Coronavirus: the optics briefing
One in five Specsavers support office jobs at risk, an ophthalmic microscope drape, and optometrists recruited for COVID-19 contact tracing
The OT team is committed to supporting optical professionals during this challenging time by providing the latest news on how coronavirus (COVID-19) is affecting the profession.
Below is our round-up of the latest coverage. Feel free to get in touch by email to share how COVID-19 is affecting your practice and how you are adjusting to support colleagues and patients at this time.
450 Specsavers support office jobs at risk
Specsavers has stated that 450 jobs at its Guernsey, Nottingham and Southampton support offices are at risk of redundancy as a result of a downturn in business following the outbreak of COVID-19.
The multiple has confirmed that optometrists and other workers at Specsavers’ 900 stores will not be affected by the potential restructure.
About one in five workers in Specsavers support office roles could be affected by the announcement.
Specsavers CEO, John Perkins, emphasised that the company had done everything possible to avoid making employees redundant, including salary cuts for senior leaders, part-time working arrangements and making use of the government furlough scheme.
“My heart goes out to each and every one of our people who could lose their jobs,” Mr Perkins added.
NHS and Public Health England encourage optometrists to assist contact tracing efforts
Clinical workers, including optometrists, are being encouraged to assist Government efforts to stem the spread of COVID-19 through contact tracing.
The NHS and Public Health England is aiming to recruit between 3000 to 4000 healthcare professionals to the Public Health England Contact Tracing Service as home-based clinical contact caseworkers.
The job description and person specification, which includes working hours, pay rate and working from home requirements, is available online.
AOP clinical director, Dr Peter Hampson, told OT: “Thousands of contact tracers are required, and these roles need to be filled by skilled healthcare professionals with clinical experience. As a regulated profession, optometrists have the transferable skills needed to perform this role to the highest standard.”
Optometry practices reopen in Ireland as lockdown eases
Optometry practices in the Republic of Ireland were permitted to open on Monday (18 May) as part of the first phase of easing lockdown measures in the country.
Patients are now permitted to book routine sight tests at Irish optometry practices, which have introduced a variety of measures to preserve social distancing.
Routine appointments remain suspended in Northern Ireland, Scotland, Wales and England, with optometrists only permitted to offer urgent and essential eye care.
Independent optometrist, Sue Doherty, told OT that leading up to the easing of restrictions she received regular calls from patients asking when her County Cork practice would re-open.
“I think there is a real eagerness in the community for us to open again. That has kept us all going,” Ms Doherty said.
Measures introduced by Irish optometry practices to prevent the spread of COVID-19 include limiting the number of patients being allowed in practices, minimising patient contact with equipment and sterilising after each use as well as using personal protective equipment for close examinations.
Dates for the diary: online learning
The lockdown has brought a rise in the number of online learning opportunities and webinars as people seek to use the time out of practice to gain some CET points, undertake professional development activities or just connect with other eye care professionals.
This evening, (20 May) the AOP will be running a webinar exploring: ‘Myopia management – stories from the chair’ from 7-8pm.
In this webinar, optometrist and practice owner, Indie Grewal, will take participants through a variety of myopia management scenarios from his practice in St Albans, exploring his thought process, discussions with parents around the different management strategies and the options considered for each case. The webinar has one interactive CET point available.
Glaucoma and retina webcasts
Pharmaceutical company, Allergan, now part of AbbVie, has been running a weekly series of ‘Wednesday webcasts’ covering a range of topics, from COVID-19 related support to wider educational content.
This evening, (20 May), Allergan will be running a Glaucoma Wednesday Webcast from 8pm exploring the topic of ‘Planning for the new normal: resuming and developing glaucoma services post-COVID’. The webcast will feature a panel discussion chaired by Professor Gus Gazzard, consultant ophthalmic surgeon at Moorfields Eye Hospital.
Following this, the next Retina Wednesday Webcast will be held on 27 May focusing on the topic: ‘Injection services – the new normal’ featuring a panel of lecturers and ophthalmologists.
