20 July 2021

Joint statement on NHS SOP and self-isolation in England

Optical sector statement on withdrawal of standard operating procedure for optical practices and self-isolation exemption in England

The College, ABDO, the AOP and FODO advise that optical practices should continue to follow Amber phase COVID-19 guidance; and self-isolation exemptions in England are unlikely to apply in primary eye care settings at this stage of the pandemic. We will continue to monitor updates to public health advice and support eye care service delivery as the situation evolves.
 
Withdrawal of NHSE/I Optical SOP
 
It has been announced that the NHS England/Improvement (NHSE/I) Standard Operating Procedure (SOP) for Optical Practices has been withdrawn. However, the optical sector bodies support the need to follow other existing guidance and maintain robust IPC measures. This means practices should continue to follow the College's Amber phase COVID-19 guidance and the GOC supporting statements for the Amber phase, including advice on patient face coverings. These are consistent with the existing COVID-19 Infection Prevention and Control (IPC) guidance which will continue to apply in all healthcare settings. 
 
Practices should:

• Maintain social distancing where possible
• Ensure all staff wear a face mask (FRFM) and follow the correct use of personal protective equipment (PPE)
• Recommend the public continue to wear a face-covering when on practice premises
• Ensure scrupulous hand washing
• Ensure good surface disinfection and frame sanitising after every patient episode
• Encourage all staff to use lateral flow tests and report the results regularly
• Maintain patient triage and prioritisation
• Maintain good ventilation throughout the practice.

Maintaining high standards of infection controls, including handwashing and wearing face masks is vital to protect practice teams and remain open to provide eye care as people begin to move about more freely. 
 
Self-isolation exemption
 
The Department on Health and Social Care (DHSC) announced that fully vaccinated frontline health and care staff may continue to work rather than self-isolate when they have been identified as close contact of a COVID-19 positive case outside of the work setting. This has been introduced to help alleviate pressure on healthcare services. The DHSC is clear that the exemption only applies where frontline health and social care staff absence may lead to a significant risk of harm to patients.
 
NHS England has published a letter confirming that this exemption applies in all NHS settings, including primary eye care, but is subject to strict conditions. The optical sector bodies support the need to help prevent patient harm.
 
The optical sector bodies have considered these conditions and concluded that this exemption is not likely to be available in primary care optical practices, except in genuinely exceptional circumstances.
 
To ensure appropriate application of this exemption, the optical sector bodies advise that practices must:

• Have a clear self-isolation risk assessment procedure, detailing how and when it should be conducted
• Identify and contact the public health authority involved in decision making and approval
• Have sufficient testing mitigations and safeguards in place to allow staff to return to work safely and in appropriate roles

This exemption must not 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 College and optical sector bodies are working with NHSE/I and continually reviewing the guidance to ensure it remains comprehensive and up-to-date. The College will be updating its amber phase guidance later this week to reflect changes in government advice.