Practices advised to suspend routine work

The AOP has outlined advice for when to offer an appointment during the COVID-19 outbreak

Eye exam
The AOP has advised members to suspend routine appointments unless there is a clinical or strong reason to provide a sight test.

In its latest guidance, the AOP has released advice stating: “Practices should stop routine work in England as a matter of clinical judgement,” recommending members use clinical judgement to decide when it is in the patient’s best interests to provide a sight test.

“Since the start of the coronavirus (COVID-19) outbreak, we have demanded clarity from NHS England about the delivery of routine sight tests,” the AOP said in a statement, emphasising the need to prioritise “the safety of practice staff and patients.”

The guidance highlighted that while the AOP advised a suspension of routine work, “NHS England is the only body that can make a binding decision for practices in England on this fundamental issue.”

Routine eye tests in Scotland and Wales have been suspended, with a financial support package outlined to support practices during the period. NHS England hasn’t yet provided an update at the time of writing.

In a statement last week, the General Optical Council advised practitioners that where there is no clinical need for a patient to attend an optical practice, businesses can consider posting or delivering spectacles, or contact lenses (if the specification is current) to the patient.

Moorfields Eye Hospital confirmed it would be deferring non-urgent appointments from 23 March on the basis of clinical needs and in order to minimise the number of people having to travel to a clinic.

Some practices have also taken the decision to close for all except emergency appointments.

We’re looking at this from a big picture perspective; this isn’t all about us, this is about community, society and the country. Having people coming in and out of optical practices is ridiculous

Nick Rumney, managing director at BBR Optometry

BBR Optometry in Hereford has moved to operating an emergency service only, cancelling routine appointments. The practice had already taken the decision as of 15 March, to cancel appointments for those patients in the at-risk groups, including the over 70s and those with underlying health conditions.

Nicholas Rumney, managing director at BBR Optometry, told OT: “We became aware that Scotland and Wales had decided to close down GOS routine services…It became clear NHS England would be having the same conversations but there was no update.”

“By Friday morning, we felt pretty certain we needed to stop,” Mr Rumney explained. The practice implemented an emergency-only approach over the weekend.

The practice door will remain closed and patients will need to telephone ahead to gain entry. A patient’s details are taken over the phone and provided to the duty optometrist to make a decision on whether they need to be seen.

Those not already known to the practice will have an electronic record made and the optometrist can have a conversation with the patient to determine if it is a suitable emergency, such as; flashing lights, floaters, pain or loss of vision.

The practice has made arrangements with wholesale suppliers for a stock of medication such as antibiotics, steroids and antiallergics so practitioners can dispense directly, without the patient having to queue up in the pharmacy.

Mr Rumney explained that while this move was “contrary to normal guidance,” he considered “we are in non-normal conditions and we think that is the best and safest route.”

A number of BBR Optometry staff are self-isolating for their wellbeing, and remaining staff will operate on a rota. The practice has also made the decision to guarantee staff salaries for six weeks.

“We very much see our role as being supportive of trying to keep people out of accident and emergency and the GP surgery,” he said.

Commenting on the issue of continuing routine appointments during the outbreak, Mr Rumney called it “indefensibly irresponsible” for practices to be open and doing routine sight tests.

“We’re looking at this from a big picture perspective; this isn’t all about us, this is about community, society and the country. Having people coming in and out of optical practices is ridiculous,” Mr Rumney said.

Boots Opticians has also taken the decision to close its stores, confirming in a statement: “To help protect the health and wellbeing of our customers and colleagues Boots Opticians and Hearingcare stores across the UK will temporarily close.”

Stores in Scotland and Wales, as well as all Hearingcare stores, will close at the end of the day on 24 March, while stores in England and Northern Ireland will close at the end of 25 March.

A small number of the stores will remain open for those with “essential” eye and hearing care needs, the company confirmed.

James Arrow, managing director of Boots Opticians, said in a statement: “A huge thanks to our team who have worked tirelessly up until this point to keep services open with great care and community spirit.”

He added that the company was monitoring the situation and working with government guidance and the NHS, adding “We will open our doors again as soon as we can.”

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.