Supporting patients with nystagmus
The Nystagmus Network charity has also launched a series of new CET webinars for eye care professionals as it aims to raise awareness of the charity, engage further with eyecare professionals and “encourage referrals.”
Each providing one CET point, the webinars will run from 26 to 28 May covering topics from an up-to-date guide to nystagmus, diagnosing and testing, and dispensing and supporting patients with nystagmus.
Moorfields Eye Hospital introduces microscope ‘drape’ to reduce infection risk
Microscope drapes are being used by eye surgeons at Moorfields Eye Hospital to prevent the spread of COVID-19.
A sterile sheet is fitted around the patient and microscope to eliminate the spread of aerosol particles in the operating theatre.
Moorfields Eye Hospital consultant ophthalmologist and chief surgeon, Louisa Wickham, highlighted that the eye hospital is continuing to provide sight-saving treatment in the safest way possible.
“We are delighted to have found an innovative solution that we hope can create a safer surgical environment to help protect both patients and staff,” she said.
The technology is described in Eye as a simple and efficient method to reduce the risk of aerosol spread within operating theatres.
“It is important to highlight that this drape should not replace the use of adequate PPE,” the authors emphasised.
Self-employment financial support scheme opens early
The Government’s Self-Employment Income Support Scheme (SEISS) has opened ahead of schedule, though concerns remain about the gaps in support for those who fall out of the eligibility criteria.
The SEISS scheme will support eligible individuals with a grant worth 80% of their average monthly trading profits. Payments will be made in a single instalment covering three months and capped at £7500.
Payments were due to begin from June, but now applicants may be able to receive a grant by 25 May, or within six days of completing a claim. Eligible individuals have been assigned a specific date on which to apply, which can be checked online.
Welcoming the early launch of the scheme, Tony Stafford, AOP policy director, told OT: “This will help those of our members who qualify for the scheme to obtain financial help quickly. It’s important that this scheme is now extended beyond the initial three months, as the furlough scheme for employees has been.”
However, eligibility for the scheme is still limited to those who earn at least half their income through self-employment and who traded in the tax year 2018 to 2019. An eligibility cap on the scheme means those who earn more than £50,000 per year are not entitled to support.
“Many of our self-employed members still can’t access the scheme because its rules are unfair,” the AOP’s Mr Stafford said, adding: “The people affected include those who don’t have a long recent track record of self-employment, and people who were making just above the £50,000 ceiling. Members who route their income through dividends are also losing out, as are people who earn slightly more from employed work than from self-employment.”
Mr Stafford emphasised that the AOP is continuing to press for additional support, explaining: “We’ve raised these problems with the Treasury and the Department for Business, Energy and Industrial Strategy (BEIS), and are working with the British Dental Association (BDA) and other representative bodies to press for change.”
COVID-19 and optics: seven insights from the GOC
The General Optical Council (GOC) held its first council meeting since the outbreak of the COVID-19 pandemic on Wednesday (13 May) using videoconferencing software.
Below OT summarises seven points from the meeting.
1. No GOC registrants have died from COVID-19
In a report prepared for the meeting, GOC chief executive, Lesley Longstone, noted that to date the regulator is not aware of any fatalities from COVID-19 within the GOC’s registrant base.
“At the time of writing, I am pleased to say that we are not aware of any COVID-19 related deaths among our registrants,” she said.
2. Retired optometrists and dispensing opticians could be invited to re-register if demand escalates
Alongside the normal GOC registration renewal process, the registration and policy team have been working together to develop plans to invite retirees to re-register if demand for optical services outstrips supply.
Ms Longstone noted that to date the feedback from the sector to date has been that this measure will not be necessary.
“The curtailing of routine appointments and the shielding of the elderly and vulnerable members of the public means that there is excess supply,” she shared.
The situation will continue to be monitored by the GOC.
