Your Questions & More

Hi , 

Welcome to 2022, we hope you had a relaxing festive break.  As the forthcoming date for WA borders reopening is nearly here, there are obviously many questions that come to mind with regard to living & working with COVID in WA. As always, we are regularly checking for further updates & information from the WA Government & Health Department, but to date, there has been no new updates concerning optometry but we will ensure that you are kept informed as soon as we have details. 

We have prepared a FAQ as per the information to date either in WA or nationally.  This information maybe subject to change and in some instances, we have provided the link to the source information.

COVID-19: Masks / PPE

Can you refuse entry to your practice to patients who refuse to wear a face mask/covering if they are required to do so under a public health direction?

• If there is a public health direction/mandate in place in your area, it is the person’s responsibility to wear a face mask or to assert that an exemption applies.  
   
• The public health direction can only be enforced by police.
   
• Your practice does not have to enforce the public health direction.
   
• Businesses will commit an offence if they do not comply with the direction.  Currently, the public health direction to wear masks indoors (hence optometry practice settings) apply to Perth, Peel and Southwest regions.  Click on the red button below for latest web update on masks in WA.  
   
• For suggested wording on how to speak with a patient, click on the blue button below for 3 scenarios under ‘how should you approach a situation where patient refused to wear a face mask‘ 

Can you refuse entry to patients who refuse to wear a face covering/mask at the practice, even if there is no government mandate to do so?

In areas where face coverings are not mandatory, the current advice is that wearing a well-fitted mask can help protect you and those around you if you are in an area with community transmission, and physical distancing is not possible, like on public transport.

As an occupier of a private optometry practice you are entitled to take reasonable steps to protect your staff and patients on the premises. You can make it a condition of entry that a person wear a face covering on arrival at the practice, unless they have a lawful reason not to wear a face covering

In these situations, we recommend that you speak with a patient about their reason for not wearing a face covering before you exclude the patient from your premises.

If the patient has a reasonable explanation (for example, a medical condition which prevents them from wearing a face covering safely), you should consider what other risk management strategies you can adopt to keep everyone safe.

For example, you might consider asking patients who are not able to wear a mask to sit in a room other than the waiting room.

What is your obligation to treat a patient without a face mask/covering? 

You do not have to provide medical services (even in an emergency) if there is a risk to the health and safety of you, your practice staff or your patients. We recommend you assess the nature of the risk and only refuse treatment if it is reasonably necessary to ensure health and safety.

Should patients be given N95/P2 masks if they are wearing their own cloth masks?

There is no directive on this.  The N95/P2 masks are better than surgical but 3x as expensive.  Wet surgical or cloth masks are deemed ineffective.  A poorly fitted mask (of any type) will also be less effective.  See below for comparison chart of cloth masks vs N95.  

Should Optoms wear disposable gloves? 

This was actually the mandatory PPE in the UK but it is NOT mandatory here in Australia.   It is your personal choice or otherwise frequent handwashing.   See button below for handwashing information. 

COVID-19: Practice Management

Do you need to enforce patients check in using the SAFEWA app?

All people (other than patients) who enter your practice must provide their contact details electronically. This includes both staff and people attending with a patient.

Your practice must facilitate this by providing a SAFEWA QR code or an alternative digital sign-in sheet for those who do not have a smart phone or are unable to sign-in using the SAFEWA QR code.  This will allow people (other than patients) entering the practice to register their contact information.

Optometry practices must take “reasonable steps” to ensure everyone complies with the requirement to check in, that is as below;

• display your QR codes in prominent locations
• remind people to check-in when entering your premises
• where possible, keep an eye out for new people who have entered your premises
• ask to see the ‘green tick’ on the SAFEWA app & check it relates to your premises.
• If a patient is non compliant, and you have provided all of the above, it is not your job to enforce if a patient continues to refuse. Use your discretion as to whether they will then comply with mask wearing or temperature test.
   

Can you undertake temperature testing before allowing a person access to the practice?

There is currently no directive or recommendation to conduct temperature testing.  We encourage you to review other methods of minimising risk just as asking triage questions  (e.g. 'Are you feeling unwell and/or showing symptoms?, if so please rebook ‘ ) and other infection control measures. 
Click on the green button below; you will need to be logged in to OA to view.

