More support should be provided to help with the cost of NHS eye tests, Healthwatch England says

The Department of Health and Social Care (DHSC) should provide more support for those on the lowest incomes to access NHS eye care, Healthwatch England said today.

The call comes after a new report found that the cost of eye care is deterring the public from visiting optometry practices.

The Seeing clearly: Attending sight tests and accessing opticians report was published today (17 April).

It builds on a previous Healthwatch England report, which highlighted public support for expanding the role of optometrists in eye care delivery.

The new research was carried out after Healthwatch England received concerns from the public around the cost of eye care.

It reveals that, of those patients who had attended an eye test in the past two years, 72% had experienced staff offering ‘additional services’ at a cost.

These patients were subsequently twice as likely to report that they had avoided accessing eye care in the past two years when compared to those who had not experienced this, the report said.

Healthwatch England is part of the Care Quality Commission, identifying and responding to matters concerning patients in England.

The report highlighted that the value of NHS optical vouchers has fallen by over 30% in real terms in recent years, and that the real terms value of the NHS sight test fee has fallen by an even greater amount.

This means optometry practices are being made to cover costs in other ways, for example via additional services, Healthwatch England said.

Louise Ansari, the organisation’s chief executive, said: “There are clear signs that the extra costs people face could discourage those struggling financially from visiting opticians.

“NHS funding to help meet eye care costs has not kept pace with inflation, which, in turn, is causing High Street opticians to rely more on selling additional services to make their businesses viable.”

The organisation also noted that “significant changes” to eligibility for some benefits is putting pressure on both patients and optometrists.

The report said that 14% of those who responded to the self-selecting survey had avoided eye care due to cost in the last two years.

Additionally, 39% of those who described themselves as ‘not at all comfortable financially’ said they were likely to avoid attending an eye examination.

People may also be avoiding booking an eye test because they are not aware of the financial support available, Healthwatch England said.

The organisation is now calling for a review of eye care support, to ensure that worries about cost do not continue to deter those on the lowest incomes from accessing eye care.

The Government and the NHS should consider a targeted communications campaign to engage low income eye care patients, the report also recommended.

It went on to emphasise that the primary eye care sector should have clear guidelines for how staff should assist those on lower incomes without affecting their confidence in seeking care.

A review of help and messaging needed

The AOP has welcomed Healthwatch England’s recommendation that the DHSC reviews support for the costs of NHS eye care. 

Adam Sampson, AOP chief executive, said: "No one should have to choose between paying for the basics like rent and food, and accessing eye care. Healthwatch makes it clear that NHS funding has failed to keep pace with reality, leaving both patients and optometrists in an increasingly untenable position.”

Optometrists are able to provide the clinical services needed to cut waiting times and improve patient outcomes, Sampson said, adding that the existing network of 6000 High Street optical practices in the UK should be utilised.

“The real terms decline in NHS sight test fees and optical voucher values makes the use of such services more challenging — yet optometry remains poised to deliver greater value for patients and the NHS,” Sampson noted.

The potential increase in use of optical coherence tomography in community settings has the potential to release over 211,000 hospital eye service appointments per year, Sampson said.

He added: “As a member of the Optical Fees Negotiating Committee, we have long emphasised that a properly resourced primary care system could further reduce hospital admissions, cut waiting lists, and ensure timely, patient-centred care. The current delay in the latest GOS fee announcements, coupled with the announced freezing of optical voucher values in England, risks further degrading the sector’s ability to care for the public – including those on the lowest incomes.

“Our data shows that many are struggling to afford the eye care they need and are entitled to receive. This Healthwatch report is another stark reminder that urgent government intervention is needed to prevent avoidable irreversible sight loss from conditions like glaucoma.”

Sampson also emphasised that the AOP "supports calls for the Department of Health and Social Care to increase funding for NHS eye care costs, ensuring that those on low incomes can access vital services with confidence, and enabling optometrists to play a full role in delivering high-quality care that is closer to home.” 

Ansari added: “It is essential that this situation does not impact on the most disadvantaged in society. This is why the Government needs to review the help available for those on the lowest incomes and ensure that more people are aware of how the NHS can help meet the costs of eye care.”

The self-selecting survey of 2568 people was carried out between July and September 2024.

The full report can be read on Healthwatch England’s website.