ABDO advice on Covid-19

This page summarises the latest advice during the COVID-19 outbreak. Scroll down for advice by country and FAQs for practitioners and the public.

Flu and COVID autumn vaccine programmes brought forward

5 September 2023

The UK Health Security Agency (UKHSA) has taken the decision to start earlier than planned as a precautionary measure.

The UKHSA has announced that this year’s autumn flu and COVID-19 vaccine programmes will start earlier than planned in England as a precautionary measure following the identification of a new COVID-19 variant. The precautionary measure is being taken as scientists from the UKHSA examine the variant BA.2.86.

The Joint Committee on Vaccination and Immunisation has advised that frontline healthcare workers should be offered a COVID-19 booster vaccine in autumn 2023. As frontline healthcare workers, dispensing opticians, optometrists and practice staff are encouraged to keep up to date with all relevant vaccinations including influenza and the COVID-19 booster vaccinations.

Access to the COVID-19 booster  

In order to access the COVID-19 booster all practice staff will be contacted by the local vaccination services to arrange an appointment. Vaccinations are set to start on 11 September 2023, with adult care home residents and those most at risk to receive vaccines first. NHS England will announce full details of the accelerated roll-out soon, and those who fall into higher-risk groups are being encouraged to take up the jab as soon as they’re invited.

Access to the influenza vaccine 

Practices (contractors) should make arrangements with their local pharmacy or occupational health provider so that all members of the practice team have access to the influenza (seasonal flu) vaccination in a timely manner. Sector bodies have called on NHS England to fund this and will continue to do so, but at this stage contractors and locums will have to fund this directly.

Other IPC measures 

As with any period of increasing infection, it is important to support team members to maintain high standards of infection control procedures (ICP) and minimise the risk posed by infection control complacency. To help minimise the risk of transmission of flu and COVID-19 this autumn.

  • Ensure scrupulous hand hygiene.
  • Follow the correct use of personal protective equipment (PPE) when required.
  • Ensure good surface disinfection after every patient episode.
  • Keep up to date with information from the UKHSA.

The best way to prepare for seasonal illness this autumn is to avoid any complacency and champion best IPC practice to ensure a continued safe working environment and in turn a safe place for patients to access their eyecare.

Produced in collaboration with College of Optometrists, FODO and the AOP.

Helpful links

5 May 2022

Each nation’s health system has confirmed that they support a move to the green phase on Tuesday 10 May 2022. From then, the College of Optometrists’ (CoOs) Covid-19 Amber phase guidance will no longer apply in all UK nations.

Dispensing opticians are advised to follow ABDO’s Advice and Guidelines, along with their nation’s infection prevention and control guidance (IPC) for healthcare settings, which have all been recently updated. General Optical Council amber phase easements will no longer apply.

From Tuesday 10 May 2022, the following Covid specific measures should be stopped:

  • Covid-19 specific decontamination protocols
  • Physical distancing (already stood down in England and Scotland, TBC in Wales and Northern Ireland)
  • Covid-19 modified eye examination, although the CoO continues to encourage a needs-led approach in the Guidance for Professional Practice

In a statement to members, ABDO said: “‘Living with Covid-19’ does not, mean a return to practice or business as it was before the pandemic. Your new normal for practice should incorporate good practices established over the past two years, which the CoO has set out in its Guidance for Professional Practice. Coronavirus continues to be a serious disease with new variants, and future waves are predicted to continue for many more years.”

The following measures will apply:

  • You should wear a Fluid Resident Surgical Face Mask (FRSM Type IIR) when:
    1. Performing procedures when in close proximity to the patient (this could include for example pre-screening, dispensing, facial measurements, contact lens appointments and I&R appointments).
    2. You consider there is a risk of respiratory infection.
    3. There is a public health requirement to wear one, such as during a pandemic, unless the mask type specified by the relevant national or local public health guidance recommends an alternative specification and level of protection.

ABDO continues to work with optical sector bodies, College of Optometrists, NHS, and public health bodies across the UK to ensure that any communications in regard to the continued safe delivery of eyecare post pandemic are shared with our members.

At the present time we still recommend the use of personal protective equipment where appropriate, and that members follow the infection prevention and control guidance for their specific nation.

