Statement on infection prevention and control during the COVID-19 pandemic

We have published a statement on infection prevention and control during the COVID-19 pandemic. The full statement can be found below as well as on our COVID-19 page.

Published 6 July 2020

1. In these extraordinary times, we are fortunate that in all four countries of the United Kingdom we have a group of exceptionally well qualified eye care professionals on whom the general public and fellow healthcare professionals can rely.Uncertain times mean that our registrants may be called upon to work at the limits of their scope of practice and vary their practice for protracted periods of time and in challenging circumstances. While registrants are encouraged to work up to the limits of their competence, refresher training and/or supervision may be needed, especially to ensure correct infection prevention (IPC) and control measures including appropriate use of personal protective equipment (PPE).
2. In this statement we hope to reassure our registrants that when they act in good conscience, for the public benefit, exercising professional judgement in all of the circumstances that apply, we will support them.
3. Along with all other healthcare regulators, we have signed a joint regulatory statement which acknowledges that registrants will need to act differently and deliver care in different ways during the COVID-19 pandemic in line with Government and public health guidance.We will take account of this in fulfilling our regulatory functions together with this statement.
4. As the lockdown is eased and optical practices begin to deliver more services face-to-face, it is important to maintain appropriate IPC measures including best practice hand and respiratory hygiene, social distancing, cleaning and decontamination, and the use of appropriate PPE.
5. The Government has issued guidance on IPC^[1], including specific guidance on PPE in primary care settings^[2], as well as guidance for businesses to work safely^[3]. This is supported by guidance and advice from the NHS, and specific guidance from the professional bodies (including The College of Optometrists^[4] and the Association of British Dispensing Opticians (ABDO) ^[5]).
6. We recognise that from time to time there may be issues with the timely delivery and provision of appropriate PPE in some areas and that registrants may be concerned in cases where they are unable to access appropriate PPE when caring for patients.

Standards

7. Our standards set out the key principles that registrants must follow to keep themselves, those they lead or manage, and those they care for safe.The standards are as follows:
   • business registrants: Standards for Optical Businesses – standards particularly relevant to this statement are standard 1.1 (patients can expect to be safe in your care), standard 1.2 (patient care is delivered in a suitable environment) and standard 3.1 (your staff are able to exercise their professional judgement);
   • optometrists and dispensing opticians: Standards of Practice for Optometrists and Dispensing Opticians – standards particularly relevant to this statement are standard 11 (protect and safeguard patients, colleagues and others from harm) and standard 12 (ensure a safe environment for your patients); and
   • student registrants: Standards for Optical Students – standards particularly relevant to this statement are standard 10 (protect and safeguard patients, colleagues and others from harm) and standard 11 (ensure a safe environment for your patients).
8. We also set education standards regarding appropriate placement provision within our accreditation and quality assurance handbooks^[6].

Responsibilities of registrants in exercising professional judgement

9. The COVID-19 pandemic requires a systems response, with individual and business registrants working together to develop and ensure compliance with IPC measures to minimise risk of virus transmission while providing eye care safely.

Business registrants

10. Although this statement applies to all optical businesses and individuals that are registered with us, for the benefit of patients and the public, we would also expect all optical businesses and other practices, such as university clinics, to meet the requirements set out in this statement, regardless of whether or not they are currently registered with us.
11. Standard 1.2 of Standards for Optical Businesses requires that business registrants ensure patient care is delivered in a suitable environment, which includes references to infection control and care requirements, and preparedness to deal with an emergency situation. Business registrants must therefore ensure compliance with IPC procedures in line with Government guidance and keep their patients and staff safe. Further information about the standard can be found on our website: https://standards.optical.org/standards/patient-care-is-delivered-in-a-suitable-environment/
12. It is the responsibility of employers to ensure appropriate IPC systems are in place including:
    • compliance with self-isolation guidance, social distancing, best practice hand and respiratory hygiene, cleaning and disinfection; and
    • the provision of appropriate PPE and ensuring that employees are trained in how to use it correctly (particular attention should be given to the guidance around whether PPE is intended for single or sessional use).
13. Where it is not possible for the employer to ensure appropriate IPC systems are in place, optometrists, dispensing opticians and student registrants should not be expected to see a patient. Employers may wish to consider working with staff to find alternative solutions, for example, introducing new IPC procedures or modifying existing procedures to aid compliance.

Individual registrants

14. It is the responsibility of optometrists, dispensing opticians and student registrants to comply with local IPC systems, which includes determining the appropriate PPE to use when seeing patients and how to use it correctly, as well as adhering to cleaning and disinfection and other protocols to reduce the risk of virus transmission. Registrants should always have regard to this guidance when in the practice, not just when with patients and members of the public.
15. Where there is a risk of non-compliance with IPC guidance, registrants should not see the patient and should use their professional judgement in deciding on the best course of action. They may wish to consider:
    • alerting their employer^[7], supervisor or placement provider to the lack of compliance with IPC (for example, not having access to appropriate PPE or not using it correctly, not having access to, or sufficient time to use, appropriate IPC materials, or not having the ability to socially distance) and agree the actions to be taken;
    • whether treatment can be delayed or provided differently (e.g. remotely); and
    • referring or signposting the patient^[8] to another practice that does have access to appropriate PPE, IPC materials or the ability to socially distance.

Recording decisions

16. As per usual practice, optometrists, dispensing opticians and student registrants must make a note of their decisions, and the reasons for these. The note should be made directly in the patient records where this is a patient specific decision. Where this is not possible, the patient records should be updated at the earliest available opportunity.
17. Decisions by business registrants relating to risk assessments, standard practice or operating procedures should be appropriately documented in an auditable format.

The GOC will keep this statement under review

18. Next routine review due: not later than 31 January 2021.

[1] https://www.gov.uk/government/publications/wuhan-novel-coronavirus-infection-prevention-and-control

[2] Recommended PPE for primary outpatient community and social care by setting

[3] England: https://www.gov.uk/guidance/working-safely-during-coronavirus-covid-19

Northern Ireland: https://www.nibusinessinfo.co.uk/content/coronavirus-workplace-safety-guidance-and-priority-sector-list-published

Scotland: https://www.gov.scot/publications/coronavirus-covid-19-phase-1-business-and-physical-distancing-guidance/

Wales: https://gov.wales/taking-all-reasonable-measures-maintain-physical-distancing-workplace

[4] https://www.college-optometrists.org/the-college/media-hub/news-listing/primary-eyecare-covid-19-guidance-amber-phase.html

[5] https://www.abdo.org.uk/coronavirus/

[6] https://www.optical.org/en/Education/Approving_courses/index.cfm

[7] Registrants will need to consider which member of staff in their employer is most appropriate to speak to.

[8] Standard 12.4.3 of the Standards of Practice for Optometrists and Dispensing Opticians