15 December 2023

Dialogue continues between The College and the NI Permanent Secretary of the Department of Health

The College have written again to the Permanent Secretary of the Department of Health NI, Mr Peter May following a response to our original letter.

Following a response to their original letter, The College of Optometrists President Professor Leon Davies FCOptom and Professor Kathryn Saunders FCOptom, Trustee and Council Representative for Northern Ireland, have again written to the Permanent Secretary of the Department of Health NI, Mr Peter May.

The letter (below) continues to highlight concerns around the lack of accessibility to vital eye care services to people in Northern Ireland once they transfer to receiving Universal Credit benefits. It emphasises that the existing interim measure of completing an HC1 form, which is 22 pages in length, is currently a significant barrier to accessing NHS eye care and urges Mr May to work with the Department for Communities to improve access as soon as possible.

Dear Mr May

Continued access to sight tests and optical vouchers for all people passported to Universal Credit in Northern Ireland

Thank you for your response dated 20 November 2023 to our recent letter regarding automatic passporting of health costs for individuals in receipt of Universal Credit and our concerns that people at most need are being prevented from accessing essential primary care optometry services.

We recognise that making the required legislative amendments has been delayed due to a number of significant factors, and welcome your acknowledgement of the need to improve the current interim measure that has been set up. However, we would like to emphasise that the existing interim measure of completing the HC1 form is a significant barrier to accessing NHS eye care.

HC1 is a 22 page form and its length will be off-putting to many members of the community who need to complete it, particularly those who have low levels of literacy (one in five adults in Northern Ireland). Once filled in, it needs to be printed (if completed digitally) and sent to a Jobs & Benefits office, extending the time taken to complete the process and receive the entitled benefit.

The digital version of HC1 requires both internet access and a significant level of digital skills to complete. Unfortunately, individuals on Universal Credit are very likely to be the most digitally excluded in Northern Ireland. 15% of the population in Northern Ireland do not have access to the internet. Almost one in five people aged 16 and over have no digital skills, with a higher proportion of those in the most deprived areas having no digital skills compared to the least deprived. Furthermore, households in the lowest income bracket are three times more likely to have no printer.

Our members report that patients are attending for their eye examinations without knowing about the new passporting requirements and are unable to pay for an eye examination in the interim. This means they are having to wait longer for an eye examination, which increases their risk of poor vision or even avoidable blindness, and impacts patient safety and outcomes. The requirement to complete an HC1 form is a barrier that is not required in other parts of the UK and we urge you to work with the Department for Communities to improve this interim solution as soon as possible.

Yours sincerely

Leon Davies FCOptom
President, The College of Optometrists

Professor Kathryn Saunders FCOptom
Trustee and Council Representative for Northern Ireland, The College of Optometrists

Related further reading

The virtual Hospital Eye Service experience replaces the in-person experience pre-registration trainees would normally have gained in a hospital setting.

The virtual Hospital Eye Service experience replaces the in-person experience pre-registration trainees would normally have gained in a hospital setting.

Adrian O’Dowd examines why optometrists need to act on behalf of patients who report temporary sight loss in one eye caused by amaurosis fugax, a potentially serious and sometimes overlooked condition.