If members have specific queries that are not answered in the links below please contact ABDO Clinical Lead Max Halford mhalford@abdo.org.uk

 

Letter on vaccinations to the joint professions 10 March 2022

You can read the letter on vaccination to the joint professions issued 10 March 2022 here.

Mask Wearing UK - Advice for the public

England – Face coverings: when to wear one, exemptions and what makes a good one – GOV.UK (www.gov.uk)

Northern Ireland – Coronavirus (COVID-19): face coverings | nidirect

Scotland – Coronavirus (COVID-19): face coverings and masks – gov.scot (www.gov.scot)

Wales – Face coverings: guidance for public | GOV.WALES

COVID vaccination advice

ABDO does not support mandatory vaccination in line with the ethics of human rights. However, ABDO strongly recommends that all health care professionals in a patient-facing role should, in line with evidence based public health advice, be vaccinated against COVID to ensure the safest delivery of patient care.

Vaccination is considered to be among the safest, most effective approach to protecting people from infectious disease. Evidence relating to COVID vaccines shows them to be safe and protect from serious illness allowing us to continue to deliver and receive vital health care as we live with the threat of COVID.

Most of the optical primary care profession has been vaccinated but some still have concerns and questions regarding the COVID vaccine/booster and are therefore hesitant to be vaccinated. We have provided the links below to support members who are still undecided to ensure you have the most up to date global/national information available:

Outcome: PPE Consultation Response and Extension of Free PPE to the Health and Care Sector in England

17 January 2022

The government has announced its decision to extend the central, free provision of all items of COVID-19 PPE to the health and care sector by up to one year to March 2023 or until the infection prevention and control (IPC) guidance on PPE usage for COVID-19 is either withdrawn or significantly amended (whichever is sooner). The press release announcing the decision to extend is available here.

Joint position on mandatory vaccinations

The College of Optometrists’ and ABDO’s joint position on mandatory vaccinations.

The College of Optometrists and the Association of British Dispensing Opticians believe all health and social care workers in primary and secondary care, and their colleagues, should have all recommended vaccinations, unless they are medically exempt. Vaccination is considered to be among the safest, most effective and evidence-based approaches to help protect people from infectious diseases.

However, we do not support mandatory vaccination as a condition of deployment in a healthcare setting. We believe that vaccine uptake will be maximized where optometrists, dispensing opticians and practice staff are supported to make their own decisions, having been provided with clear, evidence-based information on the benefit and value of vaccinations.

We recommend:

    • Encouraging optometrists, dispensing opticians and colleagues who are vaccine-hesitant to have the opportunity to fully understand the benefits of vaccinations, with risks explained proportionately, and given the autonomy to make an informed choice. They should be given time to discuss their concerns with their employer or occupational health team.
    • Optometrists, dispensing opticians and colleagues should have priority access to all vaccines as frontline healthcare workers. Employers should make having vaccinations as easy as possible; for example by enabling their employees to attend an appointment within working hours, or at a time and location that suits them.
    • Employers should undertake a risk assessment for those who are medically unable to be vaccinated, or remain hesitant about vaccines, and consider how to mitigate risks to patients and prioritise their safety.

23 September 2021

Posters to encourage face coverings, updated 26 January 2022

From 27 January 2022 there will no longer be a legal requirement for members of the public to wear a face covering in England.  This follows the Westminster Government’s announcement that the measures put in place under Plan B will be lifted.

However, the Government suggests that the public continue to wear a face covering in crowded and enclosed spaces where you may come into contact with other people you do not normally meet.

Specific guidance relating to health and social care has not yet been published.  The advice for these settings, which includes optical practices is that you should continue to follow the existing guidance and wear a face covering.  The last update can be found here for any patients who may query this request.

To further support patient awareness of this requirement in your practice you can use the NHS poster which can be found here.

The GOC has published its response to the Covid-19 statement consultation.  Updated versions of the GOC statement can be found here. These are now aligned to The College of Optometrists Primary eye care Covid-19 pandemic guidance.

