A homeless vision

01 Vision Care for Homeless People (VCHP) started out as a single one-day-a-week service in London and now has six clinics across the UK. 

In 1997, current chair of VCHP, Elaine Styles, began volunteering at Crisis at Christmas, an initiative which offers a range of services, including free sight tests for homeless people. Two years later, Elaine took over the running of the Crisis at Christmas opticians service. In 2003 she met optometrist Harinder Paul, who had the same desire to help vulnerable people, so they teamed up to establish a year-round optical service for homeless people, and VCHP was launched.

In the early days, VCHP was a one-day-a-week optical clinic based at London’s Crisis Skylight centre in Aldgate East. It offered eye examinations and spectacles free of charge to homeless people. Today, the charity runs six clinics across the UK, with three in London, and one in Brighton, Birmingham and Manchester.

Since the charity was established 13 years ago, we have performed in excess of 10000 eye examinations, and now test the sight of around 1400 homeless people annually.

02 We opened a clinic in Manchester in 2014 and it has since exceeded our expectations to become completely self-sustainable, which is the overall goal for all of our clinics. 

Prior to opening, we were very proactive in raising awareness of the charity among the local optical community to ensure that we had the volunteers required to maintain the service.

Today, the clinic is run completely by volunteers. We have a retired mathematics teacher who volunteers as clinic manager, with a healthy number of optometrists who volunteer on a regular rota basis. An optometry lecturers from the University of Manchester has supported the clinic with training and a number of optometry students volunteer.

This clinic is a great example of how important volunteers are to the success of the services offered through the charity.

03 Crisis at Christmas continues to be a key date in the calendar for VCHP.

It offers the charity the opportunity to reach out to homeless people who wouldn’t usually attend one of our regular clinics, with many homeless people travelling from quite a distance to benefit from the range of services offered during Crisis at Christmas, including physiotherapy, podiatry and hairdressing.

Crisis at Christmas operates from 10 Crisis centres across London – five day centres and five residential centres. In 2015, opticians service volunteers operated up to five mobile services each day which saw them offer sight tests in each of the centres across London.

Ophthalmologists were also on-hand at a static clinic in Bermondsey to deal with urgent referrals.

Crisis at Christmas 2015 was our most successful to date and saw our team of 85 optical volunteers test the sight of 363 people during the seven-day service. Of those tested, 24 referrals were made for further investigation. Furthermore, 242 required single vision lenses, 68 were prescribed bifocals and 82 were given ready readers.

Crisis at Christmas is expanding and this year, in addition to London, operated on a smaller scale outside of London in Birmingham, Newcastle and Edinburgh. Organisers are starting small, but, as it expands, VCHP will certainly be looking to support them in providing an opticians service in those regional centres over the Christmas period.

04 Less than 50% of the homeless people we see in our clinics are eligible for NHS funding at that point, which demonstrates a huge health inequality. 

Yet for homeless people, an eye test and a pair of spectacles could be key to getting them back into work, onto training courses and, more broadly, keeping them safe.

As a result, advocacy is key for us – we need to reduce the level of health inequality, which is rooted in the fact that the general ophthalmic services contract does not work well for homeless people.

At an awareness-raising event, hosted by the charity in the House of Lords in September, we secured support in the form of signatures from a number of attendees backing the call for change.

In reality, the amount it costs to provide a good optical service for homeless people is tiny, yet the rewards it can reap are huge.

05 Mobile clinics are the next step for the charity. 

Having operated mobile clinics as part of Crisis at Christmas over the last few years, we believe that we can make mobile clinics work on a nationwide scale.

In the cities where we run clinics, we estimate that we are only servicing around 40% of homeless people, leaving 60% who may desperately need our help who we are not reaching.

Operating out of Crisis’ Skylight centre in Spitalfields, we plan to run a mobile pilot in Tower Hamlets. This will see volunteers go out to selected hostels and day centres to offer sight tests and spectacles.

However, we are still in the process of securing the funding to enable us to begin this pilot. While we have received a kind donation of more than £4000 from the Worshipful Company of Spectacle Makers, which has allowed us to purchase the kit we require, we estimate that it will cost around £15000 a year to effectively run an evaluated pilot and then roll out the service.

06 Capacity building is key to the further expansion of VCHP. 

In the past, the charity has operated in a centralised manner, which, having now expanded across the UK, is not the most effective way to continue to operate. We understand through the success of our Manchester clinic that local involvement is key and are looking to establish federated clinics. This will allow local groups who are interested in setting up a VCHP clinic in their area to do so with the support of the charity.

We often get approached by professionals who want to offer a similar eye testing service to homeless people in their area and we want to respond by providing a package of support that will allow them to do so efficiently and effectively under the VCHP umbrella.

We currently have a team of volunteers who are working on creating the tools required to allow us to move forward with this approach. The support we will provide comprises consultancy and advice, central co-ordination and administration, common procedures and governance, fundraising and outreach  materials, all maintained within a partnership approach that is guided by a memorandum of understanding.

We are a specialist service operating to support a small amount of people. However, homeless people exist in every city across the UK so there is a definite need for the services we offer. Volunteers are key to the establishment and ongoing success of VCHP clinics across the UK, and we see this approach as the way forward.