Answering your questions on the Amber Phase

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:

• Raising a concerns, section B97-B105

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.