8 March 2022

Consultation on proposed changes to the Guidance for Professional Practice

The College proposes 13 key changes to help minimise the risk of healthcare-associated infections and ensure the guidance remains aligned with the four Nations' public health advice.

Summary

Over the coming months, we expect each UK nation’s health system to recommend that the COVID-19 Amber phase guidance will no longer be required, and optometry practices will return to “Green”. This means a return to following the standard Guidance for Professional Practice (GfPP) only. However, this will not mean returning to clinical practice as it was before the pandemic. Our thinking around Infection Prevention Controls, including PPE, has now permanently evolved to help minimise the future risk of public health emergencies and new variants of SARS-CoV-2.

Prior to the shift to Green, we have updated the Guidance for Professional Practice to ensure it incorporates the requisite Standard Infection Control Precautions for safe practice in a post-pandemic world as part of a new normal.

We propose 13 key changes to the GfPP, and a new supplementary section to help minimise the risk of healthcare-associated infections and ensure the GfPP remains aligned with the four nations' public health advice.

Highlights include:

  • a section on remote consultations and remote medicine prescribing
  • the use of face coverings when delivering direct patient care
  • managing future public health emergencies
  • safely managing patients who present with respiratory illness.

We have set out the proposed changes in the table below and welcome feedback from members, non-members and stakeholders, which we will consider before publishing the updated version. Please note when you respond, that the GfPP is the College's view of good practice, not 'best practice' or 'gold standard practice', and sets out what is expected of optometrists. The GfPP is relevant to owner practitioners, partners, employees, locums, or pre-registration optometrists and applies in all work environments, including multiples, independent practices and hospitals, and NHS and privately-funded services.

Change Log

Summary of proposed changes to the Guidance for Professional Practice
 GfPP
Section / Page 
Proposed new guidance Current guidance Notes 
1

A459

A460

(p108)

Remote consultations

  • A459
    You should use your professional judgement to decide whether it is in the patient's best interests to offer remote consultations.
  • A460 
    You should follow the high level principles for remote consultations and prescribing*.

*(GOC) High level principles for good practice in remote consultations and prescribing (optical.org)

 

 New section
4

B37, parts f&g 

(p116)

B37 f

  • Attach a breath guard or shield to the slit lamp.

B37 g 

  • You must ensure adequate ventilation within the consulting room (for example, via opening a window, mechanical ventilation or additional air filtration equipment). Where an unacceptable risk of transmission remains following a risk assessment, it may be necessary to consider the use of respiratory protective equipment (such as FFP3 or equivalent).

The Workplace (Health, Safety and Welfare) Regulations 1992

 New bullet points
5

B38

(p118)

Personal protective equipment 

B38

You should risk assess whether to wear personal protective equipment (PPE). 

a. where you anticipate exposure to protect against direct contact with blood, body fluids or non-intact skin.

b. while handling and cleaning decontaminated equipment.

All PPE should be:

c. located close to the point of use

d. single-use only items, unless specified by the manufacturer or public health body. Reusable PPE items, must be decontaminated according to the manufacturer recommendations.

e. stored appropriately

f. disposed of after use into the correct waste stream.

Protective clothing (refer to COVID-19 guidance)

 

B38

Wear protective clothing (refer to COVID-19 guidance):

  1. to protect against direct contact with body fluid
  2. while handling and cleaning decontaminated equipment.
Section rewritten to align with national IPC guidance
6

B39

(p118)

Masks

B39 

You should risk assess whether to wear an appropriate mask when: 

a. Performing procedures when in close proximity to the patient

b. you consider there is a serious risk of respiratory infection

If an FFP3 or FFP2 mask is required, a fit test must be conducted before using in practice, with a fit check carried out each time it is used. Where fit testing indicates FFP3 or FFP2 mask does not provide adequate protection, an alternative form of respiratory protective equipment that does not rely on a tight fitting to the face must be worn.

If there is a public health requirement to wear one, such as during a pandemic, you must wear an appropriate mask. You should follow the relevant national or local public health guidance to ensure you are using the correct mask with the appropriate level of protection.

Masks

B39

You do not have to use a mask, unless there is a serious risk of respiratory infection or there is a public health requirement to wear one, such as during a pandemic. If you do need to use a face mask you should follow the relevant national or local public health guidance to ensure you are using the correct mask with the appropriate level of protection. (refer to COVID-19 guidance).

Section rewritten to align with national IPC guidance
7

B40

(p118)

B40

Gloves and aprons

B40

Gloves

Section now includes aprons
8

B56

(p123)

B56

  • keeping it clean and free from clutter and dust

B56

  • keeping it clean and free from dust

 

Updated bullet point to include keeping free of clutter
9

B57

(p124)

B57 

You should decontaminate equipment that comes into contact with patients, including

g. sample frames

 New bullet point
10

B63

(p126)

B63

Isopropyl alcohol of a concentration of 70% has been shown to be effective against SARS-CoV-2, MRSA, and staphylococcus infection. Other antimicrobial wipes may be used provided they carry the CE or UKCA mark, used according to the manufacturer's instructions       

 Added to section on Isopropyl alcohol
11

B116

(p140)

Situations of increased concern – public health emergencies 

B116 

You should follow your nation's infection prevention and control procedures for the duration through which it applies. During public health emergencies there may be additional College guidance which you should refer to.

 New section to support future public health emergencies 
12

C211

(p178)

C211

You should provide copies of correspondence and any relevant supporting information in an accessible format.

 Amendment 
13-Remove all 53 references to the COVID guidance refer to COVID-19 guidanceRemove all 53 references to the COVID guidance 

Download the supplementary guidance update

Infection control measures

Complete this form and tell us your views by Friday 18 March 2022.

Consultation has now closed.

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