COVID-19: College updates

  • 3 Jul 2020

This contains the current guidance available for each nation and the latest updates from the College.

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3 July 2020: Daily update

 

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COLLEGE CLINICAL GUIDELINES
THE LATEST NATIONAL GUIDANCE ON COVID-19

England 

Northern Ireland

Scotland

Wales

You can refer patients or colleagues to the NHS 111 online decision tool

Forms and downloads for use during COVID-19

Purchase College-branded social distancing floor stickers

Download the amber phase children's poster (PDF, 1.19MB)

Download the amber phase infographic (PDF, 50.2KB)

Download the amber phase door poster (PDF, 470KB)

Download the COVID-19 traffic light table - moving from red to amber to green phase (PDF, 519KB)

Download the essential eye care services poster (PDF, 28KB)

Download the Clinical telephone review form (PDF, 492KB)

Download the supplying replacement spectacles by phone (PDF, 540KB) 

Download the supplying replacement contact lenses by phone (PDF, 535KB)

Download the Visual Acuity chart for remote consultations (PDF, 987KB)

Download the COVID-19 symptoms poster for England (PDF, 40.5KB)

Download the COVID-19 symptoms poster for Northern Ireland (PDF, 40.7KB)

Download the COVID-19 symptoms poster for Scotland (PDF, 41.4KB)

Download the COVID-19 symptoms poster for Wales (PDF, 40.7KB)

 

College FAQs

Amber phase

How does the College’s recovery phase table align with the national COVID-19 alert level?

The College’s recommendation to move to the red, amber or green phase of our guidance is informed by the positions of the four UK national health services, advice from the national public health authorities and the national COVID-19 alert level. The COVID-19 alert level was moved to Level 3 by the Chief Medical Officers of each UK nation on 19 June, following advice issued by the new Joint Biosecurity Centre (JBC).  

As of Monday 29 June, all four nations are aligned in operating within amber column 1 of the College’s recovery guidance table. Note there is some variation in how eye care in each nation is delivered and prioritised, so members should refer to our recovery guidance in conjunction with the appropriate national advice.  

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Can I see routine patients during the amber phase of the COVID-19 pandemic?

Our table and guidance are for the whole of the UK and are regularly reviewed.  In England, NHS England has said that as from 15 June 2020, 'routine' services can be resumed. However, patients should be prioritised based on their need, and triaged remotely first. This would include, assessing their risk of developing eye disease, as well as their risk related to COVID-19 infection. Optometrists can recall, or see, asymptomatic patients if capacity permits. We are still in a pandemic with the virus in general circulation, and so sight tests and urgent eye care should continue to be adapted to protect the practitioner, practice team and patients to reduce the likelihood of contracting and transmitting the COVID-19 virus. 

Updated: 19 June 2020

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The College advises that patient care can be provided on a needs- and symptoms-led basis, while still prioritising essential and urgent cases. What does that mean in practice?

We advise that optometrists continue to triage patients, over the phone or virtually, to assess their needs before an appointment is made. This would mean that low-risk asymptomatic patients are not prioritised until we have reached a point of low community transmission.

Updated: 19 June 2020

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Do the same social distancing, hygiene and PPE measures apply as have in lockdown?

Yes. We are still in a period of sustained COVID-19 transmission. All optometrists will need to continue to comply with College guidance on social distancing, adapting practice, observing hygiene control measures and wearing PPE.

Updated: 12 June 2020

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What is the difference between ‘needs led’ and ‘essential’?

The College recovery guidance states that in the first part of the amber phase, practitioners can start offering care on a ‘needs led’ basis.  A ‘needs led’ approach enables optometrists to use their professional judgment to act in their patient’s best interests. This may include where the patient is anxious or concerned about their eyesight or ocular health, is affected by a minor reduction in vision, needs a replacement pair of spectacles or contact lenses or is in an at risk group requiring a regular examination . It is appropriate to arrange face-to-face consultation following a remote triage appointment. Needs led would not typically include recalling low risk asymptomatic patients, who are happy with their current correction.
 
NHS England defined essential care as:
 
“this includes but is not limited to appointments for patients who would not normally be considered to be emergencies, but where, in the practitioner’s professional judgement, a delay in an examination may be detrimental to a patient’s sight or wellbeing. This may include where patients have broken or lost their glasses or contact lenses and need a replacement pair to function.” 

