“We see a huge range of people”

1 During the pandemic we had to close all the clinics, but they gradually starting to open again in spring 2022

 
It’s about bringing back the volunteers. Many of our previous volunteers returned to us, but others had decided to move on. There were new people coming in so there were new areas of training that we needed to do with everybody. In Gloucester we recruited a whole new team of volunteers – optometrists, dispensing opticians and lay volunteers – who all helped get the clinic up and running.

2 In Gloucestershire, we were able to secure Clinical Commissioning Group (now Integrated Care Board) funding for our patients who aren’t covered by the General Ophthalmic Services (GOS) fee

In our clinics around a third of people are covered by GOS, but around two thirds, for a variety of reasons, are not.

Some homeless people don’t come into those categories, or aren’t registered. In the past these patients had been covered by Vision Care for Homeless People (VCHP) fundraising, but in Gloucester now we’ve got an agreement with the ICB that they fund them.

That process started with the Gloucester clinic. We started invoicing within the first two weeks of opening. For example, we saw a lady early on who wasn't on any benefits as she was new to the country. So, that was billed to the then CCG. We couldn't use GOS, but there is an alternative source of funding available to us.

It’s the first time that model has been used in any of our clinics. It came about after our Local Optical Committee (LOC) chair approached the CCG and said that there was obviously a need. It's been great that we have that back-up and support. The CCG was great in supporting us and getting the word out. It helped develop those links with health and social care as well.

3 Volunteer recruitment is tricky, because a lot of optometry practices are really busy

Most of my colleagues are fully booked every day. There is a real need in general practice, and therefore, people stepping out and giving up their time for charity is not quite so easy.

However, we have been lucky in Gloucestershire. We had 12 or 14 people register to volunteer at the start. Whether you come in once a month or every three months, it just needs a small group of people to be consistently there. We’ve got some dispensing opticians and some clinic assistants volunteering. Our admin person, who looks after our GOS claims, does that from home, so she doesn’t need to come into clinic. She’s actually the mum of one of our optometrists.

I think COVID-19 forced us to have better relationships with nearby practices and colleagues. If you were the only practice open, or you couldn’t see somebody, it kind of built that network up a little bit more. That’s been handy. In Gloucestershire we had an emergency WhatsApp group, and we're building on that now as the clinic at Gloucester City Mission develops.

The homeless are not just those people who you see sleeping rough on the streets

4 We've been well supported by local practices donating equipment, and by our major suppliers

 
They’ve donated equipment, solutions and frames, and other things. People are really supportive, and that's been great. It’s been the LOC, the CCG/ICB, local practices, optometrists and suppliers all working together.

5 One of the things we’re doing at Gloucester is really looking at why people are coming to us, what their outcomes are, and where they have come from

We see a huge range of people. The homeless are not just those people who you see sleeping rough on the streets. It’s people who are sofa surfing, people in temporary accommodation, refugees, people who have been in and out the alcohol and drug services. Often you ask when their last sight test was, and they'll say never, or 20 years ago, or they can't remember; they've never had it done.

There's definitely a need. I saw somebody who had come into the City Mission for a reading programme. They were going through literacy, and they asked if we could check him for his glasses as well, so we did that same time then got him a pair of bifocals. Being in a multiuse building makes everything so much easier.

6 I think certainly there is going to be a demand for our services going forward

 
Ideally, you would like there to be no need for us to be there at all. That would be perfect, but that’s not realistic of where we are. When you look at the cost of living crisis and refugees, these are issues that are getting bigger and bigger.

I think there will always be a need for us, and I think it’s a case of seeing how far we can go. If there’s a need for more time in the clinics that’s certainly something we could easily look at. The room that we use is a dedicated clinic room, so we’ve got the full kit - everything you’d expect in a normal practice, but it’s a room that’s used by other people. There’s potential for us to use it more than one day a week if we need to.

7 At VCHP, we’d love to get a clinic in every major city

Setting up more clinics in major centres is a goal for the near future. It takes eight or nine months to get everything up and running, so it’s not a quick thing, necessarily, but that would be brilliant.

There are also opportunities for practices in smaller towns, for optometrists who perhaps want to host a pop-up or take a domiciliary kit into a day centre. VCHP can support them in doing that. If you find that that’s working and there’s a demand, then you could move on to setting up a clinic. There are lots of ways that people can go about helping.