On the road with Specsavers in Surrey

Kejal Shah, the domiciliary optometrist tasked with accompanying us as we hide underneath our hoods on this unseasonable morning, greets us in the train station car park and explains how the day will work: nine patients, all in or around Leatherhead, all of them choosing domiciliary care for different reasons.

A recent marketing push on Home Visits’ offering has meant an increase in enquiries, highlighting that there is high demand for domiciliary services, Kejal tells us as we make a dash for the car. Usually, 12 appointments would be booked for a single day.

Specsavers Home Visits’ Cobham office covers all of Surrey, as well as parts of Kent, Hampshire and South London, Kejal explains. It is, she says, “probably one of our bigger patches.”

Today, she has driven from her home in northwest London – her hour on the M25 will be her longest drive of the day, with all booked patients living within five minutes of each other.

We will be meeting Home Visits dispensing optician, Zoe Sutton, at the first location, Kejal explains.

And with that, we’re on the road heading for our 9am appointment: OT’s first experience of domiciliary care.

Within seconds of our arrival, Bernard is explaining the very specific issue he has identified with his reading glasses, listing every drug he has been prescribed, and referencing by name the consultant ophthalmologist he had seen six months previously.

He is, unsurprisingly, extremely clear about what he wants – and that he would like his new lenses to be added to his existing glasses, which have small, round frames, akin to something that might be seen being donned by an onscreen 1950s academic.

Zoe, Home Visit dispensing optician, gently explains that Specsavers is unable to take on liability for his antique gold frames, which are the product of a Savile Row eyewear brand that is no longer in business.

With the conversation ongoing, and the clinical part of the visit complete, we take our leave.

Five minutes later, back in the car, Kejal explains that this appointment has been a standard one.

The clinical team, based in Cobham, is always on hand for a second opinion if needed, she says. They also always know where each domiciliary optometrist is at any one time, adding a layer of security for those who might be concerned about working on their own or in unfamiliar settings.

OT asks how Kejal found herself working in domiciliary.

She has been with Specsavers for 20 years, she says, starting as a pre-reg and owning a practice in Feltham, west London, before moving to Perth, Western Australia, for a handful of years.

Back in the UK, she found that she wanted a change.

“I wanted to do something different,” she says. “This fell into my lap, and I love it. You’re not stuck within four walls. I feel more appreciated. It’s so rewarding.”

This fell into my lap, and I love it. You’re not stuck within two walls. I feel more appreciated. It’s so rewarding

 His wife, Anne, perches on the sofa in their sunny living room and explains that Jack was recalled by Specsavers after last having his eyes tested two years ago.

She requested a domiciliary visit, she says, because her own mobility issues mean she can no longer take her husband to the Leatherhead practice.

Outside, potted orange flowers line the patio and an apple tree bobs in the rain. Inside, photos of Jack and Annes’ six grandchildren scatter coffee tables and window ledges. Anne explains that Jack was a chemist with his own company, regularly travelling to Holland, while she was a primary teacher in Fetcham.

“When I try to read a newspaper, the letters start joining up,” Jack tells us from the sofa.

Kejal is able to identify that he has been using an old pair of reading glasses, rather than those with his correct prescription.

She also explains that Jack’s muscles have weakened since he had cataract surgery on both eyes six years ago, and how an updated prescription will lessen his double vision and allow him to see his sudoku grids more easily.

The strength of his current reading glasses is too strong, Kejal explains to Anne, which is probably why he had started using his old ones. New glasses are required, because both distance and near vision have changed in the past two years.

As we leave, Jack tells us that he has never been asked so many questions during a dispense – something that we hope is a good thing.

Varied needs

Not all domiciliary visits are to patients in their 80s or 90s – some choose the Home Visits service for other reasons.

Jill, aged 70, has a bright orange manicure and Roxy frames. She also has multiple system atrophy, Parkinson’s, and borderline diabetes.

More domiciliary optometrists will be needed amid changing demographics, Kejal explains, before wrapping up the clinical portion of the visit and handing over to Zoe, who identifies green, pink and blue frames that are similar in style to Jill’s old Roxy ones.

Jill picks two frames, and Zoe reassures her husband, who is overseeing proceedings, that the same deals that customers are offered in store are also available during domiciliary appointments.

At Henry’s bungalow, the Hairy Bikers are on the TV and more grandchildren – plus smiling faces at weddings and graduations – peer out from the mantelpiece.

While Jack and Anne were fans of The Times, here it’s Sainsbury’s magazine and Premier Christianity littering the coffee table.

