The impact of self-isolation requirements for practices

Optical sector bodies have advised that a self-isolation exemption for frontline health and care staff is not likely to be available in primary care optical practices, “except in genuinely exceptional circumstances.”

Aiming to alleviate pressure on healthcare services, the Department of Health and Social Care (DHSC) has introduced a self-isolation exemption which would allow frontline health and care workers to continue working, rather than self-isolating, when identified as a close contact of a COVID-19 positive case outside of work.

The exemption only applies in exceptional circumstances where absence may “lead to significant risk of harm to patients,” and is subject to testing mitigations.

NHS England has said the exemption applies in all NHS settings, including primary eye care, but is subject to “strict conditions,” and on reviewing these conditions, the optical sector bodies concluded that the exemption “is not likely to be available in primary care optical practices, except in genuinely exceptional circumstances.”

In jointly-issued advice, the organisations emphasised that the exemption cannot be used “as a general mechanism to prevent staff from self-isolating, or bring self-isolating staff back to work in the absence of exceptional circumstances.”

The professional bodies have put together advice on the appropriate application of the exemption, which can be read in full online.

Sharing the advice, the optical sector bodies added that they are working with NHS England/Improvement and continually reviewing the guidance.

Speaking to OT, Tushar Majithia, AOP councillor and practice owner, shared his experience of the impact of the self-isolation requirement.

He explained: “We have an optometrist and dispensing optician in one of our practices that have been told to isolate for 10 days as they had close contact with someone that has tested positive for COVID-19.”

Both team members are fully vaccinated and have negative PCR and lateral flow tests, and are asymptomatic.

“Having to reschedule all of our appointments for this period has caused significant disruption to our business,” Majithia shared, continuing: “Some of these appointments were for patients with visual concerns.”

With the new measures introduced with the aims of alleviating pressure on healthcare services, he added: “We consider ourselves to be frontline healthcare workers and believe that the new isolation exemption guidance should have been more flexible to bring members of the team back to work, if we felt that it was safe for them to do so.”

Speaking to OT, Dr Peter Hampson, clinical and professional director for the AOP, commented: “While we understand the frustration around this issue, the DHSC guidance allows people to be treated as exempt from the self-isolation requirement only if the local director of public health specifically agrees to them being exempt, on the basis that the risk to patients if they don’t work is greater than the risk of spreading COVID infection if they do.

“Understandably with the diligent infection control procedures in optical practices, many will feel this is unfair, but these are the same procedures that all of primary care has to follow.

“As with all things COVID-19, this situation could change rapidly, but Office for National Statistics data released on Friday suggests that around 1/75 people currently have COVID and therefore we should continue to be cautious.”