The term ‘low vision’ carries too many connotations with sight impairment registration, specialist referral, and the dishing out of magnifiers. And as magnifiers are not covered by a voucher scheme, we still have a situation where an already over-burdened secondary care system is being clogged up with people who would most benefit from a clear understanding of their visual environment, advice on lighting, and increasingly on the ever-growing range of adaptive and assistive devices, which are commonly used by all of us.

In my view, the majority of people needing help with their sight are not ‘low vision’, they are simply old. And surely their care falls into the remit of the ECP?

The Government want a better distribution of services throughout the primary care sector and are now proposing to get rid of the much-derided private tendering for services among CCGs. This, I suggest, opens up an opportunity for community practice.

The Welsh Low Vision scheme has been running successfully for many years now and allows a suitably accredited ECP to assess someone for a set fee and offer vision aids on free loan from a set list, including a simple electronic aid. More complex cases are still referred on. This works very well in Wales, where geography favours local access and population numbers are low.

In England, the current state all too well reflects the different approach to ‘low vision’ of different areas. In Camden and Islington, the RNIB clinic I work at is able to act as a referral centre for more challenging cases, but such centres are all too few and far between. So sadly, other areas have no provision offered by community practice and inappropriate and costly referrals run rife.

So why not introduce a nationwide ‘English Low Vision’ scheme like the Welsh model, and set up specialist low vision centres in each region for the trickier cases? I suggest this will save money and improve service in the long run.