7 January 2021

Answering your questions on the Amber Phase

Watch our video and read our FAQs for more information on eye care provision under the new national restrictions.

Watch our video

Frequently asked questions 

Red Phase guidance relates to a situation where primary care health services are suspended. This is not the case during the present lockdown and patients are still able to access their GPs, dentists, pharmacists and optometrists. Each nation's government has stated that during this lockdown, primary care services should remain open to provide care wherever possible and where it is safe to do so. The College is supportive of keeping primary care services open.  We believe if they were close, this would lead to increased pressure on eye care services and the NHS now and in the future, and would lead to vision loss and other eye health issues that could have been avoided prevented or successfully treated/managed if they were identified in time. 

Amber Phase guidance prioritises emergency/urgent and essential care on a needs- and symptoms-led basis, but still allows for patients to book a face-to-face appointment with an optometrist if, after undertaking phone triage, the optometrist believes it will be beneficial, that is does not put the patient at risk and that they have the capacity to provide it without compromising IPC.  For example, leaving adequate time between appointments to ensure that examination rooms are sufficiently cleaned. Optical practices should balance both the patient's risk of COVID-19 and their eye health when booking appointments. During these lockdowns, all asymptomatic routine patients at higher risk of COVID-19 should be offered the choice to defer their appointment.

Since the first lockdown in March, there has been robust guidance on adapting practice to reduce the risk of spreading COVID-19.  Practitioners have sufficient PPE and practices have measures in place to ensure social distancing and good hygiene practice. At present, there is no evidence to suggest that current PPE and IPC measures is insufficient to protect against the virus.  Many practices in the UK can now access equipment for twice weekly lateral flow testing, with the first kits arriving in January.  As essential workers, front line health care practitioners, including optometrists, will be prioritised for COVID-19 vaccinations.

The College’s Amber Phase guidance is supported by the GOC, AOP, FODO, Optometry Wales, Optometry Scotland and PHE.

Updated: 13 January 2021

Some hospital eye clinics (secondary care) have suspended non-urgent clinics so that staff can be deployed to deal with COVID-19 patients. However, primary care providers including, GPs, dentists, audiologists and others, have been advised by each nation’s government to remain open, including for routine/non urgent care. 

Rigorous use of PPE and IPC protocols will ensure that practices are currently safe environments for both clinicians and the public. Lateral flow tests and access to vaccinations in the coming weeks will further this protect clinicians and practice teams

Updated: 8 January 2021

The safety of patients and staff is your employer’s priority and responsibility. If you feel that your employer is encouraging staff and patients to take unnecessary risks, then you should raise this with them in the first instance. If the response is unsatisfactory, or the situation continues, and you feel patient safety is being compromised, you should follow the Raising a concern / whistle blowing procedure in the Guidance for Professional Practice and report your concerns to the GOC. If you intend to raise a concern and would like to discuss it before you go ahead, you can email or phone our clinical advisers. Any discussion with the clinical advisers is in strictest confidence.

College Guidance for Professional Practice:

Relevant GOC standards include:

  • 12.1.2 Ensure that the environment and equipment that you use is hygienic.
  • 12.2.6 Minimise the risk of infection by following appropriate infection controls including hand hygiene.
  • 16.3 Do not allow personal or commercial interests and gains to compromise patient safety.

GOC business standards:

  • 3.1.4 Allows staff sufficient time, so far as possible, to accommodate patients’ individual needs within the provision of care.

The government’s overarching message during the current lockdown is to stay at home, one of the exceptions to the message is to access medical care. Patients should be prioritised following the College’s triage procedure, over the phone, to ascertain those who need face-to-face symptoms/needs-led care, those who can managed remotely and those who should be encouraged to defer their appointment until restrictions have eased. We would also advise that practices provide guidance on eye care provision during the Amber Phase on their website and other communications with patients. You can also refer your patients to our public facing site – lookafteryoureyes.org

Online booking should be avoided unless suitable triage is in place, to ensure patients are adequately screened for symptoms of COVID19 and prioritised according to their clinical need.

Updated: 8 January 2021

We have been advised by each nation’s health system that all primary care providers should remain open, including for routine services. Some secondary care (hospitals) providers are stopping routine services, due to high numbers of COVID-19 patients. This may include some eye clinics, where staff are being redeployed to help the hospital trust’s COVID-19 response.

Ensuring safety in the workplace during the pandemic

We appreciate that working during the pandemic is stressful and challenging for optometrists. When developing our COVID-19 Guidance, the safety of practitioners and of the public was our key concern. Since the first lockdown, our knowledge of the virus and how to protect ourselves from it has increased. We recommend you follow our guidance on PPE and IPC to ensure you best protect yourself. 

It is important to remain vigilant when traveling to work and when in back office areas, as these are the times when transmission is most likely to occur. Our November edition of Clinical files provides more information. If you are concerned about your safety, speak with your employer or occupational health team. 

All UK optical practices now have access to regular lateral flow testing to check if asymptomatic staff have contracted the virus and to prevent further transmission by self-isolating according to government guidance. The first kits are being delivered to practices this month.

College Guidance on PPE, IPC and adapted practice should significantly reduce the risks of contracting COVID-19 in the workplace. However, if you have specific concerns you should try and book a home test or a test at your local testing centre.

Vaccinations are now being rolled out to all priority groups, which includes frontline health workers. All front line health workers should receive their first vaccination by the end of February, each PCN or hospital vaccination hub should make arrangements for front line health workers to access the vaccination in the coming days and weeks.

NHS England has provided more information about the vaccine here.

Government COVID-19 guidance for England is that overnight stays are permissible for work purposes and to attend education or training, and that hotels and B&Bs can stay open for these reasons. The venue has put a number of procedures in place to ensure the safety of everyone attending the OSCE, and the OSCE will operate at reduced capacity and with infection prevention and control measures in place. However, we do understand that some candidates would prefer to wait until restrictions have eased and they can defer their OSCE, free of charge, to the next sitting in March.  We will be contacting candidates who have registered for the January OSCE to ask them to confirm their place, or defer to the next sitting in March.

This article was correct at time of publication. 

Related further reading

For the very last issue of Optometry in Practice, Professor Jonathan Jackson MCOptom reflects on the past two decades of the journal and its contribution to our learning.

This paper describes how viruses infect, reproduce and damage cells. Knowing this process is critical for understanding how to treat ocular viral infections.