3. Optometrists attempting to go to work were stopped by police amid initial confusion
The GOC’s interim director of strategy Marcus Dye shared that although optometrists were designated key workers following the outbreak of COVID-19, there was some confusion on this point during the initial stages of lockdown.
“We were aware that some opticians’ practices were initially advised to close and staff advised to return home by police,” he noted.
“This was later resolved through changes to government guidance and we are not aware of any ongoing issues here,” Mr Dye added.
4. Hospitals, pharmacies and ‘track and trace’: potential redeployment opportunities for the optical sector
Mr Dye highlighted that the GOC is aware that optometrists and dispensing opticians working in Scottish hospitals have been redeployed into other roles to support the COVID-19 response.
Meanwhile, in England, some optometrists have retrained to support hospital services including within the new Nightingale Hospitals.
He noted that GOC case examiner Rosie Gavzey has assisted within the Nightingale Hospital.
The GOC is exploring opportunities for registrants to assist both in the new ‘track and trace’ scheme and within pharmacies.
“The pharmacy sector has seen increased and sustained demand for services over the period of the emergency and has been seeking to recruit further resources to cope through a campaign to recruit retired pharmacists and through access to volunteers,” Mr Dye shared.
5. NHS England chief executive aims to restore routine primary care services by mid-June
GOC meeting notes revealed that NHS England chief executive, Sir Simon Stevens, sent a letter on 30 April indicating “a desire to return to delivering ordinary services within a period of six weeks.”
The letter includes a reference to primary care services. The GOC is awaiting further clarification from NHS England on how this will apply to optometry and dispensing optics.
“It is still unknown whether the general public and patients will want to return to routine care in optical practices and this may affect demand for services,” Mr Dye said.
6. Most GOC employees may work from home until the end of the year
Speaking at the GOC meeting, chief executive Lesley Longstone highlighted that the regulator has changed its approach to fitness to practise cases, education and applying standards in light of COVID-19.
“What a different world we are operating in compared to the last time we met,” she said.
The regulator is taking a function-by-function approach in deciding the best way for GOC staff to work, Ms Longstone highlighted.
She envisaged that the “vast majority” of roles will be performed remotely until the end of the year.
“My presumption is that we are going to carry on remotely for a very significant period of time,” she shared.
7. Do I treat a patient if I don’t have PPE?
Interim director of strategy Marcus Dye highlighted that the GOC is looking at releasing a statement on PPE and professional judgement, considering issues in accessing PPE among optometrists.
This would address the situation where a registrant may have to make a judgement about whether to treat a patient if they do not have the correct PPE.
“We want to put a statement out to reassure and support registrants,” Mr Dye emphasised.
A document prepared by Mr Dye in advance of the meeting elaborated on the issue of PPE supply within optometry.
“We are aware that optical professionals are a lower priority than other frontline workers such as doctors and have experienced difficulties in accessing the equipment they need,” he noted.
“If a registrant does not have access to adequate PPE for some procedures, they will need to consider the risk to themselves and their family members in examining or treating patients where there is a risk of infection,” Mr Dye observed.
Speaking at the meeting, GOC council member and optometrist, Dr Josie Forte, emphasised: “One of the biggest barriers to getting back up and running to some state of ‘new normal’ is the lack of a consistent supply of PPE across the sector.”
The personal impact: “This is an invisible war”
At the GOC meeting on Wednesday (13 May), Scottish optometrist Scott Mackie described providing eye care to a population of 40,000 patients in an area usually served by 20 optical practices through an Emergency Eyecare Treatment Centre.
“We have been talking about how practice may change, but practice will change. This is the first time I have been wearing a tie in six weeks. I’ve been in scrubs. I’ve seen patients who have died,” he said.
Talking to the meeting remotely, Dr Mackie gestured to a framed picture on his wall of a letter King George wrote to schoolchildren at the end of WWII. He highlighted the parallels between that time and now.
“This is an invisible war. It will never go back to how it was,” Dr Mackie said.
Dr Mackie shared that his practice is working on the assumption that it will be operating at 60% capacity over the next year.