Updated: 12 June 2020

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Is there a disparity between GOS and private provision?

Both NHS and privately funded patients can access eye care services on a needs-led / essential eye care basis in the amber phase. NHSE/I have made this ‘essential eye care’ approach a contractual requirement, whereas for privately funded patients the ‘needs led’ approach it is reliant on optical practices following our guidance

Updated: 15 June 2020

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When will my GOS NHS support payments end?

NHS England/Improvement have committed to provide the average support payments until the end of June. Negotiations between the ONFC and NHSE/I are currently under way to establish whether there will be support for optical businesses thereafter.

Updated: 15 June 2020

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What resources does the College have in place for members?

As well as providing the guidance, the College has developed a door posteran infographic, and a patient video for members to use in practice, on practice websites, in patient emails and on social media. We are also printing floor stickers to encourage social distancing in practice, which members can order from Thursday 18 June. 

Updated: 15 June 2020

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Can we send out recall letters?

The advice of NHS England is that the sequencing and scheduling of patients for treatment as services resume should consider: 

  • the urgency of needs 
  • the particular unmet needs of vulnerable groups 
  • available capacity to undertake activity

This means that, if capacity permits, and you have sufficient PPE, you may recall or see routine asymptomatic patients. You should consider ways to risk stratify the patients you recall, to prioritise those who would benefit the most from a sight test.

Updated: 19 June 2020

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Business

Which areas of Leicestershire are covered by the localised lockdown introduced on 30 June?

From Tuesday 30 June, some areas of Leicestershire are in a localised lockdown. Optometric practices in this area should prioritise services and operate on the basis they are in the red phase of COVID-19 recovery initially for two weeks from that date. Leicestershire County Council has issued a map of the areas affected. These include Leicester city centre as well as suburban parts of Leicestershire, including Wigston, Oadby and Blaby.

Photo credit: Leicestershire County Council

 

More information is available on the Leicestershire County Council website.

Updated: 30 June 2020.

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Are optical practices considered to be retail shops that have to close?

The Westminster government has confirmed that optical practices are unaffected by the instruction for all non-essential retail shops to close, and should remain open to provide essential and urgent primary eye health care.

It is an individual decision for each practice owner to make as to whether or not to remain open in this difficult climate. If a practice owner does decide to remain open, they should ask all patients to telephone the practice, before attending, for remote triage to ascertain whether the patient needs essential eye care before being seen. If practices in a local area wish to close, they may choose to join with other practices to provide a local hub where essential services can be provided. This could be done on a rota basis where appropriate. Patients should be clearly signposted as to how to access the care they need. 

Updated: 1 April 2020

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Are optometrists considered ‘key workers, so their children can go to school’?

The Westminster government has defined key workers as: ‘…including but not being limited to ‘doctors, nurses, midwives, paramedics, social workers, care workers, and other frontline health and social care staff including volunteers; the support and specialist staff required to maintain the UK’s health and social care sector…’

The government has now confirmed that optometrists, and optical practice staff, who are required to maintain essential services, fall within this definition, and their children should be allowed to attend school and childcare settings where no home-based childcare options are possible.

Updated: 1 April 2020

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If we are seeing fewer routine patients, can we help out the NHS in other ways?

The optical bodies have been negotiating with the UK governments and health services about the role of optometrists in this unprecedented situation.  

On 12 April 2020, NHS England and NHS Improvement produced a statement on redeployment of optical professionals. We were disappointed that this did not make more explicit reference to optometrists’ existing clinical skills.  The GOC has also produced a statement on redeployment (PDF).

Members wishing to explore how they can help out in the NHS in England should use this link.

The OFNC has FAQs on insurance for optical professionals who take on another role during the crisis.

We understand, however, that there is a temporary pause in the recruitment of NHS volunteers, and that optometrists are not specifically mentioned.  We have asked NHS England and NHS Improvement to add optometrists to the list of healthcare professionals who can register to volunteer
 

Updated: 21 April 2020

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Should I place the poster up on my practice door?

