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Background
Domiciliary eye care is provided to people who are unable to visit a practice. For this patient group, many of whom are vulnerable adults, good eye care can have an enormous impact on their independence and wellbeing. Read on to learn more.
Domiciliary Eyecare Committee (DEC)
The Domiciliary Eyecare Committee (DEC) brings together representatives from domiciliary service providers and optical bodies. It is committed to promoting the highest standards of care for domiciliary patients, is active in lobbying for equal access to eyecare and provides support and advice to the national negotiating bodies on contractual matters.
The DEC terms of reference are available here.
The DEC developed and encourages all providers of domiciliary services to follow its Code of Practice.
High quality eye care should be available to all patients, regardless of whether the service is delivered in the patient's home or traditional primary care settings - e.g. high street practice. We encourage all domiciliary providers to read and follow the Domiciliary Eyecare Committee's Code of Practice.
If you want to provide NHS funded domiciliary eyecare, please see GOS contracts.
Other guidance
DEC has produced a variety of guidance which is either specific to or relevant for domiciliary providers.
- Guidance for providing domiciliary optical services
- Lone working guidance
- Guidance on equipment for use in mobile ophthalmic services
- DEC position statement on visual field screening in a domiciliary setting
- Safeguarding guidance
- Cooling-off period guidance
- Pre-notification form
- Pre-notification system for domiciliary sight tests
Other sources:
- AGE UK guidance on power of attorney and consent
- Mental wellbeing of older people in care homes - NICE
- College of Optometrists guidance for examining patients with dementia
- College of Optometrists guidance for examining patients with learning disabilities
- Vision 2020 checklist for examining patients with learning disabilities
- LOCSU Pathway, people with learning disabilities
You might find it useful to share the following resources with local patients and carers:
If you, or a person you care for, needs an eye test but is unable to visit a high street practice - e.g. because of a mental, physical or learning disability - you can have the test in your own home.
You can find more information in this: Guide to sight tests at home.
Optical professionals working in domiciliary settings aim to work within the principles described in the domiciliary eyecare Code of Practice.
The Domiciliary Eyecare Committee has, together with Care England, also produced a letter to highlight to care professionals and care home managers the role they can play in helping to ensure that people living in residential care homes receive high quality, personalised eye care.
Issues with domiciliary providers
Please note that with effect from 2024 DEC no longer provides an independent adjudicator function for disputes between providers.
If such an issue arises, the advice is to raise the matter with the other provider directly as this usually ensures the issue is resolved. If necessary, the providers' representative bodies can provide advice and support.
It is also open to providers to approach the OCCS or other mediation/arbitration services if resolution cannot be reached.
Any issues between providers about risk or alleged harm to patients, should be raised immediately and, if necessary, escalated in the normal way, for example with the local NHS or GOC.
Just as in fixed practices, complaints raised by patients should be handled in line with the provider's complaints procedure (which will include the relevant NHS complaints procedure for NHS patients).
Providers are encouraged to raise issues with DEC - for example in case guidance is needed - but these will be considered as general matters, not specific cases.
Updates
Originally published: September 2018
Reviewed: August 2024
Next review date: August 2025
September 2024 update: Removed references to the Optical Confederation, removed information about the Independent Adjudicator, changed terminology to align with current practice, added new DEC terms of reference.
The Domiciliary Eyecare Committee (DEC) guidance was updated in July, August 2021 and September.
View DEC guidance and statement published in July 2021, and DEC guidance published August 2021.
Previous DEC guidance published in June 2020 together with relevant statements can be viewed by clicking the relevant link. 1. DEC statement - meeting the eye health needs of vulnerable individuals during the next stages of the pandemic. 2. Guidance< - meeting the eye health needs of shielding, isolating and domiciliary patients during the coronavirus (covid-19) pandemic. 3. DEC statement - Working safely during COVID-19 in other people's homes - Implications for domiciliary eye care providers.
Info: January 2020, as part of the FODO website upgrade, the layout changed, GOS information was removed as a new section of the FODO site explains this in more detail, and patient information was simplified.
