Covid-19 - PES Advice for Community Service Contractors

In the context of the Coronavirus outbreak we are experiencing, Primary Eyecare Services is working hard with all key stakeholders to ensure we have appropriate processes in place to enable safe and effective care for patients and practitioners through the locally commissioned services that we contract with optical practices to deliver.

This guidance should be implemented and reviewed regularly as it is updated.

Care Process Guidance

First Contact Services (MECS)
Due to potential for practice closures (due to inability to staff site or for decontamination etc) there is a need for us to minimise the risk to interrupted service delivery through reducing risk and what to do should a site no longer be able to deliver the service.

Risk Reduction

  • Patient identification - Follow NHS England Standard Operating Policy (SOP) for primary care optical practices: 
    • When a patient contacts the service they should be asked whether they have any flu-like symptoms or recent onset continuous cough, if a patient states they do have these symptoms (or are self-isolating under current guidance) AND have eye symptoms/condition then they should be instructed to self-isolate and call NHS111.
    • Further work on alternative ways for optical practices supporting patients affected by these arrangements are being explored and we will keep practices updated.
  • Where a patient has recent onset mild red eye related symptoms encourage self-care wherever possible by directing patient to purchase appropriate over the counter medications.
  • A practitioner should be ensuring that they clean down slit lamp and wash hands before and after each patient.
  • Slit Lamp Shields - practices should consider the use of slit lamp shields to create a barrier between patient and practitioner as contact area with patient is less than 1 metre. These can be purchased but also made, see helpful links:
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  • Ensure you check your practice Infection control measures against the QiO Infection Control audit if you have not done this recently.

Diagnostic & Monitoring Services

Post-Op Cataract Follow Up Service
These patients are attending optical practice for post-surgical assessment but are considered a low risk for complications by the surgical provider having been transferred to our service. Despite the low risk there is a need to see a patient in a timely manner following surgery 4-6 weeks and this cohort of patients are often aged over 70 and therefore considered to be a vulnerable group. Service Specific requirements:
Use the Post Cataract Triage form to support this process.
Post Cataract Triage Form Download


Community Glaucoma Monitoring Service
Patients seen within these services are of a low risk classification and will have recall for monitoring of 12 months in most cases. It is important to consider the timescale for recall in relation to the NHS England Elective Care Transformation Program High Impact Intervention outputs that aims for patients to be seen within 25% of their recall period (e.g. a patient with a 12 month recall to be seen by the end of the 15th month).
Use the Glaucoma Monitoring Triage form to support this process.
Glaucoma Monitoring Triage Form Download


Children's Post Vision Screening Service
These are children who have failed vision screening and require diagnostic assessment.

  • If a patient is self-isolating due to being within at-risk group or has linked symptoms, then arrange assessment for post-isolation period and record the reason for delay on OptoManager

College of Optometrists Guidance
FAQs from College of Optometrists including information on what to do if a patient presents with viral conjunctivitis can be found here:.
·  https://www.college-optometrists.org/the-college/media-hub/news-listing/coronavirus-2019-advice-for-optometrists.html


Notification Protocol

Steps to take if optical practice is unable to deliver service due to staff absence / period of closure

  • At the earliest opportunity where a period of non-service delivery occurs the optical practice should notify Primary Eyecare Services at COVID@primaryeyecare.co.uk. Further information will be requested regarding the situation of the practice.
  • Practice should put sign at entrance instructing patients trying to access First Contact Services (E.g. MECS) where to find contact details for alternative optical practices (e.g. website), where possible.
  • A telephone answer machine message should include details of where alternative practice contact details can be found (e.g. website), where possible.
  • Where a practice remains open but a practitioner is unavailable then alternative arrangements must be made for the patient by another optical practice.