During both the red and amber phases of the pandemic practices should:

• Put appropriate infection control, practice modifications, and social distancing procedures in place
• Ensure there is telephone/video review to determine COVID-19 status and level of eyecare need
• Provide services remotely where possible and in the patient’s best interests
• Ask the patient to attend the practice alone where possible and reduce the number of people in the consulting room
• Ask patients to wear a face covering where possible
• Conduct a risk assessment
• Keep up to date with guidance published by UK governments.

Optometrists should:

• Wear PPE if seeing patients face to face
• Use alternatives to aerosol generating procedures (microblepharoexfoliation or Alger brush) until the green phase
• Adapt their routine to reduce close contact with patients and streamline consultations to only do tests that are clinically necessary, rather than ‘blanket testing’ all patients in a category. Annotate the record accordingly
• Make it clear on the record what adjustments have been made to the routine or decision making
• Keep up to date with guidance published by UK governments.

What this means:

• When a government or health service suspends routine primary care due to the COVID-19 pandemic.

Services provided

• Face to face essential, urgent or emergency eyecare, and essential contact lens practice only, dependent on local or national protocols
• Domiciliary care as per local protocols
• Emergency and urgent referrals only
• All other services provided remotely 

What this means:

• Ongoing COVID-19 pandemic with restrictions in place, but primary care remains open for routine services. Primary care services continue to enable the prioritisation of emergency/urgent and essential care on a needs and symptoms-led basis.

Services provided

• Face to face needs and/or symptoms led eyecare and contact lens practice as prioritised by a clinician dependent on local or national protocols. For example see Patient Risk Stratification Tool (Amber phase)
• Meet outstanding eye care needs as capacity permits (England, Northern Ireland, Scotland and Wales)
• Domiciliary care as per local protocols
• HES referrals as per local protocols

What this means:

• Social distancing requirements removed. COVID-19 related PPE is no longer required*. Prioritisation of care based on each nation’s regular local protocols.

Services provided

• Resume all services on an open access basis.
• Re-introduction of aerosol generating procedures

*UKHSA continues to recommend universal masking in all health care settings as a precaution to prevent the risk of transmission of respiratory infections including SARS-CoV-2. All staff should continue to wear a fluid-resistant face mask in the green phase as instructed by UKHSA. All people/ patients visiting health care settings should continue to be recommended to use a face covering as recommended by each nations health system.