Yes. As well as the poster advising patients not to attend if they have symptoms of COVID-19 we have designed a new poster to display to let patients know that you are only available to provide essential and urgent eye care services: 

Download the COVID-19 symptoms poster for England (PDF, 40.5KB)

Download the COVID-19 symptoms poster for Northern Ireland (PDF, 40.7KB)

Download the COVID-19 symptoms poster for Scotland (PDF, 41.4KB)

Download the COVID-19 symptoms poster for Wales (PDF, 40.7KB)

Poster pack for England

Resource pack for Scotland (direct download 21MB)

Updated: 28 May 2020

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I run a domiciliary business. Can I continue to see patients?

Domiciliary visits have been suspended by the Scottish, Northern Ireland and Welsh governments. There is currently no formal advice on domiciliary eyecare visits in England, but NHS England has stated that clinical support to social care, care homes and domiciliary care should continue.

In view of the advicethat people should not visit patients at risk who are in care homes, we advise that optometrists should only provide essential services to domiciliary patients who are in the high risk groups (over 70, those with a pre-existing health condition or those who are pregnant).

Updated: 24 March

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I, or my staff are in at-risk groups, and so have been advised to self-isolate. Without them I cannot run the practice. What should I do?

We understand the difficulties you face in running a practice with staff who have been advised to self isolate. The Welsh Assembly Government has agreed to pay practices a monthly income based on the practice average NHS claims over the previous three year period, and similar provisions have been made in Scotland. Northern Ireland has also made arrangements for financial support for contractors

The Optical Fees Negotiating Committee is currently meeting with NHS England to agree what financial support will be available to practices in England. This page will be updated when more information is available. 

The Westminster government has announced a support package for businesses. In the meantime, there is advice from other organisations to support your business. For example:

Updated: 1 April 2020

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I have underlying health conditions and so have been advised to work from home but, if I am seeing patients, I cannot do that. What should I do?

This is a very difficult time, particularly for those who are unable to work from home. You should discuss with your employer what support they can give you. If you are ill, Statutory Sick Pay will now be paid from day one, instead of day four, for those affected by coronavirus. Check current government advice. The CBI have advised that while there is still legal uncertainty about whether preventative self-isolation qualifies for Statutory Sick Pay (SSP), the Westminster government has announced its intention for the law to apply in this way. 

The Westminster government has announced a package of support measures for workers.

Updated: 1 April 2020

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What is the current situation regarding financial support for practice owners, locums and other self-employed optometrists?

The Westminster government has now announced support for self-employed people in a similar vein to that for those who are employed. 

In addition, the College is urging NHS England to provide the same level of financial support to primary care optometry practices in England during the COVID-19 pandemic as in the rest of the UK.

FODO has developed some guidance that you may find useful.

Updated: 1 April 2020

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How can I access information to give to patients during the lockdown period?

Our patient information on a range of conditions, including AMD, blepharitis and flashes and floaters, is available for free on lookafteryoureyes.org  – our public website. We recommend that you direct your patients here for phone- and desktop-friendly information during the lockdown period.
 
You can also link straight through to lookafteryoureyes.org from your practice website.
 
Our printing company are unable to fulfil orders for printed patient leaflets at this time, so we have also temporarily made our patient leaflets available online. Members can fill in our form to receive PDF versions to use for the duration of the lockdown only. The PDF versions were not designed for use on websites, so please direct your patients to lookafteryoureyes.org in the first instance.

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

While the current clinical advice on the delivery of essential, urgent and emergency eyecare remains in place, and routine sight testing remains suspended across the UK until further notice, the UK government has published guidance to help employers understand how to work safely through the pandemic. It aims to support employers “get their businesses back up and running and workplaces operating safely”. The most relevant guidance for practice owners are: 

There is also a COVID-19 secure compliance notice you can display once you have completed actions in the official guidance.
These guidance apply to England – See guidance for Wales, Scotland, and Northern Ireland
 
Optometrists should read the guidance above alongside the College of Optometrists and country-specific guidance at the top of this page. 
 
We are now in the process of developing guidance for practitioners in all four nations as we move out of lockdown and through the next phases of the pandemic.

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Personal protective equipment (PPE) and infection control

What PPE should I wear?

New guidance has now been issued by the national public health bodies. This includes guidance for primary care. It is now recommended that, for direct patient care at less than 2m, even if the patient is not currently a possible or confirmed case of COVID-19, clinicians should wear single-use disposable aprons and gloves (changed for each patient). 

