Freedom of Imformation

Patients will receive a sight test in accordance with the regulations, their individual needs and the duty of care and confidentiality of the optometrist towards the patient
Providers will utilise specialised portable equipment to enable the optometrist to deliver the best possible care to the patient consistent with the regulations
Where the environment or medical limitations of the patient make it impossible to include the full range of procedures, the reasons will be shown on the record card
Providers acknowledge that when supplying domiciliary services they are acting in a privileged position of trust. All members will monitor and support their clinical staff with regular clinical governance reviews

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 their individual choice of provider for services and appliances

Spectacles prescribed will be fitted individually to patients and any tolerance problems will be addressed by the patient's choice of suitably trained staff
Providers commit themselves to revisiting each patient for a further eye examination as indicated at their previous examination
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 have an obligation to ensure that, when a patient opts to be cared for by another provider, relevant information (eg spectacle prescription and date of last sight test) is made available to that new provider with the consent of the patient or the patient's carer

Providers will only recruit clinical personnel who possess the specialised communication skills and clinical skills necessary for domiciliary patients
Each patient will be treated as an individual and communication will primarily be with them throughout their care unless this is inappropriate
Carers and relatives will be involved where appropriate
Providers will provide a spectacle prescription or statement for each patient as required by the regulations and additionally (if relevant) will deposit further information with the home/carer, with the patient's permission, to summarise the outcomes of sight tests.

Providers are committed to providing high quality, personalised and professional eyecare and optical services for housebound patients
Business will be conducted according to the statutory regulations currently in force, the GOS Terms of Service and with regard to peer group guidance
All providers agree not to supply concessionary optical services including sight testing services, optometric products or other inducements to the owners and staff of care homes
The competitive market is recognised as a positive driver of quality and patient choice and companies will not compete in ways that are inappropriate
Providers apply a non-discrimination policy towards all patients in the supply of domiciliary services

Providers recognise the importance of probity within the NHS and are committed to employing rigorous audit processes to ensure eligibility for NHS funding

Any complaints about providers or allegations that a provider has fallen below the standards set out in this code should be addressed, in the first instance, to the provider, the relevant Primary Care Trust (PCT) or the:

Tel: 020 7261 1017

Tel: 020 7298 5151

E-mail: andrew@fodo.com

General Ophthalmic Services (GOS) are a well established, integral part of the NHS. Optometrists, Ophthalmic Medical Practitioners (OMPs) and Dispensing Opticians provide an excellent example of high quality service delivered with a high level of professionalism , utilising the most up to date equipment and offering excellent ease of access and patient choice.
Under the NHS, eligible patients who cannot leave home unaccompanied are entitled to a free sight test in the home.This domiciliary service can be provided both by high street optometrists (or OMPs) and specialist mobile services providers.
Domiciliary services are an essential part of primary ophthalmic services and a life-line for many, yet countless eligible people are unaware that the service exists. There is a need for improved awareness of its existence.

All housebound and disabled patients should have the same level of access to eye care services as able bodied patients.
This is a fundamental, underpinning principle of the NHS.
The service should be provided in exactly the same way as a high street GOS, i.e patient choice should prevail. Providers who meet specific standards should be able to extend choice, drive up quality and encourage innovation in developing a patient-centred service - particularly for hard-to-reach groups who may have difficulty in accessing high street eye care services.

Domiciliary eye care is an essential pare of the nationally negotiated GOS service.
A sight test is essential for:

children under 16 years of age,
young people under 19 years of age and in full-time education,
people who have been diagnosed with diabetes, glaucoma or ocular hypertension,
people over the age of 40 who have a close relative who has been diagnosed with glaucoma,
people who are registered as partially sighted or blind,
people receiving income support, family credit or job seekers allowance, or working disability allowance,
people over the age of 60 (people aged 60-70 are entitled to one free test every 24 months and for those over 70, one every 12 months).
people who receive Income Support or Income Based Job Seekers Allowance (not contribution based),
people who receive Working Tax Credit and are named on a Tax Credit NHS Exemption Certificate,
people who receive Child Tax Credit and are named on a Tax Credit NHS Exemption Certificate, and
those named on a NHS certificate for full help with health costs (HC2).

The Domiciliary Eyecare Commitee is grateful for the comments of the Department of Health and Support of all Optical bodies on this code.

Jan 2006