However, if you decide to implement temperature testing; 

• You can only take a person’s temperature with their consent.
• If testing is used for screening for access to the practice, you should have a protocol about temperature testing which includes what will happen if a person’s temperature is above the required temperature or a person refuses to have their temperature taken.
• You should consider whether employees with a high temperature will be paid sick leave.
• You also need to ensure compliance with the privacy laws in respect of information about a person’s temperature.
   

A staff member is required to self-isolate. How should you pay them? 

Below is the legal position, but it is up to each practice to determine how best to manage the situations that arise with their staff. Many Australian employers are choosing to provide paid special leave to employees who are required to self-isolate.   If a worker is not able to work from home, the employer will need to consider how to pay the worker, taking into account the legal position below.

1. The employee is sick    If the employee has contracted COVID-19 or is otherwise sick, the employee is entitled to paid personal/carers leave. The employee can take other forms of paid leave if they run out of paid personal/carers leave.

2. The employee is required to self-isolate due to government requirements
The following award include an entitlement to unpaid pandemic leave if an employee is required to self-isolate:

• Health Professionals and Support Services Award 2020

3. The employee is required to self-isolate by the employer    Given the unique circumstances of COVID-19, a practice can require an employee to self-isolate if the practice is concerned that the employee may be a COVID-19 risk. However, the practice must pay the employee their usual wages for the relevant period without deduction from leave entitlements.

4. Government benefits    Government benefits may be available to employees who are unable to work and not entitled to payment from their employer.

Can you tell staff that a colleague or a patient has or may have contracted COVID-19?

The Office of the Australian Information Commissioner has stated that yes, you may inform staff that a colleague or visitor has or may have contracted COVID-19 but you should only use or disclose personal information that is reasonably necessary to prevent or manage COVID-19 in the workplace.

For example, depending on the circumstances, it may not be necessary to reveal the name of an individual in order to prevent or manage COVID-19, or the disclosure of the name of the individual may be restricted to a limited number of people on a ‘need-to-know basis’. Whether disclosure is necessary should be informed by advice from the public health unit.

COVID-19: Vaccinations FAQS

Can your practice refuse entry to a patient who has not been fully vaccinated against COVID-19?  
Source: Avant’s Vaccination FAQs

Unfortunately, the answer to this question is complex.   To help you navigate this issue and minimise the chances of running into a legal problem, we suggest you consider the following issues before you refuse entry to an unvaccinated patient.

Step 1:  Check the public health directions in your state and territory 
In WA, public health directions do not currently prevent a person from entering a medical practice if the person is not vaccinated against COVID.

In the absence of a WA government directive to refuse entry to unvaccinated patients in health practice, below are some considerations if you wish to consider this as your own business policy to implement.  

As a private business, you can implement own policies for condition of entry, however, please note considerations below; 

Step 2: Obligation to treat a patient    A medical practice does not generally have to allow a person to enter the practice.

Step 3: Consider whether the decision not to treat the patient may be discriminatory   You can refuse to allow an unvaccinated patient to enter your practice except when the patient is not vaccinated for a reason such as:

• the patient’s medical condition
• the patient’s age (for example, because the TGA has not approved vaccination for their age group)
• the patient’s religious beliefs.

It can be lawful to discriminate if it is necessary to ensure the health and safety of people in the practice.

However, the practice should first consider whether there is another way to provide a service to the patient other than through entry to the practice (for example, via telehealth).

Step 4: Consider work health and safety issues   Under work health and safety laws, practices must ensure the health and safety of their workers, patients and others at the workplace.

Your practice should undertake a risk assessment in consultation with practice staff to determine whether patient vaccination against COVID-19 is necessary to ensure health and safety in the workplace.  E.g. If your practice has immunocompromised staff members.

In undertaking a risk assessment to determine whether people should be required to be vaccinated against COVID-19 before they enter a practice, you should consider factors including:

• advice from state and federal health departments
• advice from work health and safety bodies
• rate of community transmission in your location and the patient’s location
• risk of transmission in your practice, having regard to the specific features of your practice
• nature of the services provided
• consequences of refusing access to the medical service
• type of people who use the optometry service and whether there is a heightened risk they will suffer severe symptoms if they contract COVID-19 (for example, people over 60 or people with pre-existing health conditions)
• whether the business could put alternative measures in place to protect staff and patients (for example, telehealth appointments or seeing the patient outside the physical practice)
• how long people generally stay inside the optometry practice when receiving optometry services
• whether it is possible to socially distance in the practice
• availability and practicality of COVID-19 testing.