In addition to gloves and aprons, practitioners are advised to risk assess whether they feel they need to wear a fluid-resistant surgical face mask (type IIR) and/or eye/face protection such as goggles or a visor if there is an anticipated or likely risk of contamination with splashes, droplets of blood or body fluids. If masks and/or eye/face protection are worn they can be worn for the whole session (‘sessional use’) rather than changed for each patient, unless they become soiled, damaged or uncomfortable. 

Optometrists who are seeing patients should follow the same advice and we recommend that all optometrists working within 2m of a patient should choose to wear a surgical mask. For further information on assessing risk, see section 7 of the “COVID-19 personal protective equipment (PPE)” guidance.

Advice on the specification of PPE can be found here.

Fluid-resistant face masks are worn to protect the wearer from the transmission of a virus by respiratory droplets, which may be released from the mouth during coughing, sneezing or speaking. They may also reduce the risk of contamination of oral and nasal mucosa by accidental touching of your mouth or nose with a contaminated hand. They can be worn for sessional or single use and must be fitted properly around the nose, but do not require a ‘fit test’.

You should also use a plastic breath shield attached to your slit lamp and disinfect this between patients. This is because studies show that the COVID-19 virus is viable for up to 72 hours on plastic surfaces. You should avoid speaking at the slit lamp.

Primary care practices should not be seeing patients with symptoms of COVID-19. If you work in a secondary care setting where this is the case, please check table 1 of the national guidance. To preserve supplies of PPE and not require people to make visits to the practice unnecessarily, you should conduct a virtual consultation in the first instance.

Updated: 19 May 2020

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What type of mask should I wear?

Respiratory droplets from infected people, who may be asymptomatic or pre-symptomatic, are a major mode of transmission of the virus. These may be generated by coughing, sneezing, talking and breathing. Fluid-resistant face masks are designed to protect others, but may also protect the wearer from respiratory droplets. They may also reduce the risk of contamination of oral and nasal mucosa by accidental touching of the wearer’s mouth or nose with a contaminated hand. They can be worn for sessional or single-use and must be fitted properly around the nose, but do not require a ‘fit test’. 

Updated: 19 May 2020

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

Wearing a FFP3 or FFP2 mask is not recommended for primary care optometrists seeing non-Covid-19 symptomatic patients. However, if you wish to wear a FFP3 mask this requires a fit test. If a FFP3 mask is not available the HSE advises that FFP2 may be an acceptable, pragmatic compromise. HSE advises that it is widely accepted by industry that the N95 masks are comparable to FFP2 masks.

Updated: 19 May 2020

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Should my reception staff or patients wear PPE?

As respiratory droplets can be released from coughing, sneezing, speaking or breathing, UK Government advice is that people who work in an enclosed environment, where it is not possible to maintain social distancing, should cover their nose and mouth with a face covering. This would apply to your patients, and other members of the practice team if they are not able to maintain a 2m distance from others. This does not mean that everyone should wear a surgical mask, however, and there is advice on how to make a face-covering here.

Updated: 19 May 2020

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How do I put on and take off PPE correctly?

When using PPE you must be fastidious to avoid transmitting the virus via your hands or your clothes. Do not take the mask on and off between patients and do not allow it to dangle on your chest. Written instructions can be found here and useful videos on how to put on and take off PPE can be found here and here

Updated: 9 April 2020

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How should I dispose of my PPE?

Clinical waste is normally disposed of in the clinical waste stream. However, due to the unprecedented levels of PPE waste being generated, your waste provider may recommend that you double bag PPE waste and store it in a safe area for 72 hours and then dispose of it in your normal trade waste stream. Contact your waste provider for further advice.

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Do I still have to wash my hands and use other infection control techniques if I wear PPE?

PPE is not a substitute for distancing and scrupulous hand-washing, which remain essential.

You should also continue to maintain a high standard of infection control every time. Clean the consulting room door handle, computer keyboard, slit lamp joystick and clinical area regularly with an alcohol wipe.
 

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What is the College doing to help us get PPE?

