COVID-19: College updates

• Insiyah Bharmal: Life in lockdown. Insiyah Bharmal, Optometrist at Vision Express in Nottingham, takes you through her journey of returning to work during the COVID-19 pandemic.

• New FAQ: What should I do to continue, or restart, operations and work safely during the COVID-19 pandemic?

• 'Loss of, or change in taste or smell (anosmia)' has now been added to the list of COVID-19 symptoms.
• We've updated the following FAQs:

  • What PPE should I wear?

  • What type of mask should I wear?

  • Can I wear a FFP3 or FFP2 mask instead of a surgical mask?

  • Should my reception staff or patients wear PPE?

  • Should I tell my patients to stop wearing their contact lenses during this pandemic?

• England: NHS England is inviting optical practices to complete a short online survey and join an online workshop to share their experiences of the impact of Covid-19. The online workshop is anonymous and open 24/7 over the next two weeks. 
   
• Wales: All optical practices across Wales are required to complete this EPR and Open Eyes survey by 30 May 2020, in readiness for the Electronic Patient Record connectivity process to start.

• COVID-19: Diary of an optometrist - part four. The fourth and final part of Dr Deacon Harle's experiences of providing urgent and essential care during the COVID-19 pandemic.

• Urgent alert on the removal of Tiger Eye Protector Product from the supply chain in respect of COVID-19 use.
• COVID-19: Easing of lockdown in England - optometrists to continue to deliver only essential and urgent eye care.
• Jagdeep Singh: Life in lockdown. Join Jagdeep Singh MCOptom, Optometrist at Royal Shrewsbury Hospital, as he takes you through his new routine, both inside and outside the hospital during the COVID-19 pandemic.

• Donya Gharanei: Life in lockdown. Join Donya Gharanei MCOptom, Optometrist at Specsavers Opticians in Acocks Green, as she discusses the challenges faced during the COVID-19 pandemic.

• Independent prescribing (IP) update on the June examination
• COVID-19: Diary of an optometrist - part three. The third part of Dr Deacon Harle's experiences of providing urgent and essential care during the COVID-19 pandemic.
• COVID-19: Life on the frontline. Join Rosie Gavzey MCOptom as she takes you through her experience of volunteering at London’s NHS Nightingale Hospital.

• COVID-19: Update on testing for optometrists. We outline COVID-19 testing information for optometrists in all four UK nations.
   

• PPE for optical practices in England: Following the College’s successful influencing to ensure optometry was included in national PPE guidance, LOCSU, together with Primary Eyecare Services (PES), has made PPE available for optical practices in England to purchase via a not-for-profit online shop. We understand that many PPE items have already sold out, but LOCSU is working on new supply chains and advises to check the shop daily for updates. If, when stocks are back, you still are unable to access PPE for any reason, let us know.

• NHS England webinar: Implementing the COVID-19 Urgent Eyecare Service (CUES): This solutions-focused webinar, aimed at CCG primary care leads and featuring College President Colin Davidson FCOptom, will provide examples of how CCGs have implemented a CUES service or a similar in their local area and discuss how CCGs have overcome barriers to implementation. There will be the opportunity to ask questions in an extended Q&A. Sign up here.

• Patient case files: Join David Cummins MCOptom, Optometrist and Partner at PLM Optometrists in Scotland, as he takes you through a series of real-life cases, managed at his practice during the COVID-19 pandemic.
• There has been a sharp rise in DIY-related eye injuries since COVID-19: Our advice on eye protection when working in the home or garden.
• The lockdown locum life: Join Hassnain Safdar MCOptom, a Locum based in the East Midlands, as he navigates through his new 'normal' during the COVID-19 pandemic.

• Read our response to a recent contact lens promotion aimed at NHS workers.
• Our response to the Royal College of Ophthalmologist's guidance on reopening and redeveloping services after COVID-19.
• Forde Opticians: Life in lockdown. Join Gemma Hill MCOptom, Optometrist and Owner of Fordes Opticians, as she takes you through her life as a ‘one-man band’ in her independent practice during the COVID-19 pandemic.
• Acuity - Remote consultations and patient decision-making. The latest edition of our member journal is out now.

