Interpreting essential care

A message from Mike George, AOP Chairman, 4 June 2020

Mike George

The AOP has been contacted by some practice-owning members in England seeking further clarification about what constitutes essential care following the Optometric Fees Negotiating Committee (OFNC) statement of 27 May. This statement attempts to clarify the situation and reassure you that the AOP is working hard to provide you with the information and guidance you need to support you through the pandemic. 

The OFNC and the AOP

The OFNC is the recognised negotiating body for General Ophthalmic Service (GOS) fees and grants for community optometry. The AOP is a member of the OFNC, alongside the Association of British Dispensing Opticians (ABDO), the British Medical Association (BMA) and the Federation of Opticians (FODO).

As a member of the OFNC, the AOP helped to develop the 27 May OFNC statement. The purpose of the statement was to promote a shared understanding of what the current restrictions on providing eye care in England – which only allow practices to offer essential and urgent care – mean in practical terms.

In the days before the statement was issued, we were approached by AOP members who were concerned that the meaning of essential care (as set out in NHS England’s letter of 1 April) was unclear, and that some optical practices were interpreting it more widely than others. 

What is essential care?

The OFNC statement emphasises that it is for optometrists and dispensing opticians to use their professional judgement to decide whether any particular patient has needs that fall under the heading of essential care. It also gives examples of patients whose needs might now meet the definition of essential care, even if they may not have done so in the early stages of the pandemic. There is clearly a risk that the ongoing lockdown may be leading to a growing level of unmet need for essential eye healthcare.

Following the publication of the OFNC statement last week, some members have told us they are concerned that some practices are now actively promoting sight test appointments to the public, despite the fact that routine sight tests remain suspended for public health reasons. 

As the statement says, it is for practitioners to decide on a case by case basis – using remote triage in the first instance – whether a patient requires essential care and should be offered a face-to-face appointment. Since the lockdown began over two months ago, and your patients may not know that you are currently able to offer essential care, in our view it would be reasonable for you to contact your patients to check their care requirements and see if they require any assistance. 

Optometrists and dispensing opticians must consider whether it is in fact reasonable to offer essential care to any given patient. We advise that in cases where you do offer a face-to-face appointment, you record your reasons for doing so.
The current restrictions are in place for public health reasons, and the safety of your patients and staff should be your first concern. You should only provide face-to-face appointments if you are able to do so safely, using appropriate PPE and following social distancing and infection control measures. We have published guidance on the steps you should take before offering face-to-face appointments during the pandemic. 

Our work with NHS England

As set out in a further OFNC statement on 29 May, the AOP and the other members of the OFNC are working urgently with NHS England to agree appropriate arrangements for practices to provide more face-to-face care, beyond essential care, as soon as possible. It seems likely that the current restrictions will be relaxed to some extent later this month and we will provide more information about this as soon as we can.

Further guidance 

If you have a clinical question you don’t think has been answered by our guidance, please contact [email protected] with the question and we will seek to include the answer in our clinical FAQs.  

Best regards, 

Mike George's signature
Mike George
AOP Chairman