The College is working with the other UK optical bodies to raise this issue with national governments, to ensure that optometrists and other primary eye care staff are provided with appropriate PPE so that they can meet the urgent and essential eye care needs of their patients and protect themselves and their communities.

In addition, together with the other optical bodies, we have written to NHS England and NHS Improvement, Public Health England and the Academy of Medical Royal Colleges to stress the importance of PPE for optometrists who are providing urgent and essential eyecare services and ask that they ensure that optical practices are provided with sufficient quantities. We understand that national public health bodies are working to arrange supply of PPE to optical practices. We will update our website when we have further details on this.

Updated: 9 April 2020

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Are there any other things I can do to minimize my risk of contracting or transmitting the infection?

If you need to see patients for essential or urgent eye care, as well as using normal infection control procedures, and regular and scrupulous hand hygiene, there are things you can do to minimise the risk to you and your patients. Read our guidance for optometrists.

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What should I do if a patient refuses to wear a face covering?

If the patient refuses to wear a face covering you should consider whether there is a reasonable reason for this, such as the patient having a respiratory condition or a learning difficulty. In such circumstances you may wish to see the patient without them wearing a face covering, although if this is the case you should adapt the examination so that you do not use a handheld instrument. If the patient does not bring a face covering to the practice, you may choose to provide them with one or ask the patient to come back at another time with a face covering to wear. Young children under three should not be asked to wear a face covering. If you need to perform direct ophthalmoscopy on a child under three you should risk assess whether the examination can be postponed to when the social distancing measures have been relaxed.

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I am unable to get PPE – what should I do?

We advise that if you are unable to get the PPE to enable you to see patients according to national guidance, you should not conduct face to face consultations at a distance of less than 2m. We realise that this means that in most cases you will be unable to see patients. However, you can provide other services that do not require face to face contact, such as supplying spectacles or contact lenses by post, or offering telephone or video advice. 

Updated: 9 April 2020

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Clinical

Can I use direct ophthalmoscopy?

We advise using SL-BIO rather than direct ophthalmoscopy so that you can maintain a safe distance from the patient as much as possible. However, we recognise that there are occasions where this is not possible, such as for very young children, or when the patient is unable to reach the slit lamp. Fundal imaging is a useful technique, but it does not replace the use of SL-BIO, as it does not examine the patient's external eye, anterior chamber, or media. We also recognise that not all practices have fundus cameras, and that there are some patients who cannot reach the camera. In these instances, as an internal examination is one of the legally required parts of a sight test, if there is no alternative but to use direct ophthalmoscopy, you should minimise the infection risk by asking the patient to wear a face covering if possible (this may not be possible for very young children).

Updated: 16 June 2020

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Which type of tonometry should I use?

During the pandemic, we advise that you should only perform tonometry if it is clinically necessary, based on the individual patient circumstances, rather than doing it as a blanket test on everyone in a certain category. To maintain a safe distance, use a slit lamp mounted (such as Goldmann) or stand-mounted tonometer where possible. If this is not possible, you should risk-assess whether to use a handheld device such as an iCare, Perkins or Pulsair.

Updated: 19 June 2020

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How do I conduct a telephone or video consultation with a patient?

We recognise that this is a very new situation for optometrists, so we have written guidance to help you consider how best to have a telephone or video consultation with a patient. We have also designed a telephone consultation record sheet which you may choose to use if you wish. It is important to realise that you still need to adhere to confidentiality and data security procedures.

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Should I complete pre-screening?

During the pandemic, we advise that you should only perform tests if it is clinically necessary, based on the individual patient circumstances, rather than doing it as a blanket test on everyone in a certain category. Tonometry and visual fields should be performed where it is clinically indicated or for considered at high risk by their optometrist on an individual basis. 

Updated: 19 June 2020

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What urgent conditions should be referred to the Hosptial Eye Service?

Routine outpatient appointments in the HES have been suspended. 

