that a person would present with viral conjunctivitis secondary to COVID-19 without other symptoms of fever or a continuous cough as conjunctivitis seems to be a late feature where is has occurred.

Viral conjunctivitis is not currently listed in the national case definition for COVID-19. As such practitioners should treat viral conjunctivitis in the absence of other symptoms as they would usually treat any presentation of viral conjunctivitis, including normal scrupulous levels of infection control, as we do for adenovirus which is very contagious. The optometric management of viral conjunctivitis can be found in the Clinical Management Guideline, it is a self-limiting condition and should not be referred to secondary care.

During the pandemic, we recommend that, for all patients, scrupulous infection control and hand hygiene measures are employed and that, where possible, time spent on slit lamp and other close examinations is kept to a minimum safe level.

GOC response to the COVID-19 (coronavirus) emergency

March 2020

The General Optical Council (GOC) understands that many of its registrants and stakeholders will have questions about the impact of COVID-19 and wants to ensure that everyone in the optical professions is aware of the steps the GOC has taken in light of the emergency.

Support for registrants

The GOC has established a dedicated COVID-19 page on its public website where it is directing registrants to the latest Government guidance.

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 and will also be publishing a series of optical sector specific statements to reassure registrants that when they act in good conscience and exercise professional judgement for the public benefit, the GOC will support them.

Today, 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.

GOC office

In line with Government advice, GOC staff are now working remotely instead of in the office, which is now closed to visitors. The GOC will no longer take telephone calls and all enquiries should be made by email.

You can visit theContact Us page on the GOC website for a full list of email addresses within the organisation.

Homeworkers will not always have secure environments in order to have potentially sensitive and confidential telephone calls or take personal information and so this approach ensures that people’s personal data is protected. In some instances, where it is essential and where a confidential environment can be guaranteed, the GOC may make calls.

The GOC urges those wishing to communicate with them to send communications electronically in order to minimise post and ensure it is dealt with as effectively and quickly as possible. This includes supplier invoices, which the GOC will endeavour to pay as quickly as possible.

GOC Fitness to practise (FTP) hearings

To ensure the safety and wellbeing of everyone concerned, the GOC will no longer be conducting office-based hearings. The GOC is exploring options to support remote hearings and will issue a statement on this shortly.

A message from GOC Chief Executive and Registrar, Lesley Longstone. “In these extraordinary times, we are fortunate that in all four countries of the United Kingdom we have a group of exceptionally well qualified eye care professionals on whom the general public and fellow healthcare professionals can rely. Uncertain times mean that our registrants may be called upon to work at the limits of their scope of practice and vary their practice for protracted periods of time and in challenging circumstances.
With our COVID-19 statements we hope to reassure practitioners, academics and students that when they act in good conscience, for the public benefit, exercising professional judgement in all of the circumstances that apply, the GOC will support them. We will also continue to closely monitor and follow Government guidance and act accordingly. We want to thank everyone for their cooperation.”

Latest Government statements and links can be found here on Opchat's Covid-19 page

 

 
 
 
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