Code of Practice
CODE OF PRACTICE for Domiciliary Eyecare
September 2009
The Domiciliary Eyecare Committee is grateful for the comments of the Department of Health on this code
Preparation (back to top)
- NHS sight tests will be provided on request to those who cannot access community optical practices unaccompanied, as a result of mental or physical disability
- Private sight tests will be available to those who request them
- NHS contractors will satisfy themselves that an NHS sight test is clinically necessary and in the patient’s best interests
- Providers will respect the right of each patient to make their individual choice of provider of both services and appliances
- Each patient will be treated as an individual and providers will not condone ‘group testing’ of patients unless this is clinically feasible and by patient or carer choice
- NHS eligibility for a domiciliary examination will be established and the reason noted on the record card, as will any eligibility for an optical voucher
- Providers will make clear the likely cost of spectacles in advance and the specific cost before the placing of an order
- Providers will ensure that venues are suitable for testing and, in the case of NHS sight testing, meet the requirements of NHS regulations
Eye Examination (back to top)
- Patients will receive a sight test in accordance with their individual needs and the duties of care and confidentiality of the optometrist* towards the patient
- All NHS sight tests will be provided in accordance with NHS regulations
- Specialised portable equipment will be used to enable the optometrist* to deliver the best possible care to the patient
- Where the environment or medical limitations of the patient make it impossible to include the full range of procedures, the reasons will be noted on the patient’s record
- Providers recognise that, when providing domiciliary services, they are acting in a privileged position of trust
- Where appropriate, providers will follow the College of Optometrists’ guidelines on treating patients with dementia or acquired cognitive impairment and similar ABDO guidelines on the challenges of dispensing to such patients
- Providers will monitor and support clinical staff with regular clinical governance review
- NHS sight tests will be offered to those who cannot access community optical practices unaccompanied, as a result of mental or physical disability, as set out in the regulations.
- Eligibility for a domiciliary examination will be established and the reason noted on the record card, as will any eligibility for an optical voucher, as set out in the regulations.
- The provider takes responsibility for confirming that the
venue complies with the regulations and that the address is
the normal place of residence of the patient.
- Providers will respect the right of each patient to make his/her individual choice of provider for services and appliances.
Continuing Care (back to top)
- Spectacles dispensed will be fitted individually to patients and any tolerance problems will be addressed by fully trained staff
- Patients who are under 16 or blind or partially sighted will only be supplied with optical appliances by or under the supervision of GOC registered staff
- Patients have a right to expect a high standard of continuing care which ensures that any follow-up care required or requested is provided efficiently and professionally
- Providers will advise the patient as to when their next eye examination is due. They will not normally re-test before this unless the patient is experiencing specific difficulties which will be noted in the patient’s record
- Providers have an obligation to ensure that, when a patient opts to be cared for by another provider, relevant information (e.g. spectacle prescription and date of last sight test) is made available to the new provider with the consent of the patient or the patient’s carer
- Providers will make clear in advance whether follow-up care will be provided free of charge (i.e. under the NHS or at the provider’s expense) or at a cost to the patient
* or Ophthalmic Medical Practitioner (OMP)
Communication (back to top)
- Providers will ensure that all personnel receive appropriate training in the specialist communication skills necessary for domiciliary patients
- Each patient will be treated as an individual and communication will be with them throughout their care unless this is inappropriate
- When the patient is able to do so, their agreement will be sought before any aspect of their care is discussed with relatives or carers. Where a patient is unable to consent, carers and relatives will be involved where appropriate
- In addition to issuing a spectacle prescription or statement that no correction or change is necessary, providers will leave further information with the patient (if relevant) or, with the patient’s permission, with their carer or care home, to summarise the outcomes of sight tests
Standards and Probity (back to top)
- Providers are committed to providing high quality, personalised and professional eye care and optical services
- All practitioners will carry identification and show it as appropriate and on request
- At the end of the appointment, patients will be given the provider’s contact details which may be in the form of a standard leaflet
- All eye care will be provided in accordance with regulations and, in the case of NHS care, additionally in accordance with the provider’s NHS contract
- Providers will not offer or supply optical services including sight testing services, optometric products or other inducements (including any services or products), to third parties including the owners and staff of care homes, in order to gain or retain domiciliary business
- This will not prevent legitimate advertising consistent with regulations
- The competitive market is recognised as a positive driver of quality and patient choice. Providers will not therefore enter into ‘service level’, ‘preferred provider’ or similar agreements with care homes or care home chains or compete in other ways that are inappropriate
- Providers will apply a non-discrimination policy towards all patients in the supply of domiciliary services
- Providers are committed to the highest standards of probity and to employing rigorous audit processes to ensure eligibility for NHS funding
- In accordance with the national timetable, all domiciliary practitioners will be ISA registered
- Providers will only claim higher rate domiciliary fees for more than two NHS patients resident at the same establishment where such visits were reasonably made, e.g. by request of a patient or carer exercising their choice of provider
Complaints (back to top)
- Complaints about any aspect of provision should be addressed to the provider in the first instance
- If the complaint relates to an NHS sight test or to the offer of inducements, the local Primary Care Organisation can be contacted
- If the complaint relates to spectacles or contact lenses the OCCS can be contacted:
Optical Consumer Complaints Service (OCCS)
P.O. Box 219, Petersfield GU32 9BY
Tel: 0844 800 5071
E-mail: postbox@opticalcomplaints.co.uk
- Complaints can also be raised in confidence with:
Domiciliary Eyecare Committee
199 Gloucester Terrace, London W2 6LD
Tel: 020 7298 5151
E-mail: optics@fodo.com