Please note that the statement on supply of spectacles and contact lenses and the statement on verification of contact lenses specifications will now only be permitted in the red phase as defined by the CoO, “when a government or health service suspends routine primary care due to the Covid-19 pandemic”.

Find Covid vaccination information

It is helpful to consider how you might support informed decision making so that when colleagues are invited to have the Covid-19 vaccination, they are ready to act. Here are links to official guidance:

Non-NHS providers

The Covid-19 green book clarifies that frontline healthcare staff are in the same priority group for vaccination independently of how people pay for their care. If you do not provide NHS care but deliver face-to-face patient care, you should expect the local vaccination programme to contact you. Meanwhile, we recommend you contact your representative body to ensure that they can send you relevant vaccination information that might be shared with NHS contract holders.

If you have further queries about vaccines, please contact membership@abdo.org.uk.

Receiving the vaccine in England

Following published government guidance confirming that all optical practice staff and locums should be included in the priority group for Covid-19 vaccination, the Local Optical Committee Support Unit (LOCSU) is paving the way for practitioners to be included on local lists to receive their vaccination.

Non-NHS practice staff

The first port of call for non-NHS practitioners and staff is to check whether they can be included on a listing with their local optical committee (LOC).

LOCs are working across England to create lists of staff employed in GOS practices. As such, practitioners are advised to make contact with their LOC so that all practice staff may be included on its listing for the vaccination programme. Links to all LOCs in England with a web presence can be found on the LOC Online portal.

However, if none of the above applies, practitioners can complete LOCSU’s Non-NHS Practices Form to add themselves and their staff to a local vaccination list.

Locums

Locums are advised to check initially with any practices they work with, if they may be included on a practice staff list being submitted to its LOC (as above).

Locums may also be able to register directly with their clinical commissioning group or primary care network.

However, if none of the above is possible, locums may complete LOCSU’s Locum Form to ensure they are included on a local vaccination list.

Practitioners who have any further questions are advised to email info@locsu.co.uk

Receiving the vaccine in Scotland

Contact Optometry Scotland.

Website: www.optometryscotland.org.uk

Email: contact@optometryscotland.org.uk

Receiving the vaccine in Wales

Contact Optometry Wales.

Website: www.optometrywales.org.uk

Email: salidavis@optometrywales.com

Receiving the vaccine in Northern Ireland

Contact Optometry Northern Ireland.

Website: www.optometryni.co.uk

Email:  admin@optometryni.co.uk 

A letter has been released to go to all optical professionals on behalf of the professional bodies and government bodies responsible for ophthalmic dispensing and optometry. The full text of the letter can be read here.

 

More information

You can read all guidance from the College of Optometrists for the COVID-19 outbreak here.

The College of Optometrists and Royal College of Ophthalmologists joint statement on COVID-19 and viral conjunctivitis can be read here.

England

From 11 November 2021, anyone working or volunteering in a care home will be required to be fully vaccinated against coronavirus (COVID-19) unless medically exempt. 16th September is the last date to receive your first dose in order to be fully vaccinated in time to comply with the change in the rules.  The College of Optometrists Guidance for Professional Practice states you should keep up to date with immunisation. (B36)  If you cannot have the COVID-19 vaccination, you should speak with your employer and representative organisation.

https://www.gov.uk/government/publications/vaccination-of-people-working-or-deployed-in-care-homes-operational-guidance

 

Scotland, Wales and Northern Ireland

It is strongly recommended all health care professionals are fully vaccinated against coronavirus (COVID-19) unless medically exempt. Although it is not a regulatory requirement, it may be a condition of your employment – for current employment contracts this would need to be discussed. For new employees, this could be specified as a contractual requirement of employment. The College of Optometrists Guidance for Professional Practice states you should keep up to date with immunisation. (B36)  If you cannot have the COVID-19 vaccination, you should speak with your employer and representative organisation.

 

Issued in conjunction with The College of Optometrists

Updated: 24th August 2021

Patients who attend optical practices and who subsequently test positive for COVID-19 are not generally considered contacts for NHS Test and Trace/Test and Protect purposes when the practice has been following IPC procedures and practitioners have been wearing PPE properly when they were in contact with the patient.