If a patient reports a serious eye condition that will require urgent or emergency hospital treatment you should direct them to the HES without asking them to come to your practice. The Royal College of Ophthalmologists advise that patients who need to be seen and treated urgently by the HES include those with suspected: 

  • Glaucoma
    • acute glaucoma
    • uncontrolled very high IOP >40mmHg or rapidly progressive glaucoma
  • Wet active age-related macular degeneration
  • Sight threatening treatable retinovascular disease (proliferative diabetic retinopathy and CVRO)
  • Acute retinal detachments (macular on, macular off < 4weeks)
  • Uveitis – severe active
  • Ocular oncology - active, aggressive, uncontrolled or untreated lesions
  • Retinopathy of prematurity (screening and treatment)
  • Endophthalmitis
  • Sight threatening trauma
  • Sight threatening orbital disease e.g. orbital cellulitis, severe thyroid eye disease
  • Giant cell arteritis affecting vision

Updated: 8 April 2020 

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What if a patient needs new contact lenses and their CL specification has expired so we cannot supply them with lenses. Do they have to come in for a fitting?

We understand that optometrists would like to use their professional judgement on this, and the GOC has issued advice on this. We have a proforma to help you triage patients who have out of date contact lens specifications or spectacle prescriptions. The forms can be used by practioners completing and recording a telephone review and then issuing a temporary supply.

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

There have been several media reports relating to the safety of contact lens use in this pandemic. We have seen no evidence to suggest that wearing contact lenses would increase a person’s chances of contracting COVID-19. Patients can continue to use their contact lenses as normal if they do not have COVID-19 or any of the associated symptoms (fever, new continuous cough or anosmia (loss of taste or smell)). 

It is good general advice for patients to reduce their contact lens wearing time if they do not need to wear their lenses and can manage with spectacles, as may well be the case if they are at home more. If they wish to wear their contact lenses you should stress to patients that they should practise good contact lens hygiene as always, and that thoroughly washing their hands before and after handling their lenses is essential. 

We would also advise that if patients are ill, they stop wearing contact lenses until they are better. This applies to all illnesses, including the common cold, influenza and COVID-19.

If you wish, you may advise patients that if they are in the same household as a person with symptoms of COVID19 they may wish to stop contact lens wear until everyone in the house is well.

A paper on the important considerations for contact lens practitioners during the COVID-19 pandemic has been published here.

Updated: 19 May 2020

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We normally provide post-cataract check-ups for the local NHS. Should we continue to do this?

Routine cataract operations are being postponed by the hospital, so it is likely that the number of patients coming to you will cease, and some areas are recommending that you do post-operative reviews remotely. If patients do come to you, use appropriate social distancing and infection control measures as outlined above.

Updated: 27 March 2020

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What should I do if a patient identifies as being at risk of having COVID-19 in the consultation room?

If College advice is followed, patients should not attend the practice if they show signs of COVID-19 infection. However, if COVID-19 is considered possible when an appointment is already in progress, assess a suitable and safe point to bring the consultation to a close, withdraw from the room, close the door and wash your hands thoroughly with soap and water. Refer to the relevant national guidance for next steps.

Updated: 23 March

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I did not make up spectacles for a patient who I recently referred for cataract surgery. However, as their surgery is now likely to be delayed should I make them up some?

This is up to your professional judgement. We suggest you telephone the patient and explain the situation and ask them if they would like you to make up some spectacles for them.  If you have previous details you may be able to do this remotely (for example if they are happy for you to reglaze their spectacles, which they can post to you), and post the reglazed spectacles back to them.  If they would prefer to have a new frame then arrange for them to come into the practice for dispensing and take appropriate social distancing and infection control procedures as outlined above.

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How can I tell my patients to check their visual acuity remotely?

We have created a simple and easy to use visual acuity (VA) chart which patients can use at home. The chart has been designed to work at 3 metres, and will enable patients with access to an A4 printer to approximately measure their own visual acuity in advance of the remote clinical assessment. You can email the chart to patients, so a rough visual acuity can be recorded during the remote review.
 
The chart can be used at different distances to extend its range, we have included a conversion table so clinicians can easily record an approximate VA when used at 1 and 4 metres.
 
You can download and send the chart to your patients, or direct them to our public website, where they can also watch a video on how to use the chart.


Disclaimer: 

We have taken the steps necessary to ensure this test is broadly equivalent to a validated vision chart when it is used in a well-lit room, printed on an A4 size piece of white paper used at the correct distance.  However, our chart has not been independently validated as such, it is not a substitute for a vision assessment by a clinician using a correctly calibrated and validated vision test chart. The purpose of this College chart is to provide a broad evaluation of visual acuity in order to identify clinically significant sight loss in a home environment, in conjunction with a virtual clinical assessment.

