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COVID-19 Guidance

In the context of the Coronavirus outbreak we are experiencing, Primary Eyecare 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.

Guidance on this page should be implemented and reviewed on a regular basis, as it is being continually updated.

Please see our Communications Checklist for Practices for guidance on how to communicate with both patients and other healthcare professionals.

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.

Risk Reduction

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:

  • Arrange telephone / Video consultation and book follow up for during COVID recovery phase (once restrictions lifted)
  • Arrange face to face appointment (where urgent ocular symptoms and no COVID risk factors)
  • Contact the surgical provider to discuss next steps (where urgent symptoms and COVID risk factors present)

Post Cataract Triage Form Download

 

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).

 

Diagnostic and monitoring services

 

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:

https://www.college-optometrists.org/the-college/media-hub/news-listing/coronavirus-2019-advice-for-optometrists.html

 


Personal Protection Equipment (PPE)

Primary care practices should not be seeing patients with symptoms of COVID-19.

We recommend that, to preserve supplies of PPE and not require people to make visits to the practice unnecessarily, you should conduct a virtual consultation in the first instance.

We understand that National Public Health bodies are working to arrange supply of PPE to optical practices. When we have further details on this, we will update our guidance.

For urgent eye care service reception staff should maintain a 2-meter distance at all times, and as such do not require PPE to be used.

Distancing and scrupulous hand-washing remain essential. The new guidance now recommends that clinicians should assess risk of infection to themselves and their patients. For the direct care or assessment (within 2 metres) of a patient or resident that is not currently a possible or confirmed COVID-19 case they should wear. PPE should always be worn before entering the room where the patient is, put the PPE on in the following order

    1. single use disposable plastic apron
    2. fluid resistant surgical mask (sessional use, based on risk assessment)
    3. reusable face or eye protection (sessional use, based on risk assessment)
    4. single use gloves

Public Health England have produced a poster for clinicians which can be displayed in practices:

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/878056/PHE_COVID-19_visual_guide_poster_PPE.pdf

Latest College of Optometrist guidance on COVID-19 and PPE in particular can be found on their Update page:

https://www.college-optometrists.org/the-college/media-hub/news-listing/coronavirus-2019-advice-for-optometrists.html

Putting on (donning) and Removal (doffing) of personal protective equipment

Public Health England have produced guidance for putting on and removing personal protective equipment, these resources can be used in optical practices as posters to provide a reminder for staff.

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/875211/Putting_on_PPE_for_non-aerosol_generating_procedures_quick_guide.pdf

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/875212/Taking_off_PPE_for_non-aerosol_generating_procedures_quick_guide.pdf

Clinicians using PPE should watch the video below before using PPE:

https://www.gov.uk/government/publications/covid-19-personal-protective-equipment-use-for-non-aerosol-generating-procedures

PPE Waste Disposal

Waste from possible cases and cleaning of areas where possible cases have been (including PPE, disposable cloths and tissues): 

  1. Should be put in a plastic rubbish bag and tied. 
  2.  The plastic bag should then be placed in a second bin bag which is tied when full. You may choose to use a large pedal operated bin for the second bin bag. 

Waste should be stored safely and kept away from area’s where staff may come into contact with it. You should not put your waste in communal waste areas until the waste has been stored for at least 72 hours. 

If storage for at least 72 hours is not appropriate, arrange for collection as a Category B infectious waste either by your local waste collection authority if they currently collect your waste or otherwise by a specialist clinical waste contractor. They will supply you with orange clinical waste bags for you to place your bags into so the waste can be sent for appropriate treatment. 

Infection Control – Hand Hygiene

Washing hands

It is still essential to ensure scrupulous hand hygiene at all times. You should also continue to maintain a high standard of infection control every time. Clean the consulting room door handle, computer keyboard, slit lamp joystick and clinical area regularly with an alcohol wipe. The resources below give further advice on hand hygiene.

https://www.nhs.uk/live-well/healthy-body/best-way-to-wash-your-hands/

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/877530/Best_Practice_hand_wash.pdf

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/877529/Best_Practice_hand_rub.pdf


Notification Protocol

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.

Catch It. Bin It. Kill It.