Domiciliary at your door

The scenario

Valerie, AOP member

“I own a small independent practice in the Lake District and have been thinking about introducing a domiciliary eye care service in order to meet a growing demand from my patient base. What business-related regulations do I need to meet and what technology do I require to ensure I can perform a comprehensive mobile sight test?”

The advice

Paul Chapman-Hatchett, founder and managing director of Complete Community Care

As we get older, our bodies naturally begin to slow down and deteriorate, and we have an increasing need for assistance. Many people use domiciliary (home-based) help to assist them with the day-to-day difficulties that arise from being less mobile.  

It is worth remembering that 95% of over 65s require a spectacle correction and yet only 35% of this age group have attended their essential eye examination. As a consequence, about 75% of this population are suffering sight loss, which is deemed significant enough to affect their quality of life. Coupled with this, nearly half of us will suffer from cataract and over 50% of us will have some sight loss due to macular degeneration. This is a remarkable statistic in an era where medicine and optometry are achieving more than ever in terms of diagnosis and treatment to correct and enhance vision. 

Therefore, if you are looking to help your clients who are unable to access your practice on the High Street, there are a few options available. You can either set up a domiciliary arm to your practice as you state, or you could use a bolt on service that is offered through the practice but delivered by another company.

"Only 35% of over 65s sign themselves up for regular eye examinations...This has led to a staggering 95% of over 65s wearing the wrong prescription glasses "

Option A: Set up on your own

If you decide to establish your own domiciliary practice, you will need to take into consideration the following:

• New equipment – much of the essential equipment used in the High Street has a portable equivalent. The practice would be looking at an investment of approximately £15,000 of optical equipment and a further £2,500 of dispensing equipment and frames
• Updated insurance – both for the business and a car
• Additional NHS contracts – before you are able to start to provide a domiciliary service you are required to apply for an additional services contract, which can take between three to six months. You will need to provide all of the evidence to support your application to the NHS to be awarded the contract
• NHS notification requirements – firstly, you will need to establish with the client their eligibility for an NHS domiciliary examination If you are seeing three or more people, three weeks notice is required, for one or two clients 48 hours notice is required in advance of your planned visit. This must be done by fax or by email using an nhs.net email address
• Communication, protection and dignity of clients – all members of staff will need to adhere to the Equality Act 2010 and Mental Capacity Act 2005 when testing. As well as the necessary skills for effective communication with domiciliary patients, particularly those living with cognitive impairment
• Safeguarding and lone working guidance – all staff must be aware of the lone working guidance and safeguarding guidance to protect all parties as well as understand what to do in cases of concern.

Option B: Offer domiciliary care as a bolt on service

The logistics of offering a domiciliary service are often not financially or logistically viable for a High Street opticians. Therefore, Complete Community Care has established a solution that can be utilised by practices to help ensure that their clients remain happy and loyal to their brand. This bolt on service through us is called Just Peachy.

Could partnering with Just Peachy be the answer?

The Just Peachy Optical Partnership was founded by Community Care Opticians in order to enable a high street practice to offer a bolt on domiciliary service. This offers opportunities to help your practice to grow and also ensures that you are able to complete your existing service and provide eye care to all your patients. It will also bring you in line with some of the larger multiples who offer an exisiting domiciliary service.

For more information on this partnership, contact 0203 418 8488 or email [email protected]

Useful information 

• General guidance on domiciliary sight tests is available in the leaflet Sight test at home  
• Guidance on preparing for a sight test is available on the SeeAbility website, which can be easily be adapted for domiciliary patients 
• Further guidance on NHS notification and claims is available in the Optical Confederation documents on Making accurate claims.

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