The acuities given for each line are approximate equivalents to aid optometric differential diagnosis. The room illumination, chart distance and printing contrast may all vary. Optometrists should be mindful of this when considering a patient supplied self-recorded visual acuity along side other findings. However, even with these caveats, where a person can print and complete the test, the benefit of knowing an approximate and broadly equivalent level of vision, is in our view a useful aid to any telephone or video clinical review. We would welcome the development of an validated and fully automated visual acuity recording app for home use.

Updated: 22 April 2020

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Driving

What should I do if a patient needs to have a medical or asks for a driving vision/VA or visual field test?

The DVLA has confirmed that although online services are running as normal, paper applications sent to their office in Swansea are taking longer to process. They have therefore advised that providing the patient has a current driving licence and they have not been told by their doctor or optician that they should not drive, the patient will be able to drive while the DVLA is considering their application.

The DVLA has also advised that the Government is making temporary provisions for bus and lorry drivers aged 45 or over to forego the need for a D4 medical in order to renew their driving entitlement. These changes are temporary and will only apply where the licence did not expire before 1 January 2020.

If a taxi driver needs a vision/VA or visual field test we suggest you ask the driver to check with the licensing authority as to whether this can be postponed until the social distancing measures are over. 

We have also added information on our patient-facing website, LookAfterYourEyes.org.

Updated: 18 June 2020

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CET

Do I still need to meet the GOC’s CET requirements for this year?

The GOC advises that it is still important to maintain and develop your knowledge, skills and professionalism, even during this emergency situation, and so the overall current cycle requirements for CET will remain in place to be completed by 31 December 2021.

However, the annual recommendation of six CET points has been waived for 2020.

In keeping with guidance on social distancing, the GOC will automatically allow all registrant-led peer reviews to be conducted using video-conferencing technologies. All other requirements, including the minimum period of one hour and the need to have this approved by the GOC in advance, remain in place.

Updated: 6 April 2020

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Scheme for Registration

 

Independent Prescribing

What is being done to ensure optometrists can continue to undertake IP training?

We recognise the expertise of IP optometrists, and that this is likely to be of increasing relevance in the current situation, with patients being diverted from secondary care.

In addition, we are actively addressing the following:  

  • Seeking to achieve the required regulatory change to enable IP optometrists to supervise other optometrists on IP placement, rather than a medical practitioner (ophthalmologist) having to take on this supervisory role.
  • Working with optometry university departments seeking to increase optometrists’ access to the theoretical component of IP education.
  • Optimising how public funding can be drawn upon to support more optometrists undertake IP education.

Through collaboration with different stakeholders, we hope that it will be possible to achieve the required sequence of changes to enable more optometrists to integrate IP into their practice.

Update: 1 April 2020
 

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I was due to sit my IP exam, but I couldn’t because it was cancelled. Can I ‘act up’ during this pandemic, as I have nearly qualified?

We have received confirmation that the GOC is not currently planning to set up a temporary register, as some other regulators have done in the current exceptional circumstances. Such arrangements, which enable practitioners who’ve retired or stepped away from practice to return, or enable students to progress into practice, are not deemed needed for the optical professions and not to reflect current needs and issues for the professions.

Where other regulators have set up temporary registers, they have expressly excluded IP from their temporary register arrangements. We understand that this is part of their risk management measures.

Although this means that optometrists who have trained for prescribing rights, but not yet obtained them will not be admitted onto the specialist register, we recognise that the broader skills that IP education helps to develop can and should be promoted as part of the broad contribution that optometrists can make to patient care.

Updated: 1 April 2020

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I have my IP assessment coming up. Is this still going ahead?

Following the cancellation of the April 2020 Therapeutics Common Final Assessment in Independent Prescribing due to the current Covid-19 restrictions, we have been working hard to find a software solution that allows candidates to sit this examination remotely, while assuring the integrity of the assessment process. We have been keen to provide an alternative date and mode of delivery for this examination sitting as swiftly as possible.
 
We have now done this and are able to offer those candidates who were enrolled on the TCFA examination in April 2020 to sit this remotely in early May 2020. Affected candidates have been contacted by email.
 