We have been talking about how practice may change, but practice will change. This is the first time I have been wearing a tie in six weeks. I’ve been in scrubs, I’ve seen patients who have died
While there have been challenges, Dr Mackie emphasised that the crisis has also brought opportunities for new ways of working.
He has been able to access GP records and communicate with secondary care using teleophthalmology.
“We have been able to enact things that would usually take years in weeks,” he said.
Welsh optometrist and GOC council member, Helen Tilley, told the meeting that she has seen 250 emergency cases through her small practice since the crisis began.
“I have been working more now than I ever have in the past 25 years,” she said. She highlighted that the financial implications of the pandemic for optical practices are “huge.”
“We are not going to be able to see the same volume of patients,” Ms Tilley added.
Optical bodies seek answers on return to routine sight testing in the UK
The Optical Fees Negotiating Committee (OFNC), Optometry Northern Ireland, Optometry Scotland and Optometry Wales have confirmed that they are working closely with governments and the NHS to provide more information for practices on routine sight testing in the UK.
This follows the UK Government announcement on Monday 11 May that some parts of the economy in England should now be open, as long as they adhere to current national guidance and sector-specific advice.
Routine sight testing currently remains suspended across the UK.
“Opticians across the UK are essential services and continue to operate in accordance with College of Optometrists and local NHS guidance, as they have throughout the pandemic. The current clinical advice on the delivery of essential, urgent and emergency eye care remains in place, as confirmed in a joint statement by the College of Optometrists and the Association of British Dispensing Opticians on 11 May,” the OFNC, Optometry Northern Ireland, Optometry Scotland and Optometry Wales explained in a joint statement.
The Welsh Government has issued a letter from the Chief Optometric Adviser reiterating the advice to the public in Wales outlining the current situation, which is that for the next three weeks, until further review, Wales remains in a state of lockdown.
The Northern Ireland Assembly has published a five-stage plan to ease Northern Ireland out of lockdown. The roadmap to loosening COVID-19 restrictions does not include target dates. The situation in Northern Ireland remains unchanged and will be reviewed in three weeks.
Hospitals note “worrying” drop in retinal detachment presentations to emergency walk-in units
Hospitals across the country have noted a drop in the number of patients attending accident and emergency during the lockdown, with some emergency eye clinics noting a similar decrease.
The lockdown restrictions do allow the public to leave their homes for medical needs, but findings reported by the NHS suggested that four in ten people are concerned about “being a burden” on the NHS.
Speaking to OT, Felipe Dhawahir-Scala, consultant ophthalmologist and vitreoretinal surgeon and director of the Acute Ophthalmic Services at Manchester Royal Eye Hospital shared that the hospital’s emergency walk-in unit had seen a reduction in the number of patients, from approximately 110 per day to between 35 and 40.
Mr Dhawahir-Scala highlighted that the reductions have mainly been in those conditions that can be treated within the community, adding that the hospital has seen more of the urgent cases “that have always been important to see in an emergency eye department.”
The hospital has particularly noticed a decrease in the number of patients attending the emergency department with retinal detachments, which Mr Dhawahir-Scala said was particularly “worrying” due to the sight-threatening nature of the condition if untreated.
In April this year, the hospital saw 25 patients presenting at the emergency department with retinal detachment, compared to 49 in April 2019, a decrease of 49%.
“We were puzzled as to where all these patients were,” he continued, adding: “My concern at the moment is that retinal detachments should still happen, there is no reason we’ve analysed that could stop retinal detachment from happening.”
Mr Dhawahir-Scala suggested the reasons for the drop in attendance are complex and may require further consideration, but as the weeks have gone by, attendance has begun to rise again.
“Make time for your eyes”: AOP launches campaign highlighting the importance of eye care in lockdown
The Association of Optometrists (AOP) is reminding the public of the importance of eye care as part of a campaign that highlights a number of ways in which the lockdown has affected people’s eye health.
