A great deal of change and upheaval to the way eye care is delivered has been forced upon optics as a result of the pandemic. At the beginning of lockdown, some practices opted to stay open to provide urgent and emergency eye care and others decided to close completely, which meant different methods of providing services were required. Now that lockdown has eased and routine appointments have returned, many optical practices will be considering whether these methods could be applied permanently.
Covid-19 forced new ways of working on the entire industry and with eye care classified as essential, teleoptometry came to the fore once again. What was previously discussed as the future of the profession became a part of the immediate response to providing eye care during the pandemic.
Remote consultations were included as part of the introduction of Covid-19 urgent eye care service (Cues) in order to minimise the need for patient travel and the risk of infection transmission. It was one of the three principles Cues was built upon. Primary Eyecare Companies were highlighted by the Local Optical Committee Support Unit as a resource to provide software support to optical practices in order for them to deliver remote consultation. While teleoptometry does not allow eye care practitioners to utilise their full range of skills, it does allow for some services such as triage to occur.
Delivering services
In order to provide clarity to eye care practitioners who have introduced new equipment and technology during the pandemic, the General Optical Council (GOC) has highlighted the relevant legal requirements. The statement was prompted in response to a query regarding the use of technology, particularly online technology for use during remote consultations.
A statement said: ‘In these extraordinary times, we are fortunate that in all four countries of the UK 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.’
The GOC added that it hoped to reassure registrants that when they act in good conscience, for the public benefit, exercising professional judgement in all of the circumstances that apply, the GOC will support them.
‘Along with all other healthcare regulators, the GOC has signed a joint regulatory statement which acknowledges that registrants will need to act differently and deliver care in different ways during the Covid-19 emergency in line with government and public health guidance,’ the GOC said.
Meeting standards
The GOC noted that the Opticians Act 1989 does not restrict the type of equipment, products or technology that can be used by registrants. In addition, GOC standards state that registrants must follow key principles to keep themselves, those they lead or manage, and those they care for, safe. Standards for optometrists and dispensing opticians include: ensure that knowledge and skills are up to date; conduct appropriate assessments, examinations, treatments and referrals; and ensure a safe environment for patients.
Standards for business registrants include: when technological interventions, including artificial intelligence and machine learning, are introduced ensure they do not compromise patient care; only provide, promote and utilise equipment, medications and medical devices, including software and other technologies, that are fit for their intended use, hygienic and in a good state of repair; ensure that staff have undergone appropriate training in their use; prevent unauthorised access to equipment; and provide patients or carers with the information they need to be able to safely use software and other technologies that they have been directed to use in order to manage their eye conditions.
Professional judgement
The GOC’s statement acknowledged that some registrants may look to use equipment or technology that they have not used before during Covid-19 in order to provide care remotely, facilitate social distancing in practice, or triage patients.
‘The landscape for regulating technology is complex. We do not have a direct role in the regulation of equipment, products or technology that is used by our registrants, and it is for our registrants to apply their professional judgment to determine when its use is appropriate,’ the statement said.
In order to exercise professional judgement, the GOC highlighted that registrants should consider relevant clinical advice, advice from optical professional bodies and advice from other regulators. In addition, registrants should consider public health advice at the time as some patients may be self-isolating, vulnerable, unable to attend the practice because of availability of public transport, and domiciliary visits may not be possible.
The GOC concluded that registrants should make note of their decisions, including their reasoning, and patient records should be updated at the earliest opportunity. A review of the GOC’s statement will take place before October 31.