ODOB: For those moving to Level 3

Please find below information that would be relevant to your specific Alert Level.

Alert Level 3 – Summary
At this stage the Board has not received any new updates or communication from the Ministry of Health. Therefore we recommend to follow the same advice we communicated previously regarding Alert Level 3.

Appointments for allied health services such as physiotherapy, podiatry, optometry and Well Child Tamaraki Ora services will continue to be mainly online or over the phone. Some face-to-face physiotherapy, podiatry, optometry appointments may be provided for urgent appointments only, so long as professionals can take appropriate measures to manage public health risks.

If you decide to practise:

• The Ministry of Health has advised that acute/emergency or ‘urgent care’ consultations that cannot be postponed are allowed. Virtual and non-contact consultations where possible is the preferred method of service delivery. Sales and commercial gain should not influence any clinical decision making

‘Urgent care’ for community allied health professionals is defined as:
1. a condition which is life or limb threatening or
2. treatment required to maintain the basic necessities of life or
3. treatment that cannot be delayed or carried out remotely without risk of significant harm or permanent and/or significant disability and
4. which cannot be delivered by a service which is currently operating or by health professionals that are already in contact with the patient.

• You are not allowed to physically open your practice or have consultations for ‘retail’ purposes. Practitioners who want to engage in ‘retail’ selling must do so without members of the public entering the practice and without physical contact eg. through phone/online orders and delivery (following all MBIE hygiene protocols).
• The repair and/or supply of prescription glasses and contact lenses required to ensure that a person has the ability to carry out their usual life activities.
• The supply of new eye wear only in circumstances where the customer cannot make do with their current eye wear because it is either broken, lost or is no longer providing them the vision they need to operate a normal life.
• Routine examinations, recall examinations, ‘browsing’ practice visits or examinations that could be deferred are not allowed.
• Continue to triage all patients and asking Covid-19 screening questions before permitting them to enter premises. This should not be done face to face, where possible.
• If you are using messaging, telehealth or virtual technology, the Ministry of Health has created advice that you should follow. Click here
• People at higher-risk of severe illness from Covid-19 (e.g. those with underlying medical conditions, especially if not well-controlled, and the elderly) are encouraged to take additional precautions when leaving home. We recommend that unless necessary you should not see patients in this category.
• Entry by members of the public to your practice should be by arranged appointment only.
• You must record details of all members of the public entering your place of business to ensure effective contact tracing. The Board may, at any time request this information and it should be readily available. For further information: Click here
• If a patient has a support person(s) with them, please ask the support person to wait in their car/outside the practice. If the patient requests or needs a support person then allow to enter the practice (remember to ask Covid-19 screening questions, follow all physical distancing and hygiene protocols).
• Ensure that any person entering the practice sanitise their hands and follow Ministry of Health hygiene protocols.
• Physical distancing must occur and you must ensure that the practice environment allows for this. This includes controlled/restricted entry (one patient in the practice at a time rule) to the practice and restricting staff numbers. With the exception of a consultation, 2 metre physical distancing should occur with members of the public and in a controlled environment such as a workplace, 1 metre distancing is required.
• Allow adequate time between appointments to allow to properly clean and disinfect equipment that the patient came in contact with (e.g. slit-lamp, camera, OCT etc) and any areas of physical touch made by the patient (e.g. handrails, reception counter, EFTPOS terminal).
• Minimise any close contact assessment such as slit lamp examination to less than 15 minutes.
• We advise not to use aerosol generating procedures (e.g. the use of non-contact tonometry). The Ministry of Health advises that they pose a higher infection risk for health professionals.
• PPE should be worn when in close contact with patients (e.g. consultations). You should be familiar with how to safely apply and remove PPE. Incorrect use of PPE can create more risk.
• Staff working within 2 metres of a patient should wear a mask.
• Domiciliary visits and rest home/aged care facility visits should not occur.

The Board also recommends that you continue to work collaboratively with your DHB. Follow, at a minimum, the current Ministry of Health guidelines, published on their website and stay in contact with your professional body including the NZAO and ADONZ.

Alert Level 4 – Summary

Emergency and acute eye care – new restrictions

As you are aware, optometrists are recognised as essential health services in the delivery of 'emergency and acute' eye care under Alert Level 4. However, due to the increased risk of the transmissibility of the Delta variant, the scope of provision is to preserve life or limb only.

Click here for the communication from the Chief Allied Health Professions Officer.

Therefore, if your patient needs are urgent/acute and cannot be assessed, or treated via telehealth, please contact your local DHB and refer them to these services. Face to face consultation should not occur under Alert Level 4 unless it is to preserve life or limb.

The Board has be in contact with RANZCO to ensure ophthalmology is aware of these changes and the subsequent impact on DHB eye departments around the country.

In addition the Ministry of Health has provided extra clarity around the provision of emergency and acute eye care. Click here

Provision of optical products and devices – new restrictions

As indicated earlier the provision of optical products could be considered an essential non-food product, if it is deemed by the practitioner that it is an essential good and meets the definitions set out by the Government.
However, this must be limited to instances where it is at a level of a “true emergency” only (using sound clinical judgement) and can only be done without any face to face contact. Optometry practices should remained closed and patients should not be invited to attend the practice. Delivery of goods should be done adhering to all strict Covid-19 protocols specified by the Government. Sales and commercial gain should not influence any clinical decision making.
The above information may be subject to change. If any further updates become available, especially around Alert Level 3 requirements, these will be communicated as soon as possible.
Noho ora mai / stay well
Jayesh Chouhan, Board chair and Antony McFelin, registrar