Each Test and Trace/Test and Protect call handler is a clinician who will make a clinical judgment about the risk of each person’s interaction but may not fully understand the nature of primary eye care and how IPC in our sector operates.

If you are contacted by NHS Test and Trace/ Test and Protect call handler, it is essential you explain to them that the contact was within a healthcare setting and to describe the PPE you were using and the IPC procedures you were following.

If you are asked how long you spent with the contact, make sure you let the call handler know BOTH the total duration of the sight test/dispense AND how long the Optom/DO were in close proximity to the patient. For many contacts, proximity will be a relatively short period of time. (Such as the time at the slit lamp, behind the slit lamp Perspex screen, fitting/adjusting of frames with the rest of the consultation performed at two meters or more.)

If you believe the call handler has incorrectly assessed the risk of the interaction, you should escalate the decision by requesting a second opinion.  This is an accepted part of the internal process at NHS Test and Trace/ Test and Protect and will not cause offence.

If, after the escalation request and further discussion, it is decided you did not have a close contact and can return to work, you can then do so. However, it is a legal requirement to follow the advice of the call handler, including isolation for 14 days, even if you believe this to be an incorrect decision.

If you had to escalate a decision, or believe the advice was incorrect, please contact our ABDO Head of Policy dmcgill@abdo.org.uk so we can collectively collate examples to feedback to the relevant NHS tracing service.

Updated: 2 December 2020”

The advice to practices is to ask any patient that feels unwell, in any way, to not present to the practice at all. The Government advice provided to the public is to self-isolate if they are showing symptoms that could be COVID-19 therefore patients attending optical practices for eye care should not be a risk. Practices should not deliver care to patients who have COVID-19 as they are not in supply of PPE. OFNC advises that cleaning of practices is carried out more regularly at this time and it is not unreasonable to ask patients who attend to wash their hands on entering or use hand sanitiser. The usual formal sanitising procedures should be adhered to as stated in the ABDO advice and guidelines on our website:

Principles of Cleaning, Sterilisation & Disinfection

4.4.1 There are numerous pieces of equipment that regularly come into contact with patients e.g. trial frames, chin rests, refractor heads, hand held occluders and rulers, as well as ophthalmic devices which come into direct contact with ocular tissues e.g. tonometer heads, gonioscope and other contact lenses. It is essential that they are all appropriately decontaminated, for example by wiping headrests and/or chin rests with a disinfectant wipe, to reduce the risk of transmission of infection.

There are three levels of decontamination:

Cleaning – The removal of organic and inorganic debris from a surface which might support micro-organisms and provide insulation that reduces the efficiency of disinfecting or sterilisation procedures. Detergents and ultrasonic cleaners are frequently used for cleaning purposes.

Disinfection – A treatment that reduces the number of viable micro-organisms but not necessarily bacterial spores or some viruses. Disinfection can be achieved by physical methods such as heat or by the use of chemical disinfecting agents. Chemical disinfection can be an uncertain procedure as it involves an integration between the chemical used, the micro-organism and exposure time.

Sterilisation – A treatment, which completely kills or removes all kind of micro-organisms including spores. Sterilisation can be achieved by ionising radiation, by gaseous ethylene oxide, by gaseous hydrogen peroxide, by low pressure steam and formaldehyde, by filtration, by dry heat (hot air oven) or by moist heat (autoclave).

4.4.2 To be effective all items must be physically clean before being exposed to any sterilisation or disinfection process.

4.4.3 Not all equipment, however, needs to be sterile before use and the following is a general guideline:

Sterile – Equipment introduced into a sterile body area or in contact with a break in the skin or mucous membrane.

Disinfected – Equipment in close contact with body surfaces or intact mucous membranes, such as the ocular surface e.g. tonometer heads, gonioscope and other contact lenses.

Clean – Equipment not coming into close contact with mucous membranes or sterile body areas e.g. trial frames, refractor heads.

4.4.4 Surfaces in the consulting room should be cleaned after every patient with detergent and water unless contaminated with body fluids. If contaminated with body fluids a chlorine-based disinfectant should be used. All consulting rooms should have access to a wash hand basin and it is good practice for this to be within the consulting room

We advise that you look for the latest information from the Royal College of Obstetricians and Gynaecologists.