• Scheme for Registration: Read our update for final year students and watch our video.
• COVID-19 - Staying safe with remote consultations. Léa Surugue looks at how to carry out effective virtual consultations in a time of social distancing and discusses the clinical and legal pitfalls in the latest edition of Acuity.
• Difficult times: Amid the upheaval caused by COVID-19, Dr Susan Blakeney FCOptom, the College’s Clinical Adviser, asks if one of the unexpected consequences of the crisis could be positive clinical change, in her latest Clinical notes.
• COVID-19: Diary of an optometrist - part two. The second part of Dr Deacon Harle's experiences of providing urgent and essential care during the COVID-19 pandemic.

• Scheme for Registration update. We appreciate how difficult and worrying this time is for all pre-registration trainees. To help provide some clarity, we have also included a new video update on the Scheme for Registration.
• Clinical question: Can I prescribe a medicine based on a remote consultation? 

• Charles Bonnet Syndrome: Life in isolation - Judith Potts, founder of Esme's Umbrella, discusses the effects of isolation on those who live with Charles Bonnet Syndrome.

• Life in lockdown: Join Nicola and Oliver Gatehouse, owners of Ball & Gatehouse Opticians, as they update you on the challenges they have faced in their practice since the start of the COVID-19 pandemic.

• Diary of an optometrist (part one) - Dr Deacon Harle FCOptom records his experiences of working during the COVID-19 pandemic.
• New FAQ on our patient-facing website, LookAfterYourEyes.org: I have a medical condition and am waiting for the DVLA to renew my driving licence. Can I continue to drive while I’m waiting?

• New COVID-19 diaries: Join Faye McDearmid MCOptom, optometrist at Campbell & McDearmid in Redcar, as she updates us on her week at work during the COVID-19 pandemic.
• New FAQ: What should I do if a patient needs to have a medical or asks for a driving vision/VA or visual field test?
• Updated FAQ: 'How can I tell my patients to check their visual acuity remotely?' includes a link to a video on how to use a home sight test chart.

• NHS England: COVID-19 Urgent Eyecare Service - CUES: This outlines a COVID-19 Urgent Eyecare Service delivered from a network of optical practices, acting as urgent eye care hubs, to support the immediate and recovery phase of the coronavirus pandemic.

• New FAQ: How can I tell my patients to check their visual acuity remotely?
• Updated FAQ: If we are seeing fewer routine patients, can we help out the NHS in other ways?

• The NHSEI statement on redeploying the optical workforce.

• Updates on PPE made to the Coronavirus (COVID-19) pandemic: Guidance for optometrists
• Updated FAQs: 
  • What PPE should I wear?
  • Should reception staff wear PPE?
  • How do I put on and take off PPE correctly?
  • How should I dispose of my PPE?
  • Do I still have to wash my hands and use other infection control techniques if I wear PPE?
  • What is the College doing to help us get PPE?
  • I am unable to get PPE – what should I do?
  • How do I conduct a phone or video consultation with a patient?

• Ophthalmology and Optometry Patient Management during the COVID-19 Pandemic
• Updated FAQs: 
  • Do I still need to meet the GOC’s CET requirements for this year?
  • I have my IP assessment coming up. Is this still going ahead?

• Ophthalmology and Optometry Patient Management during the COVID-19 Pandemic
• The UK‘s public health bodies and the Academy of Medical Royal Colleges have published new guidance about personal protective equipment (PPE).
• England: Updates and guidance for optical settings.
• New/updated FAQs: 
  • UK Government and NHS leaders across all four nations have published new PPE guidance, what PPE should I use?
  • How should I put on and take off Personal Protective Equipment?
  • Do I need to wear a surgical mask when examining healthy asymptomatic patients? 
  • I am unable to get a PPE – what should I do?
  • What urgent conditions should be referred to the Hosptial Eye Service?
  • What precautions should I put in place if I need to see patients?
• New Scheme for Registration FAQs for trainees sponsored by the College on a Tier 5 visa

• New FAQs: 
  • Should I continue with business as normal?
  • How can I access information to give to patients during the lockdown period?
  • Should I tell my patients to stop wearing their contact lenses during this pandemic?
     
• New FAQ on LookAfterYourEyes.org for people living with sight loss.

