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  • When examining patients with diabetes mellitus, you should take reasonable care to detect ocular changes.
  • You should encourage patients to attend an NHS diabetic eye screening programme.
A211
This Guidance does not change what you must do under the law.
A212
When examining a patient with diabetes you should look for ocular changes that are not related to that condition, as well as those that are.
A213
You should ask the patient if they are being screened for retinopathy in an NHS diabetic eye screening programme. If they are, you should ask when they last had a screening. You should clarify, as far as possible, who is responsible for the overall care and clinical management of the patient.
A214
Even if you are not responsible for providing diabetic eye screening, you should encourage the patient to attend an NHS diabetic eye screening programme and should tell them if you believe their screening is overdue.
A215
In addition to the procedures related to the routine eye examination, you may select additional ones according to the patient’s clinical need. You do not need to dilate for the sole purpose of retinopathy detection where an NHS diabetic eye screening programme is in place.
A216
If patients are in an NHS diabetic eye screening programme, recall should be the same as for patients who do not have diabetes. 
A217
You should report all relevant findings to whoever is responsible for the overall care and clinical management of the patient’s condition.
A218
In England, the NHS diabetic eye screening programme service specification no 22 is commissioned by NHS England;83 in Wales it is the Diabetic Retinopathy Screening Service for Wales (DRSSW);84 in Northern Ireland it is the Diabetic Retinopathy Screening Programme (DRSP);85 and in Scotland it is the Scottish Diabetic Retinopathy Screening (DRS) collaborative.86
A219
If you participate in an NHS diabetic eye screening programme you should follow local protocols. 
A220
If a patient does not intend to attend the local NHS diabetic eye screening programme, you should offer them a dilated retinal examination. This can be part of a sight test or an additional separate service.
A221
Even if you offer a dilated retinal examination with appropriate fundus photography or imaging, you should make it clear that your service is not an alternative to the NHS diabetic eye screening programme which conforms to National Screening Committee standards.
A222
You should not use the term ‘screening’ unless you are referring to a quality assured scheme which meets national standards.