In the context of the Coronavirus outbreak we are experiencing, Primary Eyecare Services is working hard with all key stakeholders to ensure we have appropriate processes in place to enable safe and effective care for patients and practitioners through the locally commissioned services that we contract with optical practices to deliver. As you will be aware under the current COVID control measures all routine eye care is suspended and optical practice that are open are for urgent and essential care only.
This guidance should be implemented and reviewed regularly as it is updated.
Care Process Guidance
First Contact Services (MECS)
Due to potential for practice closures (due to inability to staff site or for decontamination etc) there is a need for us to minimise the risk to interrupted service delivery through reducing risk and what to do should a site no longer be able to deliver the service due to staffing issues and closure.
- Patient identification - Follow NHS England Standard Operating Policy (SOP) for primary care optical practices (we await updated versions please follow current government guidance on screening):
- Please see additional MECS Triage Sheet to determine outcome for patient contact, this contact will be either via telephone / video consultation in the first instance or advise to contact the local urgent eye care department for discussion about next steps. Guidance on this Telemedicine Assessment and how to carry out is linked below.
- MECS Triage Form Download
- Telemedicine Guidance Download
- Where a patient has recent onset mild red eye related symptoms encourage self-care wherever possible by directing patient to purchase appropriate over the counter medications.
- A practitioner should be ensuring that they clean down slit lamp and wash hands before and after each patient.
- Slit Lamp Shields - practices should consider the use of slit lamp shields to create a barrier between patient and practitioner as contact area with patient is less than 1 metre. These can be purchased but also made, see helpful links:
- Ensure you check your practice Infection control measures against the QiO Infection Control audit if you have not done this recently.
Diagnostic & Monitoring Services
Post-Op Cataract Follow Up Service
These patients are attending optical practice for post-surgical assessment but are considered a low risk for complications by the surgical provider having been transferred to our service. Despite the low risk there is a need to contact the patient in a timely manner following surgery 4-6 weeks and this cohort of patients are often aged over 70 and therefore considered to be a vulnerable group.
Please see Post-Cataract Triage sheet, this will guide you to either:
Community Glaucoma Monitoring Service
Patients seen within these services are of a low risk classification and will have recall for monitoring of 12 months in most cases. As per current NHS England guidance to suspend routine outpatient appointments, we have taken the decision that all activity is postponed until recovery phase (COVID restrictions lifted).
Children's Post Vision Screening Service
These are children who have failed vision screening and require diagnostic assessment. We will be working with screening teams that refer to these services to only send the high-risk patients, whilst the lower risk patient can be postponed until the recovery phase (COVID restriction lifted).
Low Vision Services
These services will be postponed until the recovery phase (COVID restrictions lifted), unless urgent requirement due to preventing patient to carry out essential job / severally affecting quality of life.
College of Optometrists Guidance
FAQs from College of Optometrists including information on what to do if a patient presents with viral conjunctivitis can be found here:.
Personal Protection Equipment (PPE)
We are being increasing approached by practice and practitioners for advise on necessity to use PPE when seeing ALL patients, please see below the guidance published by Royal College of Ophthalmologists and College of Optometrists plus additional measures to take.
College of Optometrists 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 Optometrists have advised: 'No known risk: see as normal, using scrupulous standard infection control as for any patient (e.g. hand hygiene, clean instruments). There is no known need for using face masks or gloves for every patient but discretion is to be used.'
Steps to take if optical practice is unable to deliver service due to staff absence / period of closure
- At the earliest opportunity where a period of non-service delivery occurs the optical practice should notify Primary Eyecare Services at COVID@primaryeyecare.co.uk. Further information will be requested regarding the situation of the practice.
- Practice should put sign at entrance (as well as on your website) instructing patients trying to access First Contact Services (E.g. MECS) where to find contact details for alternative optical practices (e.g. website), where possible.
- A telephone answer machine message should include details of where alternative practice contact details can be found (e.g. website), where possible.
- Where a practice remains open but a practitioner is unavailable then alternative arrangements must be made for the patient by another optical practice.