The arrangements are still subject to GOC approval - we have submitted our proposal to run the exam remotely to the GOC, as we are required to do under GOC accreditation, and expect to receive a response on this shortly.
 
This examination sitting will be limited to those who were originally enrolled to take the TCFA on 1 April. We will release details of future remote examination sittings in due course.
 
For those candidates who have enrolled on the June 2020 TCFA examination, we will be unable to run this examination face-to-face as planned in London. We are actively pursuing arrangements to run this remotely once the rearranged April sitting is completed in May, and will be in touch with those affected candidates soon.

Further updates on the Independent Prescribing exam can be found here.

Updated: 17 April 2020

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Other questions

I am really worried about this situation and how it will affect me and my family

We understand how worrying this unprecedented situation is. MIND has some really useful information on their website. There are also several coronavirus community aid groups being set up for people who are self isolating, who may be able to give you some support locally. 

If you need to talk to someone you can call the Samaritans for free on 116 123.

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Is there any training available so I can become more informed about COVID-19?

The World Health Organisation provides a free online course for healthcare professionals which takes about an hour to complete. It may be useful for each practice lead to complete this training, but it is not compulsory.

The College now runs online COVID-19 CET courses based on the latest College and national guidance:

Updated: 3 July 2020

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You can read more here:
Please look on our social media channels for continued updates on coronavirus (COVID-19).

 

Past updates and announcements

2 July 2020: Daily update

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30 June 2020: Daily update

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29 June 2020: Daily update

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26 June 2020: Daily update

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25 June 2020: Daily update

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24 June 2020: Daily update

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23 June 2020: Daily update

  • The College ran a live Instagram Q&A session yesterday, answering all your amber phase guidance queries. Watch the video.

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15 June 2020: Daily update

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11 June 2020: Daily update

  • Yasmine Sahraie: Life in lockdown. Join optometrist, Yasmine Sahraie MCOptom, as she gives us an insight into the Emergency Eye Care Treatment team in Grampian, Scotland during the COVID-19 pandemic.

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10 June 2020: Daily update

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8 June 2020: Daily update

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4 June 2020: Daily update

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29 May 2020: Daily update

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28 May 2020: Daily update

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26 May 2020: Daily update

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21 May 2020: Daily update

  • 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.

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19 May 2020: Daily update

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14 May 2020: Daily update

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12 May 2020: Daily update

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11 May 2020: Daily update

  • 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.

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7 May 2020: Daily update

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6 May 2020: Daily update

  • 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.

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5 May 2020: Daily update

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1 May 2020: Daily update

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30 April 2020: Daily update

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29 April 2020: Daily update

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28 April 2020: Daily update

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27 April 2020: Daily update

  • 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.

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22 April 2020: Daily updates

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17 April 2020: Daily update

 

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9 April 2020: Daily update

  • 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?

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31 March 2020: Daily update

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.

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30 March 2020: Daily update

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26 March 2020: Daily update

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26 March 2020: Scheme for Registration 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.

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26 March 2020: Independent prescribing (IP) examination update

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.

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23 March 2020: Recommendation to only offer ‘essential’ eye care

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. 

For the safety of the public and of our members, the College is calling on all key optical bodies to support us in urging NHS England and the HSCB (Health and Social Care Board) in Northern Ireland to tell optometrists to cease provision of all non-essential optometric procedures, including routine sight tests and eye examinations. Please note that, although we strongly support this course of action, the decision to enforce it lies with NHS England and the HSCB. In the meantime, we are asking our members to follow our strong recommendation that they cease to provide non-essential services.

We are also asking that NHS England and the HSCB provide clarification on what constitutes essential primary eye services to avoid further confusion and ensure consistency across the four nations.

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.

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20 March 2020: College daily update

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.

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18 March 2020: College daily update

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.

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18 March 2020: Joint statement from the Optometry Schools Council (OSC) and College of Optometrists on supporting final-year students’ progression to the Scheme for Registration

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.

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17 March 2020: Message to candidates due to sit the TCFA in Independent Prescribing on 1 April 2020

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.

 

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17 March 2020: Message to trainees, supervisors and assessors

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.

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16 March 2020: Member alert

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.

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28 February 2020: NHS England standard operating procedure

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. 

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