Somerset Local Optical Committee
My Local Optician


OFNC guidance on changes to primary eye care in England

 

As set out in our statement of 1 April, this document addresses the main questions raised by our members so far about the NHS England optical letter of 1 April 2020. It is based on our understanding of the information NHS England has shared to date. We will update this guidance as the situation develops, and as we receive more information from NHS England and queries from the members of the OFNC bodies.
 
Provision of services

1. All routine care is suspended – am I required to close my practice?
No, you do not have to close. You should not offer routine sight-testing and dispensing (to avoid all unnecessary travel and person-to-person contact) but you may stay open so that your clinical team can provide:

  • essential eye care as defined in the NHS England letter, and/or
  • urgent / emergency care. 

This includes providing remote care and dispensing, and meeting the needs of those patients not entitled to GOS, in line with the College of Optometrists’ guidance on providing care during the crisis and the GOC’s guidance on the provision of spectacles and contact lenses.
 
2. Will I be forced to open?
NHS England has no plans either to force practices to close or to remain open. The aim is to direct all patients who need essential, urgent or emergency NHS eye care to optical practices during the crisis, to meet their care needs and keep pressure off other parts of the NHS. If undersupply occurs, NHS England or CCGs may work through LOCs to ask practices to volunteer to reopen if they can. In most cases, we expect practices will continue to offer essential eye care and support their own patients.
 
3.Why does the NHS England letter talk about delivering services from only a limited number of practices?
Depending on the progress of the COVID-19 crisis, NHS England regional teams may need to work with optical practices, LOCs, and CCGs to ensure that practice opening arrangements continue to protect public health and ensure appropriate and adequate levels of care – particularly urgent and emergency care. The OFNC will monitor this closely and provide further advice if necessary. 
 
4. Do I need permission to continue to provide essential care?
No, you do not need to get permission to stay open or to inform your NHS England regional team. 
 
5. If I provide essential NHS care, do I also need to provide urgent or emergency care?
You only need to provide urgent or emergency NHS care if you have a contract to do so. 
 
6. I don’t currently provide urgent or emergency care under a MECS or similar contract, how can I start doing that?
The OFNC, LOCSU and others are working with NHS England to put in place local urgent and emergency care services where these do not already exist. LOCSU will work with all LOCs to communicate these arrangements as soon as possible.
 
7. What happens if I’ve already completely closed my practice, or want to close it now or in future?
If your practice is completely closed and you are not providing any essential care (e.g. remotely), you will not receive GOS support payments for the duration of the closure. You will be able to claim any general Government business support for which you are eligible, such as business grants and payments under the Coronavirus Job Retention Scheme and the Self-Employment Income Support Scheme. 
 
Domiciliary services

8. I have a domiciliary practice, how does the letter apply to me?
In the same way as any other practice as above. People who cannot leave home unaided will need essential and urgent eye care during the crisis the same way as everyone else.  
 
9. What if a non-COVID positive patient in a care home needs essential or urgent care, but their care home is locked down or they are being sheltered or self-isolating?
Remote care (including symptom relief) should be provided. This may involve advising and working with and through other clinicians (e.g. nurses, visiting GPs), trained care workers or carers who are admitted into the home. In the case of lost or broken glasses, consider using any available evidence such as broken glasses, old prescriptions and previous records to enable emergency replacements to be supplied.
 
Support for services that remain open

10. I wish to continue to provide essential services – what payment will I receive?
If you continue to provide essential care in line with official public health advice and College of Optometrists guidance, you will receive a monthly payment based on your average monthly GOS claims for the period from March 2019 to February 2020. This will include voucher claims. Where your actual GOS claims during the crisis exceed this level, you will be paid the additional claims in the usual way. This is a grant payment, not a loan. It will be subject to a reduction for variable costs associated with service delivery, which will be agreed with the OFNC. We will provide more information about this process as soon as we can.
 
11. My practice has been open less than a year, how will average fees be calculated?
NHS England has said average fees will be calculated on a fair and reasonable basis taking into account your average monthly GOS claims during the period your practice has been open.
 
12. When will I know how much will be deducted for variable costs?
The OFNC will agree this with NHS England. We will provide further information as soon as we can. 
 
