The RNIB clinic I work in is temporarily closed to move location. After several decades at its St Pancras site in London, the clinic closed at the end of last year and is set to reopen nearby at the end of February. So, despite the odd train strike, the focus has been on home visits.
According to the National Audit Office, around 814,000 people in the UK received home care or supported living services just prior to lockdown, and figures are rapidly returning to this level. Domiciliary eye care has, in the past, enjoyed a somewhat unfair reputation. Scenes of elderly people in a Henry Ford production line shuffling past a retinoscope and focimeter used to spring to mind. And comments such as ‘remember to check that the chair is dry before you sit down’, did not help.
I would absolutely argue that domiciliary eye care requires the full range of optometric and optical skills. To offer the full range of tests, you have to keep up to date with the latest software and kit, for a start. My goal over the past few years has been to try to reduce the amount being lugged around to a laptop and a retinoscope. Not quite there yet, but many of the excellent apps now available do help.
Often, the patients have comorbidities linked with their eye health and good communication links with other professionals are essential. Also, the ‘if in doubt, refer’ default is no longer an option, and you are often faced with decisions about care with a high level of responsibility. The rollout of IP qualifications is an opportunity for much better home care services.
The new RNIB HQ opens soon at Grimaldi House, named after the famous clown. Don’t say a word!
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