12 May 2020

Covid-19 sector update – primary eye care

At FODO, we are supporting members seven days a week throughout the Covid-19 crisis. If you need us, please email or call us as usual. 

In this update: 

1. Furlough scheme update 
2. Government Covid-19 strategy on next phase 
3. Guidance for retail premises, offices and sector guidance update 
4. Delivering eye and hearing care during the pandemic and beyond
5. New maculopathy referral filtering and monitoring pathway
6. Official advice and guidance - quick access 
7. Other news    

1. Furlough scheme update 

The UK Coronavirus Job Retention Scheme will remain open until the end of October with flexibilities starting in August, the Chancellor announced today. 

This four-month extension is welcome news for the sector, and something FODO has been working for through the CBI and with HM Treasury. It will help protect more jobs and facilitate a phased return to practice where safe and practical to do so. Flexibilities that start in August will allow part-time working and employers will be asked to pay a percentage towards salaries of furloughed staff. 

We will update you when full details are published; this is currently expected by the end of May.   

2. Government Covid-19 strategy on next phase 

All UK governments have now published frameworks or strategies detailing how they plan to move out of the current lockdown and on through the pandemic.

• England/UK - Government's Covid-19 recovery strategy -11 May
• Scotland - Covid-19 framework for decision making - last updated 5 May
• Wales - Leading Wales out of the coronavirus pandemic - 24 April
• Northern Ireland - Coronavirus - Executive approach to decision-making - 12 May 

As we set out in our 1 May update, scenario planning to keep the R rate ('infection rate') down is at the heart of all these strategies. Optical practices will have a pivotal role to play in this and in preventing non-Covid harms as we move out of lockdown as soon as it is safe to do so. 

Although governments in all UK countries are aiming for a pan-UK approach where possible, with different R rates in different parts of the country, we will inevitably see more localised planning. 

This week the UK government acknowledged, for example, that at present its strategy for restarting the economy was more England centric for the above reasons and made clear: 

• "Restrictions may be adjusted by the devolved administrations at a different pace in Scotland, Wales and Northern Ireland because the level of infection - and therefore the risk - will differ. Similarly, in England, the government may adjust restrictions in some regions before others: a greater risk in Cornwall should not lead to disproportionate restrictions in Newcastle if the risk is lower." 

The government's strategy is based on enacting measures that have the largest effect on controlling the epidemic but the lowest health, economic and social costs. It will take account of the health, economic and societal impacts of Covid-19 and follow five principles: science, fairness, proportionality, privacy and transparency. 

The strategy signals moving from phase one - during which the focus was to contain, delay, research and mitigate - to phase two, which focuses on 'smarter controls'. For example, backed by a strategy to expand testing and tracing, the government hopes to take a more localised approach to "stop hotspots developing by detecting infection outbreaks at a more localised level and rapidly intervening with targeted measures." 

As we move into and through phase two, the government reiterated that "people will need to minimise the spread of the disease through continuing good hygiene practices: hand washing, social distancing and regular disinfecting of surfaces touched by others". It added, "these will be in place for some time" and that the "virus is unlikely to die out spontaneously; nor is it likely to be eradicated". 

The UK government plans gradually to lift restrictions in three steps, only proceeding to each stage if it is safe to do so (see section 1.2). If the rate of infection is not kept under control, a second national or more localised lockdown period is possible. 

Perhaps most importantly for eye care, in phase two, the government plans to "continue to increase health and care capacity to ensure Covid-19 care for all Covid-19 patients while restoring 'normal' healthcare provision". 

A new UK Joint Biosecurity Centre (JBC) will be responsible for setting new Covid-19 Alert levels to communicate the level of risk to the public: 

• Level 1: Covid-19 is not known to be present in the UK 
• Level 2: Covid-19 is present in the UK, but the number of cases and transmission is low
• Level 3: Covid-19 epidemic is in general circulation
• Level 4: Covid-19 epidemic is in general circulation; transmission is high or rising exponentially
• Level 5: As level 4 and there is a material risk of healthcare services being overwhelmed. 

This will remain in place until there is a reliable treatment in phase three. 

The FODO team has now analysed the 60-page strategy and we will work with sector partners with the view to publishing guidance by the weekend (see update below).   

3. Guidance for retail premises, offices and sector guidance update 

The UK government has published eight guides to help employers understand how to work safely through the pandemic. The guidance aims to support employers "get their businesses back up and running and workplaces operating safely". 

Firms, unions, industry bodies and devolved administrations in Northern Ireland, Scotland and Wales have all had an input into the guides which emphasise the continued advice to:

1. Work from home, if you can 
2. Carry out a Covid-19 risk assessment, in consultation with workers or trade unions 
3. Maintain two metres social distancing, wherever possible 
4. Where people cannot be two metres apart, manage transmission risk 
5. Reinforce cleaning processes. 

The most relevant guides for opticians are: 

• Shops and branches - including essential premises that are currently open 

• Office and contact centres - offices and contact centres. 

There is also a Covid-19 secure compliance notice you can display once you have completed actions in the official guidance. 

Opticians should read the guidance above alongside College of Optometrists guidance and country-specific guidance including on public health, NHS and optical contacts and services. 

We have now analysed these and other documents and, following our 7 May update, are currently consulting members on an overarching guiding matrix for optical practices and practitioners as we move out of lockdown and through the next phases of the pandemic. We plan to publish it shortly.     

4. Delivering eye and hearing care during the pandemic and beyond 

FODO responded to the Health and Social Care Select Committee's inquiry into 'Delivering core NHS and care services during the pandemic and beyond'. 

The response sets out how there is an urgent need to plan how and where we see patients for non-Covid-19 health issues during the pandemic rather than simply not seeing them because of Covid-19. It sets out how this would help to mitigate the risk of sensory-related harms and costs and reduce the risk of cross-infection. 

The response also explains how there is a considerable risk that the lower priority traditionally accorded to long-term conditions, disability and quality of life issues will be perpetuated during the move out of lockdown, resulting in lifelong harmful consequences for the most vulnerable and isolated in our society. Read the full response.    

5. NEW: Maculopathy referral filtering and monitoring pathway 

LOCSU has published a new service pathway which aims to improve the efficiency and accuracy of case-finding for AMD. It includes the speed at which people are diagnosed and treated within the hospital eye service to prevent sight loss. Learn more.   

6. Official advice and guidance - quick access 

FODO has created a pdf resource for keeping updated with the official government, public health and healthcare Covid-19 guidance.    

7. Other news

Read the College and ABDO feedback on the Prime Minister's announcement on Sunday. 

Yesterday, Sky News reported that healthcare roles dominated the list of occupations exposed to Covid-19, including opticians. You can read the full ONS briefing here. 

College of Optometrists advises children to take a break from screens during the lockdown.