Henry’s wife explains that their granddaughter, the only girl amongst six grandchildren, “is not little anymore, but is still spoilt” – and so the small slice of people’s lives that you see into when providing domiciliary care continues.

Henry has cataracts in his stronger eye, Kejal identifies, so a discussion ensues around whether he would like to be referred. His wife, who has recently had her own successful cataract surgery, is keen, and it is decided that this is the best course of action – as Kejal explains to them both, Henry’s vision will not improve without surgery.

No dispense required here, so Zoe’s huge box of frames stays folded together and we’re back in the car to visit Emma, the youngest of all our patients so far, at the cosy upstairs flat that she shares with her husband.

Emma’s various health conditions have led her to book a domiciliary visit, and she explains that experiencing blurred and double vision led her to contact Specsavers. Her vision is particularly bad in the dark, she says.

She explains that she is worried about her eyes in the context of her wider health. Kejal’s eye examination assures her that her eyes are healthy, but that her vision has changed since her last appointment.

Kejal is also able to advise on the type of lamp that Emma should buy for her living room so as not to interfere with her sensitivity to light – another benefit of being able to see a patient in their home environment.

After our visit to Emma, OT is in dire need of some sustenance. Lunch is a prawn sandwich, grabbed as part of a meal deal from a BP garage. One patient has cancelled this afternoon’s appointment, leaving us with a potential gap. Emails are sent, and then we’re back on track for patient number six.

Afternoon visits

“My eyes,” retired electrical engineer Anthony, 87, tells us as we perch next to a pile of radio industry magazines in his living room, “are a bit clapped.”

Anthony has been seeing Specsavers for four years, after developing a need for domiciliary services that his old independent was unable to provide.

With his only family being a sister in South London, and a third floor flat that looks out towards the tops of trees, receiving eye care at home is only becoming more vital as he heads towards his tenth decade.

He has been here “so long I can remember the Swan Centre being built,” he tells OT.

Another Home Visits patient who would not be able to receive eye care if it wasn’t for domiciliary services is Florence, 94, who tells us that she can no longer visit her local optometrist in Leatherhead because the chairs do not have arm rests and once she is sat down, she cannot get back up again.

“I don’t want anything expensive, because I don’t plan to be around very long,” she cheerfully tells Zoe.

During the eye exam, I ask Florence what she had for lunch (gammon in cider sauce, delivered to her door) and she tells me about her granddaughter, who has written a novel (“it’s ok, but a bit Mills and Boon-ey for me.”)

She has one daughter, four grandchildren, and “six and a quarter great grandchild,” she says, adding that she used to work at Lloyds Bank, until she got married: “they kicked us out, even though we worked hard.”

Their loss, OT tells her.

Kejal explains in detail what kind of lamp Florence should buy to ensure the best lighting possible from her armchair, and how it should be positioned. Then we leave her looking out onto her garden and head off to meet Arthur, our final patient of the day.

Arthur’s reasons for enlisting the help of Specsavers Home Visits are specific: after experiencing a seizure whilst washing his car outside his flat, he made the decision to stop driving.

His wife, Peggy, died in November 2022 after 70 years of marriage. “We had been together since school,” he tells us.

It turns out that Arthur is also 94, although his general demeanour could have him placed a decade younger.

It’s something that he might put down to his 50 years in the Caravan and Motorhome Club (“we enjoyed ourselves,” he explains. “We have stacks of photographs. I sit and look at them rather than watching the television.”) Or maybe his huge record collection, or maybe his happy marriage, which he is delighted to talk about.

After the eye exam and the dispense, OT and Kejal crowd into Arthur’s hallway to grab a few minutes on camera – the rain, which hasn’t let up all day, putting to bed any notion that we might be able to film outside.

Kejal would encourage all optometrists to consider domiciliary.

“No two days are the same,” she tells OT. “Every day is different; we see loads of different patients, in loads of different areas. There is a lot of emotional involvement in it. You see loads of people who are bed-bound, who have been through recent bereavements.

“Empathy is the word that I would use. We are there for people; we’re probably the only people that they’ll talk to all day. It’s such a lovely feeling to know that you’ve gone in there and you’ve made them happy.”

She continues: “For me, there is an emotional element. It is part of the job; it comes with it. The main reason I went into optometry in the first place was to help people. This gives us an opportunity to help those who really need it.”

It seems, after a day observing how domiciliary care works from a lay person’s perspective, that bringing this service directly to patients – specifically, to those who would not be able to access it otherwise – might be the purest form of helping people that there is.

As we talk, Arthur is holding court with Zoe in his living room – a clear example of someone who, as well as needing eye care, has also benefitted from the simple joy of a good old natter with a visitor.

*Some names have been changed to protect patient identities