Reminding the public: “There’s never been a more important time to look after your eyes,” the campaign highlights the importance of wearing eye protection during DIY, regular screen breaks, and cautions the public around buying contact lenses online.
“Unfortunately, the shift in lifestyle is taking a toll on many people’s eye health,” explained Optometrist and AOP spokesperson Henry Leonard, highlighting an increase in DIY-related injuries seen across hospitals and practices: “Patients are needing to have foreign objects removed or chemical burns treated because they are not wearing safety goggles.”
Oxford Eye Hospital is amongst those reporting a spike in serious eye injuries as a result of lockdown DIY-projects, reporting six in one week in April – where one in every two to three weeks would be typical.
“Other areas of concern include people buying contact lenses from unregulated suppliers online and a surge in people experiencing headaches and eye strain as they turn to television, mobile and computer screens for work and entertainment,” Mr Leonard added.
To share essential eye health advice, the AOP has launched a range of graphics and videos for use on social media, accessible online.
“There are many things people can still do to protect their vision – including making sure they have eye protection to do DIY, taking regular breaks from their screen and buying contact lenses from a reputable supplier,” Mr Leonard continued, also highlighting resources for patient advice on the AOP website.
“A huge weight off my mind”: furlough scheme extended until October
The government has confirmed the extension of a furlough scheme that encourages employers to retain workers despite the financial challenges posed by the COVID-19 pandemic.
Chancellor of the Exchequer Rishi Sunak announced on Tuesday (12 May) that the furlough scheme would continue unchanged until the end of July, with the government covering 80% of monthly earnings up to a cap of £2500.
From July to October, employees will still receive 80% of their monthly wage – although employers will be asked to cover some of this cost.
There will also be more flexibility around allowing furloughed employees to work part-time while receiving the payment.
Here in Scotland it looks like the new normal of social distancing will be with us for some time and that means it’ll be quite a while before we’re operating at full capacity
Mr Sunak highlighted that further detail on how the furlough scheme will operate over the coming months will be released by the end of May.
Cameron Optometry managing director, Ian Cameron, shared with OT that the furlough scheme has been a “lifeline” for his practice.
“Here in Scotland it looks like the new normal of social distancing will be with us for some time and that means it’ll be quite a while before we’re operating at full capacity,” he shared.
“Knowing the scheme is running for longer gives me reassurance that I can un-furlough staff gradually if I need to, allowing my operating costs to steadily increase in line with income and not swamp it as soon as we open. That’s a huge weight off my mind as I figure out how to best look after my team and pay the wage bill each month,” Mr Cameron emphasised.
Finance director for the Hakim Group, Suaib Issa, told OT that the announcement helps companies to plan suitable strategies for their respective businesses.
“It is important that there is no cliff edge to the government support as our economy starts to fire up again. Consumer confidence and mobility will most likely take time to ramp up as lockdown eases, and the government’s job retention scheme needs to wind down at a rate that takes this into account,” Mr Issa emphasised.
He added that the full details of the extension have not been released yet, including information about how the cost will be shared between government and employers after July.
BBR Optometry managing director, Nick Rumney, told OT that he thinks the Chancellor has taken the right approach.
“On balance I think he’s got it right. Enough incentive to get people back into a productive economy but not overly generous to make it easier to stay put. I might have liked the part-time furlough option to come in in July but hey, two out of three ain’t bad,” he said.
Mr Rumney added that practices are examining staff rotas and opening hours to enhance social distancing when routine sight tests are offered again.
He does not envisage routine practice returning before the start of July.
“No one expects practices to be seeing the same patient throughput per hour and so gradually re-introducing staff will be tricky and a phased return to work would be nice,” Mr Rumney added.
AOP head of employment, Liz Stephenson, said: “We welcome the announcement and look forward to more detail as soon as possible to allow employers and employees to plan for the future.”
“The AOP is also continuing its work with other representative bodies to press the government to fix the gaps in its current support for workers, particularly those who are not eligible for furlough and those who are wholly or partly self-employed,” she said.