• The College and The Royal College of Ophthalmologists have issued a joint letter requesting urgent GOS financial support for optical practices during the COVID-19 pandemic.
• Remote consultations during COVID-19 pandemic guidance and forms.
• Updated guidance for optometrists.
• Northern Ireland: COVID-19 - Financial support for ophthalmic contractors (25 March 2020)
• Updated FAQs, including:
  • helping the NHS
  • what to do if you or your staff are in at-risk groups and have been asked to self-isolate
  • financial support for practice owners, locums and other self-employed optometrists
  • wearing surgical masks
  • what the College is doing about ensuring you have the appropriate PPE
  • what to do if you are unable to get a mask
  • what precautions to put in place if seeing patients
  • advice on air-puff tonometry.
• Updated IP FAQs

Acuity: COVID-19 – can chloroquine help tackle the pandemic? The antimalarial drug may be a glimmer of hope as coronavirus takes hold across the world, if the threat of retinopathy can be managed.

• Optical practices have now been added to the list of primary care providers who require appropriate PPE.
• If you missed our COVID-19 Q&A with our Clinical Advisers, Sue and Daniel, and Head of Assessment, Alastair, on Friday, you can catch up now on their answers to your clinical, Scheme for Registration and PPE queries.
• The Welsh Government has issued further guidance on the provision of urgent and essential eye care and financial support.

• Protecting patients in Primary Care: Our latest position statement on seeing patients in primary care during COVID-19. 
• COVID-19 Q&A on social media from 12pm-3pm today. Post your questions on Instagram, Twitter, Facebook and LinkedIn
• Position on use of PPE Personal Protective Equipment) during the COVID-19 pandemic
• Royal College of Ophthalmologists updates its guidance on PPE (25 March 2020)
• Updated FAQs
• COVID-19 advice for patients on LookAfterYourEyes.org

• The NHS is looking for volunteer health and care professionals – follow the link to find out how you can get involved.
• Ophthalmic and Physiological Optics (OPO): All journal articles relating to COVID-19 research are now free to access online and are updated daily. 
• Scottish Government: information on the provision of emergency or essential community eye care during the COVID-19 social distancing measures announced on 23 March. It also provides clarification of aspects of the financial support measures introduced in the previous communication and an update on emergency dispensing.
• Scheme for Registration update: announcement regarding COVID-19 and the Scheme for Registration
• Independent Prescribing (IP) examination update

We want assure trainees, supervisors and employers that we are developing proposals to modify the Scheme for Registration requirements in these exceptional circumstances. While work has begun on these, it will take some time to develop full proposals and have them signed-off by the GOC. 

We are working to put in place arrangements that recognise that pre-registration trainees are unlikely to be employed in supervised practice for a period of time, and therefore not able to meet the standard Scheme requirements. We are also exploring what we can do differently, having had to suspend work-based assessment visits on the Scheme. 

We are exploring modifications we can make and how competencies can be assessed differently, all while upholding the rigour of the Scheme and ensuring patient safety. We are involving key stakeholders in this work, and will test our plans with different parties, including employers and the GOC. We recognise we need to build confidence in any potential modifications, so that they are both credible and practical.

We are developing a process for approving extensions to allotted time on the Scheme for trainees whose placements and progress are affected by COVID-19. This will aim to avoid individual trainees needing to apply separately for extensions (as is the case under standard Scheme regulations).

We are also exploring how we can work with employers to support trainees’ learning and development while their supervised practice is suspended. 

We will keep you updated with all Scheme for Registration developments. 

We want assure trainees, supervisors and employers that we are developing proposals to modify the Scheme for Registration requirements in these exceptional circumstances. While work has begun on these, it will take some time to develop full proposals and have them signed-off by the GOC. 

We are working to put in place arrangements that recognise that pre-registration trainees are unlikely to be employed in supervised practice for a period of time, and therefore not able to meet the standard Scheme requirements. We are also exploring what we can do differently, having had to suspend work-based assessment visits on the Scheme. 

We are exploring modifications we can make and how competencies can be assessed differently, all while upholding the rigour of the Scheme and ensuring patient safety. We are involving key stakeholders in this work, and will test our plans with different parties, including employers and the GOC. We recognise we need to build confidence in any potential modifications, so that they are both credible and practical.