13. How do I ensure that claims for additional Government support schemes only relate to my proportion of private revenue?
NHS England wants to ensure that where it continues to pay contractors to provide essential care during the crisis, those contractors do not also receive a separate contribution from general Government financial support which directly covers the cost of providing essential GOS – in other words, they do not want the Government to pay twice for the same thing. 
 
If you receive general Government support while providing essential care under these arrangements, which will likely be the situation for most practice owners, you should keep records to show that the general support is not being used to fund the costs of providing essential care, which will be separately funded through GOS.
 
For instance, if you are receiving payments under the Coronavirus Job Retention Scheme, those payments would relate to staff who are currently furloughed and therefore unable to contribute to providing essential care. Similarly, if you receive a grant under the Small Business Grant Fund or the Retail, Hospitality and Leisure Grant Fund, that would relate to the retail business element of your practice and not to providing essential care.
 
Practical issues
 
For guidance on the practical issues raised by the NHS England letter, including: 

  • How do I provide remote consultations?
  • How do I provide emergency dispensing and supply?
  • Where can I find out more about infection control to maintain my practice environment?
  • Where do I find the latest information and recommendations on Personal Protective Equipment (PPE)?
  • How can I obtain PPE?

Please see the COVID-19 guidance of the College of Optometrists and the General Optical Council
 
Further questions

Contractors and practitioners should direct further questions to their representative bodies, using the email addresses below, so that the bodies can consolidate queries to inform more detailed guidance and FAQ resources as required:

 
LOCs can also raise LOC matters via LOCSU by emailing info@locsu.co.uk where they will be fed into the central process.
 
The Optometric Fees Negotiating Committee
The Optical Fees Negotiating Committee (OFNC) is the national negotiating body for eye care in the UK and England with the Westminster Parliament, the Department of Health and Social Care, and NHS England-NHS Improvement.   It comprises the leaders of the UK representative bodies: ABDO, AOP, FODO and BMA (for OMPs) and works in partnerships with the College of Optometrists and the General Optical Council. 

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South West COVID-19 Primary Care update for Contractors

We are starting to send contractors daily updates relating to Covid19 and Feedback from the NHS England and Improvement Local Covid19 Workstream.  This is the first of these updates giving you an update on the information that is being discussed on our daily calls. 

 DAILY COVID-19 UPDATE – 31.03.2020


  • Guidance on use of PPE

A letter is currently being issued to all providers with a broad outline of what can be used/when: whether you are 1mtre from patient, when to use masks and increase settings for FFP3 etc.

 

  • Supply of PPE

As of this week this NHS Supply chain will no longer issue PPE: ‘Clipper Logistics’ will now issue a ‘push’ supply to those on the NHS Supply chain.   For Primary Care/Social Care providers there will be a new portal, to order and get delivery, from Next Monday: details to follow.

 

  • Shelf life of PPE products

REMINDER: Some products may appear to have out-of-date ‘use by/expiration’ dates or have relabelled ‘use by/expiration’ dates. Please be assured products being issued have passed stringent tests that demonstrate they are safe. The PPE is exposed to extreme conditions for prolonged periods, to see how the product deteriorates. All that are not up to standard are destroyed and not distributed to trusts.   We have been working with independent test facilities and the Health and Safety Executive (HSE) who, after being provided with scientific evidence, were content with our assessment that these are safe to use by NHS staff.

 

  • Staff Testing – National antigen testing process is being rolled out for key staff shortly (awaiting confirmation when testing for the South West will commence).    In the short-term, there will be a small number of tests available for primary care community staff, targeted at critical services: details to follow this week.  

 

  • Shielded Patients

Shielded patients lists have been shared with practices for review.  IG issues have now been addressed to allow systems to access PID.

 

  • Methadone

There have been some issues regarding access to Methadone for people in the community: nationally looking at changes to legislation to support resolving these issues.

 

  • Deaths

An increase in deaths being reported is expected over the next few days.

 

  • Ventilators

Currently developing a distribution mechanism for ventilators, with the immediate focus on London.

 

  • Oxygen

Currently planning oxygen capacity: all providers are being asked to return cylinders to assist capacity.

