“I’m most definitely getting ready for change”

Independent prescribing (IP)-optometrist, Suresh Munyal, has four practices based across the North, South, East and West of Coventry. Speaking to OT about how his business, Eyesite Eyecare Centres, is operating currently, Mr Munyal said: “The adjustments that we have made in such a short space of time have been huge.”

Sharing his experience of how practice began to change as coronavirus (COVID-19) spread, Mr Munyal recalled how as the situation worsened people began talking about self-isolating and he noticed that staff across his practice group were “disappearing bit by bit.”

“Then it hit, and we realised that the situation was getting serious,” he said.

As a result of the Government’s announcement on 23 March, the practice owner decided that “the time had come to massively decrease our exposure to the general public; partly for the safety of the public but also for the safety of our staff and ourselves,” he said.

However, during the short period between this time, the practice experienced “the toilet paper effect,” Mr Munyal shared.

“We found that everyone began to want everything now and, unlike some of my peers who I have spoken to, we were actually busier. Due to everything being so unknown at that point, people wanted to make sure that they had their contact lenses and their solutions, etc,” he said.

I was giving advice to my staff daily, but this advice was very different each day as new information and guidance emerged. I had to digest and react to each new piece of information daily

Remaining operational

Balancing being a clinician with being a business owner during the initially very uncertain times, Mr Munyal admits that he would not be surprised if some of his employees thought he had gone mad.

“I was giving advice to my staff daily, but this advice was very different each day as new information and guidance emerged. I had to digest and react to each new piece of information daily,” he shared.

Mr Munyal emphasised that “most of my staff were absolutely fantastic and completely understood.”

On 23 March, Mr Munyal decided to close two of his practices completely, while the other two remain open from 9am–1pm daily for essential and emergency care.

He has furloughed 21 of his 25 employees through the Government’s Coronavirus Job Retention Scheme, with a skeletal crew of four remaining to keep operations going.

The four staff include one optometrist, a dispensing optician and two optical assistants.

Mr Munyal explained that staff are mainly manning the telephones and responding to emails, as well as triaging photos that are sent via its NHS.net account and WhatsApp.

Last week the optometrist also took to the road alongside his wife to deliver outstanding spectacles, contact lenses, contact lens solution and eye drop orders to his patients. “I became an optical Deliveroo driver,” Mr Munyal laughed.

With all urgent orders now delivered, the business will use a Royal Mail delivery service for customers going forward. However, he highlighted that he will continue to deliver to his patients when urgent situations do arise.

“Whilst it is correct that we should only be seeing essential and emergency cases, when people are at home self-isolating, especially if they are elderly, they want to be able to read and watch television. Therefore, in this situation if they lose or break their glasses, it suddenly becomes pretty important. So, we have decided that cases like this fall under essential care and we will deliver to these patients,” he explained.

Of course I feel nervous being in practice, but I feel more nervous for my staff. I want to make sure that they are doing everything they can to protect themselves and feel a huge sense of responsibility to them as an employer

In practice

For Mr Munyal’s two practices that remain in operation, while the doors are shut, the shutters are up and therefore adjustments in practice for when patients do need to visit have been made.

This includes asking all patients a standard set of COVID-19 questions about their health before they visit, one and two metre distance markers across the practice floors and self-made shields for the slit lamps. The optometrist will wear a mask when seeing a patient, while patients are asked to arrive wearing masks too.

Over the last few weeks, patients who have been advised to present to practice include a police officer who had broken his glasses, two uveitis patients, a six-year-old hyperopic patient experiencing headaches, and a nurse with sudden loss of vision on one side.

However, Mr Munyal admits saying to his staff that he hopes they see no one each day.

“If I’m honest, in the current situation, of course I feel nervous being in practice, but I feel more nervous for my staff. I want to make sure that they are doing everything they can to protect themselves and feel a huge sense of responsibility to them as an employer,” he told OT.

That’s how independents work – you develop a relationship over the years with your patients and you try to carry this on regardless of the situation

Patients are precious

For Mr Munyal, it is important for his practices to provide essential and emergency care because “they are my patients and they are my responsibility,” he emphasised.

The business owner revealed he has just started the process of telephoning all elderly patients on his database to check in and make sure they are ok. “I have also said that if they are struggling to access essentials such as milk and eggs, they should call and I will deliver to them if I can,” he said.

While clearly a duty above and beyond his role as a clinician and business owner, Mr Munyal said that it was important for him to do this because: “That’s how independents work – you develop a relationship over the years with your patients and you try to carry this on regardless of the situation.”

Patients on the business’ contact lens care retention scheme have also received a text message to let them know the practice is there to support them if needed. However, it also advised them to consider the frequency of their contact lens use during this self-isolation period. “I want my patients to minimise their risk of needing us and putting any foreign body such as a contact lens into the eye can pose some risk. I think this is important for them to know as currently the services are not there to support them in this situation,’ he said.

Business afterwards

Discussing the ‘bigger picture’ of what business looks like when the profession returns to normal, Mr Munyal is positive. “I’m most definitely getting ready for change,” he told OT. “We will continue to use Consultant Connect and have learnt a lot from the optical verification of spectacles process that we are now carrying out over the phone, as well as contact lens aftercare calls and triage forms,” he shared.

“All of these are new systems that we can and will be putting in place when we open again,” he confirmed.

OT endeavours to keep the most up-to-date news on our website and this information was correct when published. However, the situation regarding COVID-19 is rapidly evolving. Please check OT’s rolling optics-specific coverage for the latest news and guidance on COVID-19.