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Make eye care at home easier to provide

Domiciliary providers have a role to play in preventative care

Brown eyes

Key points

  • Domiciliary optometrists can be instrumental to the eye health and overall wellbeing of the most vulnerable members of society. They can also assess risk of falls and frailty to help prevent accidents that can be devastating
  • Enablers for domiciliary practitioners must be put in place to formally monitor and report back on a patient’s risk of further harm
  • There are prohibitive Pre-Visit Notification (PVN) requirements in many areas of the country, these requirements must be revoked so that practitioners can see their patients as soon as possible.

People in care homes or in their own homes who cannot travel for an eye examination/sight test are entitled to domiciliary eye care. As the ageing population of the UK continues to expand, so too does the number of people who may require access to domiciliary eye care. Indeed, data shows levels of domiciliary eye tests have risen by more than 80,000 over the last nine years.

The importance of good quality domiciliary eye care cannot be overstated from a psychological perspective. Qualitative research suggests that receiving domiciliary care for the first time is a significant life event, often prompting a self-realisation of advancing age. This means that the provision, relationship and approach from visiting optometrists are crucial for the psychological well-being of older people.

Similarly, comprehensive care-home eye assessments are shown to improve the management of eye conditions with the interventions improving visual acuity and quality of life for those who receive it. The practitioners are also in a perfect position to assess the home environment for any risks of falls offering crucial preventative advice, and also to note any concerns about mental health or feelings of isolation.

However, it is a service that has low core NHS funding (with £40 per patient barely covering cost), and geographic coverage for care homes being variable.

There is also a cumbersome Pre-Visit Notification (PVN) requirement that can mean a patient waits between 48 hours and four weeks before the practitioner can perform the eye examinations. Since the pandemic, the PVN requirement for practitioners providing domiciliary eye care has become increasingly divergent across the four nations, but most practitioners feel that it is unnecessary and prohibitive for the patient.

Recommendations 

  1. Remove or standardise PVN requirements for domiciliary sight tests in England and Scotland, as already done in Wales
  2. Practitioners performing domiciliary visits, should be empowered to enable preventative care, both in terms of falls prevention (environment, frailty check, lighting etc) and for identifying risks that relate to isolation/mental health issues 
  3. Establish a clear, accessible reporting mechanism to social care services and/or to the GP.

References

For a full list of resources used to create this information hub visit our reference page.

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