Coronavirus update for domiciliary and mobile services

The Optical Confederation’s Domiciliary Eyecare Committee has issued a statement that highlights the urgent need to protect domiciliary patients, staff and providers in all four UK countries in response to the coronavirus (COVID-19), and sets out the work the committee is leading on to defend domiciliary and mobile services.

Responding to care homes that decide to isolate patients on precautionary grounds, committee co-chairs Dawn Roberts and Gordon Ilett write, “we are acutely aware that the current restrictions could easily result in domiciliary practices closing which would be in neither patients nor the NHS’s best interests. To mitigate against this unacceptable outcome, we have been supporting the national bodies (OFNC, OW, OS and ONI) and partners (College of Optometrists, GOC and LOCSU in England) who have been working urgently with governments, health departments and the various NHS systems, to ensure that GOS and other NHS funding continues to flow to practices during the crisis. Domiciliary provision because of its particular and immediate vulnerabilities has been at the top of the agenda in all four countries.”

The statement adds that the committee will also support the College of Optometrists and ABDO who are developing Q&A guidance on clinical matters while the optical bodies are dealing with NHS contractual and business queries.

The committee also invites practitioners to “let us know personally if we can help you or your staff in any way to keep this crucial NHS service operating for the most vulnerable individuals in society during this very difficult time.”

Read the statement from the Domiciliary Eyecare Committee in full

We are writing to update you on action that we have taken in response to COVID-19 at the highest-level to protect domiciliary patients, staff and providers in all four UK countries.

As we all know, domiciliary practice is similar to fixed-premises practice in that normal clinical, infection control and staff and patient health protection advice applies. You should have been receiving this advice through the NHS and the optical professional and representative organisations in all four countries.

In many ways however domiciliary practice is very different in the complexity, vulnerabilities, disabilities and co-morbidities of the cohorts of patients we care for and the fact that a lot of this care is provided to patients in care homes. We also depend on a highly skilled eye health professionals and clinical support staff who have additional training and knowledge in supporting this vulnerable population.

The cost of our skilled workforce however means that if a care home decides to isolate patients on precautionary grounds, which many have been doing, no patients in that location can receive care and the vital services we provide cannot function. Given the low margins in the sector, we are acutely aware that the current restrictions could easily result in domiciliary practices closing which would be in neither patients nor the NHS’s best interests. 

GOS/NHS services

To mitigate against this unacceptable outcome, we have been supporting the national bodies (OFNC, OW, OS and ONI) and partners (College of Optometrists, GOC and LOCSU in England) who have been working urgently with governments, health departments and the various NHS systems, to ensure that GOS and other NHS funding continues to flow to practices during the crisis. Domiciliary provision because of its particular and immediate vulnerabilities has been at the top of the agenda in all four countries.

So far, Welsh Government has announced a package of measures, including continuing funding, to keep eye care services operating throughout the crisis whether or not normal service provision is possible

Letter to Primary Care Optometry Teams[1]

Temporary Primary Care Contract Changes[2]

Frequently Asked Questions Covid-19[3]

This is very welcome.

Negotiations are also underway in England, Scotland and Northern Ireland and further announcements are hoped for in the near future.

We are also exploring how business rates and other easements may be extended to head offices and other non-retail locations of mobile businesses which do not yet benefit from the business rates relief measures announced by the government in response to COVID-19.

Potential redeployment

We are also discussing with the four governments and NHS systems how our highly trained domiciliary professional staff might be able to respond to urgent cases in care homes, which may otherwise have restricted access, and how they and our facilities may potentially be redeployed during the next stages of the crisis. For example, we are also exploring how providers might be able to support care homes based on current government advice[4].

Professional regulation

Meanwhile the General Optical Council (GOC), together with the other health and social care regulators, has made clear that we are now all working in highly challenging circumstances in which professionals may need to depart from established procedures. Where a concern is raised about a registered professional, those circumstances informed by any national guidance will be taken into account. Learn more.[5]

The GOC is also due to issue further guidance shortly about using professional judgement to make eye care as safe as possible.

Q&A

We will also support the College and ABDO who are developing Q&A guidance on clinical matters while the optical bodies are dealing with NHS contractual and business queries.

Further information

We will continue to keep you posted on development across the four countries. If you have any general queries, please contact Peter Fogarty DEC secretary [email protected] or Gary Robjent at [email protected]

Please also let us know personally if we can help you or your staff in any way to keep this crucial NHS service operating for the most vulnerable individuals in society during this very difficult time.

Dawn Roberts, Co-Chair, [email protected]

Gordon Ilett, Co-Chair, [email protected]