Coronavirus: on the ground in the South Wales Valleys

We have an independent optical group with four practices in the South Wales Valleys area. Our patient base is mainly NHS and we operate in areas with high levels of deprivation. Following the COVID-19 pandemic, we completely changed our approach to running the business.

Before the outbreak, we were as welcoming and friendly as possible to patients coming through the doors. We then found ourselves having to keep the front door locked, trying to manage many patients over the phone and encouraging patients not to attend unless they had an urgent or essential problem.

The rules in Wales were similar to England under lockdown. People were told to work from home if they could, although key workers could continue to travel to work. As optometrists, we were trying to keep patients out of the Hospital Eye Service by managing as many of the acute eye problems as we could and utilising the skills of independent prescribing optometrists.

Now lockdown is beginning to ease, we’ve got more furloughed staff returning on a part-time basis and all of the practices are now open. We’re still concentrating on patients with acute problems, but we are also using spaces in our appointment system to start working our way through the list of patients with less urgent problems that has built up through lockdown. We’re not currently sending out recalls and have extended our appointment times to allow for a full clean down between patients. Optometrists and optical assistants are wearing personal protective equipment and we have a welcome station on arrival with hand sanitiser and a temperature check.

The initial stage, when we first went into lockdown, was the most difficult part. The Welsh Government decided to keep selected practices open, with other practices closing. Two of our four practices remained open, covering two cluster areas. As an employer with a responsibility towards the welfare of my staff, this was where difficult decisions had to be made.

We operated each practice five days each week from 10am to 4pm. The practices were staffed by myself, our independent prescribing optometrist and two optical assistants. After a few weeks, I think we adapted reasonably well to the ‘new world’ of optometry and then I think it gradually got easier.

Initially, I was very worried as to whether the business would be able to survive through this. I was worried about the staff and determined not to have to make any redundancies if possible. I was also apprehensive about difficult conversations around furloughing and deciding which staff would continue working. However, in reality the conversations were much easier than I feared.

I must say that I’m incredibly thankful to have such a great team who have accepted the decisions that I’ve made and how the company has handled this crisis. I’ve also been heartened by the responses we’ve had from patients who have attended with acute eye problems and from those who we’ve delivered contact lenses and repaired spectacles to. The gratitude and compliments have definitely helped with our morale.

The key priorities moving forward haven’t really changed since the lockdown started. We are aiming to keep the business going so that we can recover once Wales is in a green alert level, and retain our full team of staff with no enforced redundancies. It would also be nice to get a week in Marbella in September to unwind.

Following the outbreak of COVID-19, we saw more foreign bodies and corneal abrasion issues due to gardening and DIY accidents. There were also more patients with anterior uveitis and viral conjunctivitis. More recently, maybe due to the use of masks, we’re seeing more hordeolums.

One part of lockdown I enjoyed was personally delivering contact lenses and repaired spectacles to patients. These trips were usually done during the last two hours of the day. It was quite nice to get out of the practice, open the car windows, stick some music on and become a delivery driver. There was nothing clinically challenging in the task but I still received many compliments and thank yous.

There were some challenging moments during lockdown, and difficult discussions at home. I'm sure my family would’ve preferred it if we’d closed all the practices. However, I think they understood the duty of care we have to our patients. I couldn’t have clapped on my doorstep every Thursday evening if I felt like I wasn’t doing my bit during this crisis.