Q&A: Paul Chapman-Hatchett
OT hears from the co-chair of the Domiciliary Eyecare Committee about issues affecting the sector – and the focus for 2023
He speaks with OT about the importance of engaging with all domiciliary providers, the role of DEC meetings, and the issues facing the sector.
What is your vision for the DEC?We want to have an organisation that represents as many domiciliary providers as possible. The aim is to have a single voice to represent our views, making sure that we are heard and represented at the top table.
I have been involved in DEC for many years as a committee member, then when Gordon [Ilett, former chair] stepped down, I became co-chair. Fellow co-chair, Dawn Roberts, and I plan on continuing the good work Gordon was doing – ensuring that domiciliary providers are heard and making the DEC more influential within our sector.
I firmly believe that the domiciliary sector has a huge scope for growth within optometry. I think it is important that our profession recognises that opportunity. Because we only make up 3–4% of current NHS work, people may say we should only be allocated that amount of influence. But actually, we need to look at the future, and how important domiciliary eye care will be in 10 or 15 years’ time.
The fact that you are housebound should not diminish your opportunity to maximise the quality of your sight
Internally, we need to ensure that we promote the highest standards of care for domiciliary patients and encourage and support all domiciliary providers to follow the Optical Confederation Domiciliary Code of Practice.
Can you tell me about what is involved in DEC meetings?I would like to encourage as many domiciliary eye care providers as possible to attend DEC meetings or request to receive the minutes of the meeting. This will help support them as the future of domiciliary optometry continues to grow and develop across all four nations. The meetings also provide insight on where the pinch points are within our sector.
There are four DEC meetings each year, held remotely via Teams. We had our first meeting of 2023 in January, with meetings scheduled for April, September and December. Optometrists who would like to attend a meeting or receive the minutes can get in touch with me by email.
Broadening the representation of providers within the DEC is really important. As an example, during COVID-19, several members of the DEC fed back information about what was happening in their practices as a result of the pandemic. This information helped in the negotiations with NHS England to gain financial support.
What do you see as the key issues facing domiciliary eye care at the moment? What work is the DEC undertaking?
At the moment, DEC is looking at the prior notification process. We are pushing for that process to be removed. For more than 20 years, we have had a system where we have to give the NHS 48 hours’ notice when we receive a request from a patient to be tested in their own home. If you want to see three or more people at the same site, then you have to give three weeks’ notice. That is obviously not something you have to do when working as an optometrist on the High Street and is clearly detrimental to level of optometric care we are able to give to our more vulnerable members of society. It is an example of a policy that was bought in, but nobody within the domiciliary sector had input into the practicalities. Because we are a small part of a small profession, it is difficult to get the Department of Health and Social Care to allocate time to this issue and remove the prior notification process.
We are also focussing on IT connectivity. There is a movement at the moment for practices to be able to access NHS records – we need to figure out how that will work for the domiciliary sector.
DEC believes strongly in the fundamental right to sight – the fact that you are housebound should not diminish your opportunity to maximise the quality of your sight. We send out communications to organisations that care for housebound individuals, for example care homes, on a regular basis talking about the importance of making sure their residents receive screenings to check if they need a sight test.
There is an independent adjudicator who works for the DEC on a voluntary basis and helps to mediate conflict between different parties within the domiciliary sector. He reviews situations where there is disagreement between domiciliary companies but there are no concerns about professional practice that would require a referral to the General Optical Council. The independent adjudicator plays an important role in highlighting the responsibilities that a domiciliary provider has and ensuring that they follow best practice.