We are developing a process for approving extensions to allotted time on the Scheme for trainees whose placements and progress are affected by COVID-19. This will aim to avoid individual trainees needing to apply separately for extensions (as is the case under standard Scheme regulations).

We are also exploring how we can work with employers to support trainees’ learning and development while their supervised practice is suspended. 

We will keep you updated with all Scheme for Registration developments. 

The latest guidance and information is available on our COVID-19 page and on our social media channels.

We had to cancel delivery of the College’s IP exam, due to have been held on 1st April, to comply with Covid-19 requirements. We will keep under review when it will be possible to deliver the exam in its conventional format.

We are currently exploring how the exam could be conducted differently. We are looking into the feasibility of the College using software that enables candidates to sit exams securely online, with remote invigilation (our current exam system does not allow us to run the exam online). We will provide an update once we can indicate precisely what it is possible for us to do.

We also recognise that optometrists with IP rights can make a particularly valuable contribution to meeting patient care needs differently, including in the context of more eye care being delivered outside hospital settings where this is safe to do so. We are involved in discussions with the General Optical Council and other partners on how optometrists’ professional skills, including those relating to IP, can be optimised to meet patient care and service delivery needs in the current circumstances and how the profession’s skills and contribution can be promoted. We will provide an update on this shortly.

• Coronavirus (COVID-19) pandemic: Guidance for optometrists
• OFNC updated guidance on opening arrangements for optical practices.
• Updated COVID-19 in -practice poster (PDF, 130KB)
• Updated FAQs, including a new FAQ on financial support for practice owners, locums and other self-employed optometrists.

• Updated FAQs, including new essential eye services poster.
• Northern Ireland: Health and Social Care Board announcement to suspend all routine General Ophthalmic Services and domiciliary eyecare services (PDF, 135KB). 

We have listened to our members’ concerns, and the public health advice coming from the UK's governments to avoid social contact where possible. As a result the College recommends that every optometrist and practice owner stops providing routine sight tests and routine eye examinations, and offers only essential services. Essential services would include sight tests based on a clinical need, and urgent eye care pathways. We note that some practices are doing this on a voluntary basis already.

There are several reasons for this:

1. Practices now need to contribute to the public health endeavour of ensuring that people only go out when necessary. Routine sight tests can be safely delayed.
2. It is essential we help to keep the nation‘s sight healthy - from NHS frontline staff to those in self-isolation. Our communities still need essential eye care, and secondary care may need our support to see urgent cases. We therefore need to ensure our members and all optical staff are able to protect themselves and maintain the safety of their communities.
3. We understand the growing concern about the potential for tears to lead to COVID-19 infection and are waiting for more certain evidence on this.  In the meantime optometrists should not put themselves at unnecessary risk, and we are asking UK governments to provide appropriate PPE for optometrists who are providing essential services.

We note that the Welsh and Scottish governments have already issued advice on essential primary eye services and stopping routine sight tests. We are pressing NHS England and the HSCNI to do the same, and to provide financial support to enable practices to continue to be viable eye care centres. 

I feel unsafe seeing patients without appropriate personal protective equipment (PPE)

We are calling on UK governments to provide access to PPE and training on how to use it for optometrists wishing to provide essential eye care.

I am a pre-reg trainee – how will this affect me?

Although assessments have stopped, we know that we have previously advised that trainees can continue to see patients. With only essential services being provided, trainees can help with telephone triage to decide whether a patient should be seen. We are currently liaising with the GOC on changes that we can make to the Scheme for Registration requirements so that trainees are not unfairly held back in their progress.

What is essential?

Examples of essential optometric practice would include providing replacement spectacles for a key worker who has broken theirs, or seeing patients with acute eye- or sight-related symptoms. It would not include seeing patients who are attending practice for their routine sight test without eye- or sight-related symptoms.

We recommend that – before making any appointment – you operate a telephone triage service to determine whether or not a patient falls into the ‘essential’ category, and explain to other patients why you are postponing their appointment.

This will affect my business – how will I cope?

We understand that this is a difficult decision for practice owners to make, but we feel this is the right decision for optometrists, their staff and the wider public in helping slow the spread of the pandemic and ensuring that we are able to help with the backlog of patients that will ensue as a result. We are pressing NHS England and NHSCI to provide financial support to enable practices to continue to be viable eye care centres.