 

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COVID-19 OPTO COMMUNICATION (PCSE)

Please click  on the link at the bottom of the page to view the latest communications that have sent out to all the independents about how PCSE are working during the COVID 19 crisis and confirming we currently still processing NHS GOS forms.

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UPDATE POSITION FROM SOMERSET LOC AND THE LOCAL HOSPITALS

 
As you are all too aware, we are in unprecedented times. The Hospital system is under more pressure than ever to try to manage demand and keep vulnerable patients out of their clinics. We are currently working closely with the local eye departments to try and organise systems to help the flow of patients. They have asked us under these circumstances to consider our current actions as follows:
 
1. We need to send as few patients in to the hospital as we can, to reduce the risk of infection to them and to the staff.
 
2. Routine referrals will still be accepted but they are unlikely to be seen for at least 6-9 months.
 
IF REFERRING TO MUSGROVE:
3. They have specifically asked if we can accompany any referrals we are making with any imaging where possible. This will help them better triage patients and cut down on unnecessary hospital visits. Therefore we are asking to please send any referrals where imaging triaging is appropriate direct to the email address: 
 
OphthalmologySecretaries@tst.nhs.uk (with a normal copy of the referral to the patients GP but specify that you have emailed referral to hospital on the GP letter so the patient does not get referred twice)
 
They have also specifically stated: "Whilst preferable to come through secure e-mail. If unavailable unsecured should be acceptable with patient consent. The red tape should be set aside at this time."
"Patients may need a monitoring visit eg a pressure check or OCT whilst routine hospital appointments are suspended. We are trying to set up an NHS funded mechanism for this – initially it may be on a patient self-pay basis. We will update you on any developments."
 
IF REFERRING TO YEOVIL;
4. Yeovil will provide increased telephone support for patients and optoms with queries to help reduce unnecessary referrals. The telephone number for this is 07584 312399 or 01935 475122 extension 6198. if you have a referral which may be able to be managed in practice or need advice then phone the number for support.

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UPDATED TABLE PRACTICE CLOSURES/REDUCED HOURS ETC

- Green; Re-opened

- Orange; Reduced hours

- Red; Closed

Date

Practice

Area

Note

Advised Local GPs/Optoms?

Next Nearest Open Practice

Indicative monthly activity

Variation Start Date

Variation End Date

17/03/2020

Millicans Opticians Wells

Mendip

Closed for 14 days due to Self Isolation

ü

Richard Mansfield
Specsavers Wells

37 appts

17/03/2020

31/03/2020

23/03/2020

Sarah Gibson Wincanton

South Somerset

Re-opened

ü

Robert Frith Wincanton

10 appts

23/03/2020

30/03/2020

24/03/2020

Turners Eyecare Bridgwater

Somerset Coast

Closed due to government guidelines

ü

Specsavers Bridgwater
East Quay Vision

55 appts

24/03/2020

TBA

24/03/2020

David Kneebone Opticians Somerton

South Somerset

Closed due to government guidelines

ü

Specsavers Yeovil
Robert Frith Yeovil

13 appts

24/03/2020

TBA

24/03/2020

EyeTech Frome

Mendip

Closed due to government guidelines

ü

Specsavers Frome

31 appts

24/03/2020

TBA

24/03/2020

EyeTech Street

Mendip

Closed due to government guidelines

ü

Specsavers Street

30 appts

24/03/2020

TBA

24/03/2020

East Quay Vision Bridgwater

Somerset Coast

Reduced hours - 08:30 to 15:30

ü

Specsavers Bridgwater

 

24/03/2020

TBA

25/03/2020

Boots Yeovil

South Somerset

Closed due to government guidelines

 

Specsavers Yeovil
Robert Frith Yeovil

68 appts

25/03/2020

TBA

25/03/2020

Boots Frome

Mendip

Closed due to government guidelines

 

Specsavers Frome

8 appts

25/03/2020

TBA

25/03/2020

Boots Taunton

Taunton

Closed due to government guidelines

 

Earlham & Christopher Taunton
Specsavers Taunton
Watson and Smith Opticians

88 appts

25/03/2020

TBA

25/03/2020

Specsavers Bridgwater

Somerset Coast

Reduced hours - 10:00 to 16:00 Mon-Sat

ü

East Quay Vision

 