Your practice should already have policies in place for dealing with:

• how you initially see patients
• the use of personal protective equipment (PPE)
• how you manage cases where patients have COVID-19 symptoms.

Telehealth may be an option for treating a patient who is unvaccinated.  Though we appreciate that Telehealth may not be suitable for all patients, it may be an option for some patients. We have telehealth optometry tips here. 

Step 5: Other factors    Your practice may wish to consider other factors before making a decision to refuse treatment to an unvaccinated patient:

• the reason the patient is not vaccinated (e.g. the patient intends to be vaccinated but has had difficulties accessing vaccination)
• whether the patient is a new patient or existing patient
• if a optom elects to terminate the optom-patient relationship or deny treatment to a patient because the patient is not vaccinated, the patient may make a complaint
• the capacity of the patient to obtain treatment elsewhere (for example, denying treatment at a your practice versus a specialist practice where there are a limited number of specialists in that area)
• the patient’s need for continuity of care (having regard to factors such as the urgency of care, the value of an ongoing treating relationship etc)
• your right to conscientiously object to treating patients who are not vaccinated.  

Other Questions asked: 

1. Are Optometrist's included in Healthcare in terms of being one of the industries that the government says DO NOT have to isolate if a person is a close contact but tests negative?
   Awaiting further clarification from WA Gov Health department but current information indicates NO at present.  Optometrists or other private allied health are not included to date.
    
2. We would like to continue seeing unvaccinated patients. What are some tips to minimise risk?
   You can consider booking unvaccinated patients as last patient of the day, or request they take a Rapid Antigen Test prior. 
   
   In general, you may wish to consider the implications of a staff member testing positive and the planning of a staff roster that keeps key workers separate.  Split your work force to ensure if 'Team A' have to isolate, 'Team B' do not as they have not come into contact with their colleagues on the other roster. 
    
3. Where do we purchase RATS?   

   Other than suppliers who sell home-use tests and suppliers such as Good Optical in Melbourne, the recent change in availability of ‘Point of Care’ RATs  to optometrists may widen your net of suppliers.
    

   As of 7 January 2022, the TGA has now allowed optometrists in all states to be able to test their patients using COVID-19 rapid antigen Point of Care tests. Point of Care rapid antigen tests are designed for larger-scale professional testing and require user training. They are not the same as COVID-19 rapid antigen self-tests (home use tests), but are often less expensive. See RAT comparison chart below red button. 
   
   Until this date, only medical practitioners and paramedics were able to test patients. This means that point of care tests can now be legally supplied under specific conditions for use by trained health practitioners (including optometrists) and trained staff under their supervision.
   
   There is no directive to do so, but if optometrists wish to test patients (or employees) using Point of Care tests, you are responsible for sourcing the test kits yourself. Optometrists can charge patients a reasonable amount as a privately billed service to recoup costs of testing. As part of these changes, optometrists are not permitted to provide a general testing service for members of the public (i.e. for people who are not their patients).
   
   A list of approved tests with their local Australian sponsors (suppliers) is available on the TGA website.  
   
   To find approved Point of Care rapid antigen tests, select 'Point-of-Care test' under 'show only' and sort by 'Point of Care test' , and contact the ‘ Australian sponsor’ listed.

    

4.  Some members have asked about Discrimination - please click on the button below to read the WA Gov webpage on Discrimination.

Discrimination Information 
Click below for WA Statement

5.  When borders open or even now does an Optometry practice require patients or customers browsing, to have to show proof of vaccination?

To date, the WA Gov has NOT included optometry practices in the list of venues that are required to check vaccination status prior to allowing entry. 
 

6.   Please note that although we have a national definition of 'close contacts' the national & state definitions of close contacts vary wildly. 
We are yet to hear from WA State Government regarding their specific definition and instructions in an attempt to minimise workplace disruption. 
 

Submit your Question below or contact the OA Helpdesk for any COVID-19 queries on national@optometrywa.org.au

Optometry Western Australia acknowledges the Traditional Custodians of the lands where our optometrists live and work and pays respect to the past, present and emerging Elders of this nation and the continuation of cultural, spiritual and educational practices of Aboriginal and Torres Strait Islander peoples.