• Are optometrists considered key workers?
• Do I need to wear a surgical mask when examining healthy asymptomatic patients?
• England: OFNC Announcement on Support for GOS Contractors in England
• Scotland: Suspension of routine eye examinations; Financial support measures for community optometry practices; Other important COVID-19 updates (PDF, 366KB)
• Wales: Temporary Primary Care Contract Changes (PDF, 491KB) and letter to Primary Care Optometry and Health Boards (PDF, 565KB)

It is essential that you continue to take personal responsibility for keeping yourself informed. You should only follow the relevant official guidance and do not act on, or share, any information that cannot be verified, or information that is not consistent with official advice. Clinical misinformation can have significant consequences and we all need to actively guard against it. If you have any queries, consult our FAQs in the first instance, or email our clinical advice service.

Scheme for Registration update:

• Information for trainees, supervisors and assessors on Cancellation of stage 1 and stage 2 assessment visits and exceptional measures
• FAQs for trainees
• FAQs for assessors.

Clinical updates:

• The College of Optometrists and The Royal College of Ophthalmologists’ joint statement on viral conjunctivitis
• Telephone-based consultancy for replacement glasses and contact lenses – guidance and templates
• New and updated FAQs.

Over the days and weeks to come, we will work with our members and stakeholders across the UK to identify what we can do to best serve the public as the situation develops.

We will share information and updates with you on a daily basis - follow us on Linkedin, Facebook, Twitter and Instagram for the latest guidance. It is also essential that you continue to take personal responsibility for keeping yourself informed. You should only follow the relevant official guidance and do not act on, or share, any information that cannot be verified, or information that is not consistent with official advice. Clinical misinformation can have significant consequences and we all need to actively guard against it.

The OSC and the College of Optometrists are working together to minimise the disruption caused by COVID-19 to optometry education provision and to enable optometry students to meet the requirements to enrol on the Scheme for Registration in 2020. 

We are developing plans, as a matter of urgency, to provide as smooth a transition as possible for graduating students, and for students on programmes that integrate university study and the Scheme. We are doing this in ways that uphold high education and professional standards and ensure adherence to GOC requirements.

We are working to put in place the following arrangements: 

1. Students/new graduates with any deficits in their patient episode numbers and/or clinical competencies that cannot be addressed due to the current disruption to their undergraduate study created by COVID-19, will be supported by their university and the College to demonstrate fulfilment of these requirements during the early stages of their pre-registration placement.
    
2. The College and universities will work with other stakeholders, including supervisors, employers and College assessors, to ensure that all parties, including patients and the public, can have confidence in the modified arrangements and feel supported in contributing to their implementation. 
    
3. Students who have outstanding patient episode numbers and/or clinical competencies in 2020 will be eligible for the award of an Optometry degree, providing that their degree performance is at 2:2 standard or above.
    
4. Universities will work with the College to explore how new graduates can appropriately be supported in their transition to the Scheme during this period of exceptional circumstance, recognising that there may be unavoidable gaps between individuals’ last contact with patients as undergraduate students and their enrolment on the Scheme. 

The OSC and the College will share more detailed plans to progress the above as these are developed. We will particularly consider the situation and needs of students enrolled on degree programmes into which the Scheme for Registration is integrated, and of students who enter the Scheme via other progression routes. 

The College is developing plans to support all trainees’ progression through the Scheme for Registration during the exceptional circumstances created by COVID-19. This approach is again to uphold high education and professional standards and to meet GOC requirements. These will be shared by the College in due course.

In the same way as other organisations in these unprecedented times, the College continues to monitor the COVID-19 situation carefully. We understand that this is a difficult, worrying and fast-changing situation for everyone.

In the context of latest government advice regarding COVID-19, we have taken the decision to cancel the Therapeutics Common Final Assessment in Independent Prescribing sitting that was scheduled to take place on 1 April 2020. 

We have made this decision so that all candidates and College staff can follow government and organisational advice on self-isolation and social distancing and respond, as required, to any escalation in this advice. 

Please do not travel to the venue.