25/03/2020

TBA

25/03/2020

Martock Opticians

South Somerset

Closed due to government guidelines

ü

Specsavers Yeovil
Robert Frith Yeovil

10 appts

25/03/2020

TBA

26/03/2020

NK Opticians Cheddar

Somerset Coast

Closed due to government guidelines

ü

Richard Mansfield
Specsavers Wells

8 appts

25/03/2020

TBA

26/03/2020

Specsavers Minehead

West Somerset

Closed due to government guidelines

ü

Cranmers

13 appts

27/03/2020

TBA

30/03/2020

Specsavers Yeovil

South Somerset

Reduced times to 10:00 - 16:00 closed wed and Sun

ü

Robert Frith Yeovil

1 appt

30/03/2020

TBA


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COVID-19 UPDATE FROM MUSGROVE PARK HOSPITAL
 

Dear Colleagues,
 
Re COVID-19
 
We wanted to get in touch with our Optometry colleagues regarding the situation with the Ophthalmology

Service at T&ST. This is a rapidly changing situation, the situation as of Monday 23rd March is the following:
 

  • The Department is open and we are continuing to see patients who have urgent, sight threatening or potentially sight threatening disease
  • The Anti-Vegf service is running, but to a new protocol. It continues to treat patients with sight threatening macular disease
  • There are currently no plans to close the service
  • We are more than happy to receive referrals in the normal way, but are adopting a strict triage protocol
  • Senior nursing advice re triage is available on 01823 344603. (0900 to 1700 hrs Mon to FRi) and out of hours via the T&ST switchboard (01823 333444 and ask to speak to Ophthalmology first on-call – emergencies only please)
  • The purpose of all the above is to lower footfall in the department and therefore to protect our elderly patients
As the situation changes we will do our best to keep you all updated.
Thank you for your continuing efforts and support in these challenging times.
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 OFNC GUIDANCE - OPTICAL PRACTICES - ESSENTIAL OPENING ARRANGEMENT - 24th March 2020


Please click here for the joint statement from the Optometric Fees Negotiating Committee (OFNC), Optometry Scotland, Optometry Wales and Optometry Northern Ireland regarding optical practices and essential opening arrangements.

Please also click on the link below to view the statement from OFNC:-  

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COVID-19 UPDATES

We’re aware you have been receiving a lot of information recently. Below there are links to the various bits of information so they are all in one place. These link have also been mailed out to all LOC's:-

 Useful Links 

 

The College of Optometrists   LINK

 

The AOP LINK 

 

ABDO LINK 

 

GOC LINK 

 

The College have also produced a well worded joint statement with the Royal College of Ophthalmologists

 about Viral Conjunctivitis and Covid-19 : LINK

 

The NHS England SOPs for Primary care (link) have not changed since 5th March but expect an update

any time now.  


The GOC has issued a couple of important statements:

1) A joint statement with the other healthcare regulators recognising that professionals

may need to depart from their usual procedures at this time : LINK

2) Reassurance that using professional judgement we can supply spectacles and contact

lenses without first requiring the patient to attend an optical practice : LINK

 

The main GOC Covid-19 page which references these and other statements is here : LINK

 

Optical Fees Negotiating Committee (OFNC) are working with NHSE on financial support and

adjustment to contract requirements. Statement today : LINK.

 


This sector-specific advice sits on top of the Government advice to all citizens : LINK  

 

This advises risk groups, those over 70 and those with underlying health conditions

(details on the site) to follow social distancing measures.

 

Social distancing is explained here : LINK

 

It has been announced that Schools will provide childcare (not education) for children of health

& social care workers so they can continue to work.

 

The guidance the schools are following is here : LINK

 

As yet there is no clarity on whether or not optical professionals are ‘essential workers’.  

For now we advise that if you can’t do without the childcare support in order to fulfil your

healthcare role you should assert that you are a key worker, until we are provided with a clear

position on this.   The argument is especially strong if you provide MECS which we expect

to be busier than usual.  The Optical Bodies are working on a model letter you can use to reply

to schools which will come out via the optical representative organisations. 

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PCSE COVID 19 UPDATE.
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OFNC STATEMENT
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