The College and Optometry Scotland have published a joint statement developed in conjunction with Scottish Government to explain how lockdown restriction easing will affect optical practices and have issued guidance on the appropriate application of the self-isolation exemption in Scotland following recent government announcements.
Following the publication of a letter from the Scottish Government Health and Workforce Directorate, fully vaccinated frontline health and care staff may continue to work on a voluntary basis rather than self-isolate when they have been identified as a close contact of a COVID-19 positive case outside of the work setting. This has been introduced to help alleviate pressure on healthcare services and only applies “in extremis” situations where healthcare settings are experiencing or facing a major disruption to service provision that poses a significant risk of harm to patients, service-users, and staff.
NHS Scotland has provided guidance on the strict criteria required for safe and effective early return to work for self-isolating individuals. The College and Optometry Scotland support the need to prevent service disruption but believe this exemption is unlikely to apply in primary eye care except in exceptional circumstances as determined and approved by the local Health Board authority.
To ensure appropriate application of the exemption in primary eye care, the College and Optometry Scotland advise that practices should:
• Ensure all existing resilience measures in place as part of the practice’s service risk mitigation plan have been exhausted
• Demonstrate from a full risk assessment that individual staff absence due to self-isolation would cause major service disruption
• Ensure that all exemption criteria for the individual staff members apply
• Apply to the local Health Board authority involved in decision-making for exemption approval on a case by case basis
• Have sufficient testing mitigations and clinical safeguards in place to allow staff to return to work safely in appropriate roles.
The exemption should 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.
Easing of restrictions
The First Minister for Scotland announced on 3 August that COVID-19 restrictions are set to be further eased as Scotland moves beyond level 0 of the five-tier alert system from the 9 August. However, Scottish Government has confirmed that the infection prevention control guidance (IPC) for primary care settings, including optical practices, remains unchanged. This means the College’s Amber phase guidance continues to apply in Scotland, so practices should continue to:
• Follow and implement COVID-19 IPC procedures
• Triage patients for COVID-19 symptoms and prioritise appointments based on need and symptoms
• Require patients to wear face coverings when on the practice premises unless they are exempt
• Maintain good ventilation throughout the practice
• Ensure all staff are wearing a face mask and follow the correct use of PPE
• Encourage all staff to undertake lateral flow tests and report the results regularly.
Practices should also continue to maintain 2m physical distancing where possible. However, it is understood that the physical distancing rules for health and care settings in Scotland is currently under review which may result in changes to the 2m recommendation. We will continue to work with Scottish Government and alert members to any changes to physical distancing guidance.
We recognise how hard practices have worked and continue to work to keep patients safe and wish to emphasise the importance of continued scrupulous hand washing and surface disinfection to protect practice teams and patients.