All candidates will be automatically transferred onto the next examination sitting, which is currently scheduled for June 2020. Alternatively, candidates may apply to cancel their place altogether, and may request a refund of their examination fee by emailing education.help@college-optometrists.org. 

We will be taking a decision in the next few weeks regarding future examination sittings and are actively exploring alternative assessment arrangements. We will be in touch again with all candidates as these decisions are made.

If you have any queries, please send them to education.help@college-optometrists.org and one of the team will be in touch.

In the same way as other organisations in these unprecedented times, the College continues to monitor the COVID-19 situation carefully. We understand that this is a difficult, worrying and fast-changing situation for everyone. We want to assure trainees, supervisors and assessors of the College’s continued support to all those enrolled on and involved with delivery of the Scheme for Registration.

Following the Prime Minister’s announcement on Monday 16 March 2020, we have decided to stop all assessment activity on the Scheme for Registration from 8am on Wednesday 18 March 2020. This means that all assessment visits, at both stage 1 and stage 2, will be cancelled until further notice. We will keep under review how long this suspension needs to be in place, obviously informed by government advice and requirements. 

We have not taken this decision lightly. It is to protect the safety of trainees, supervisors and assessors, as well as patients and the public.

We realise that there will be a number of consequences arising from the decision. We will be in touch again in the next 48 hours with further advice.

Trainees should be assured that the College will continue to support them during this challenging time. As part of our contingency plans, we are exploring how we can most smoothly enable trainees’ allotted time on the Scheme (normally up to 27 months) to be extended, where this need arises due to cancelled visits and wider disruption caused by COVID-19. We will be explaining these arrangements in our updates. 

If you have any urgent queries about assessment an visit that was due to take place in the next 72 hours, please send them to education.help@college-optometrists.org and one of team will be in touch. Otherwise, please wait for further updates.

The College, alongside other optical bodies including the GOC and the Optical Confederation, is part of a regular weekly meeting with NHS England and Improvement to feed into and be updated on coronavirus/COVID-19 related issues relevant to primary care. We are also in contact with the optical advisors in Scotland, Wales and Northern Ireland to ensure we can provide links to the latest national guidance.

The UK optical bodies maintain regular contact so that we can streamline communications and address common questions and concerns, and share these with the national optical leads. 

We know that the Optometric Fees Negotiating Committee has put forward a number of contractual proposals to keep the optical sector supported and able to continue treating patients during this, and the next phases of the pandemic. Similar negotiations will be happening in Scotland, Wales and Northern Ireland in respect of the arrangements there. We will share relevant updates on these when we receive them. 

In the coming weeks and months we will be working with other professional bodies across primary and secondary healthcare and eye care to identify ways that our professions can work together to best serve the public during this developing situation. 

In the meantime, please keep checking the national websites linked above each day for updates. We are committed to sharing the latest official information as the situation develops. It is essential that every optometrist continues to take personal responsibility for keeping themselves informed, and checking the national websites linked above each day for updates. Practitioners must only follow the relevant official guidance and ensure they do not act on, or share any information that cannot be verified, or information that is not consistent with the official advice. Clinical misinformation can have significant consequences, we all need to actively guard against it.

If you have questions about the current COVID-19 situation or wish to sense-check information you have seen, email our clinical advice service for support.

NHS England and NHS Improvement have issued a new coronavirus (COVID-19) standard operating procedure (SOP) for primary care optical settings in England.

It is intended to support primary care teams to implement the PHE guidance COVID-19: interim guidance for primary care by explaining the actions an optical practice should take in managing patients who they suspect may have COVID-19.

Please note that nhs.net will be NHS England’s preferred means for communicating key guidance and resources to practices. Practices that don’t have an nhs.net email address will need to register for one - details on how to do this are included in the SOP.

The key points in the document are:

• the preparations each optical practice should make
• how to register for a nhs.net account for you and your practice 
• information practices should give to the public about the virus, including practice posters
• what to do if you think a patient has COVID-19
• how optical practices should perform isolation and decontamination.

Updated guidance

Standard operating procedure for primary care optical settings (England)

Health Protection Scotland has also issued updated advice for opticians and optometrists

Guidance for opticians and optometrists (Scotland)

In Wales and Northern Ireland stay up to date with the latest information and advice from your country’s health authority and ensure you take appropriate precautions if required.