Government outlines COVID-19 safety measures for different work settings
The government has published a series of guidelines by workplace setting to help employers, employees and self-employed workers safely return to work during the COVID-19 pandemic.
The advice for optometrists from optical bodies is that routine sight tests remain suspended until further notice.
Optometrists are not mentioned specifically within the new guidelines, although chemists are named within the ‘shops and branches guidance.’
The guidance also includes a section for people working in, visiting or delivering to other people’s homes.
A range of topics are covered for each workplace setting, including social distancing at work, who should attend work, cleaning the workplace and personal protective equipment.
Domiciliary optometrists grapple with challenges of providing eye care to shielding patients
While the government outlines its planned steps to bring the country out of lockdown and ease restrictions, the optical sector is considering what this means for the future of resuming routine eyecare services.
Those in domiciliary eyecare are particularly considering what the future could mean for them as care homes shield vulnerable patients and social distancing requirements remain in place.
Gordon Ilett, optometrist, AOP Board Member and co-chair of the Optical Confederation’s Domiciliary Eyecare Committee, described the impact of the coronavirus (COVID-19) outbreak and lockdown on domiciliary providers as “devastating” as care homes closed their doors to shield vulnerable patients.
While NHS England is looking at domiciliary eyecare and what can be allowed, the Domiciliary Eyecare Committee is considering the role they believe domiciliary optometrists could take in the ‘new normal’.
“We need to be on the front foot, emphasising the fact that domiciliary eyecare is important, and even more important in the new world with the population of people who are shielding,” Mr Ilett commented, adding: “We can’t overlook that part of the population in suitable eyecare provision.”
NHS England has sent letters to those who are “clinically extremely vulnerable” to advise them to stay home at all times and avoid face-to-face contact, with approximately 2.16 million patients identified as vulnerable.
“First of all, we are concerned about the number of people who are unable to access community care settings because of shielding – they may be in care homes or shielding in their own home,” Mr Ilett told OT.
“We also have to remember that 50% of adults in social care are of working age. That is often overlooked. So we have a big section of people with learning disabilities, autism and other social care needs who are in residential accommodation and they too are shielding and will ultimately need routine eye care,” he added.
The uncertainty of how long vulnerable people may be required to shield for poses a significant challenge for domiciliary eye care and raises concerns for those patients who do not have access to eye care.
“My real concerns are that their needs will be overlooked. They won’t have access to the levels of expertise related to eye care, and there will be numbers of people who are losing their sight,” Mr Ilett said. “There is certainly avoidable blindness occurring in those settings because there is not timely intervention.”
In the short-term, Mr Ilett explained that the Domiciliary Eyecare Committee is working on a statement to highlight the needs of these vast numbers of people who are shielding.
We need to be on the front foot, emphasising the fact that domiciliary eye care is important
He added that the committee is also considering “The opportunity for the domiciliary sector to expand its remit to visit, not just people in residential care settings, but those who are shielding in their own homes and can’t go out,” but added that clarification on the eligibility of these patients is needed from NHS England.
With the potential for care homes to be restricted to a GP or group of practices, Mr Ilett shared his hope that optometry will be able to work with the clinicians to respond to eye care needs.
Mr Ilett said the Prime Minister’s statement provided space for the various professions to lead with ideas on the way forwards and suggested this presented an opportunity for optics, commenting: “We need to come up with sensible, safe working practices, and be willing to meet the needs of the patient base who are having to shield or are in care settings where they can’t access those community settings.”
An update from the AOP
The AOP has produced an online page for members that contains the latest information relating to the evolving COVID-19 situation, as well as answers to frequently asked questions, that is being updated as the situation develops. This can be access on the AOP website.
To view OT's coverage of COVID-19 in full, click here.
As the coronavirus (COVID-19) pandemic transforms the way optometrists practise, OT is sharing the experiences of optometrists across the UK. If you, or a colleague, is interested in sharing your story, please get in touch by email.