15 November 2023

College responds to concerns around access to vital eye care services in Northern Ireland

The College of Optometrists President Professor Leon Davies FCOptom and Professor Kathryn Saunders FCOptom, Trustee and Council Representative for Northern Ireland, have written to the Permanent Secretary of the Department of Health NI.

The College has written to Mr Peter May, Permanent Secretary of the Department of Health NI, raising concerns that vital eye care services are no longer readily accessible to people in Northern Ireland once they transfer to receiving Universal Credit benefits.

Dear Mr May

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

Optometrists have raised urgent concerns with us regarding access to NHS sight tests and optical vouchers for over 200,000 individuals recently or soon to be passported to Universal Credit (UC) in Northern Ireland. It is unacceptable that vital eye care services are no longer readily accessible to this group of people, who were previously eligible.

Regular sight tests are vital to ensure that everyone has good vision and to detect and treat eye conditions that could lead to sight loss. If members of the public are prevented from accessing eye care, they are at greater risk of being affected by poor vision or being diagnosed with an eye condition at a late stage, when treatments may be less effective.

The current situation, i.e. that people passported to UC now need to complete a long and confusing application to access eye care, will undoubtedly be an additional barrier. This means that people in receipt of UC across Northern Ireland will be less likely to see clearly and will not benefit from ocular health assessments. This will impact their quality of life and ability to work, socialise and learn, and increases the risk of avoidable sight loss. It is not right that people in receipt of UC discover this for the first time when attending a sight test, and optometrists must then turn patients away or ask them to pay.

The sight test provides opportunities for prevention and early intervention, of both sight loss and other systemic conditions. If these are missed, later clinical presentations add to ophthalmology pressures and inferior health outcomes. The increase in ocular health inequalities due to this is stark, and we call for immediate action to address this issue.


  • Introduction of an immediate transition arrangement, where all people on Universal Credit can continue accessing eye care services without additional barriers
  • Immediate communication to all NHS eye care contractors on how they can check a person is receiving Universal Credit and confirmation that sight tests and optical vouchers will continue to be funded during this transition period
  • A clear immediate instruction to the Counter-Fraud Team that they must not pursue people on Universal Credit attempting to access eye care during the transition period
  • The appropriate legislative changes made to ensure Universal Credit is recognised and people in receipt can continue to access support for sight tests and optical vouchers
  • Once the appropriate legislative changes are made, ensure people receiving Universal Credit are clearly and promptly told about their eligibility, and that there is a process of automatic entitlement.

We ask you to work with colleagues at the Department for Communities to address this as a matter of urgency. Optometrists across Northern Ireland provide members of their local communities with vital routine NHS sight tests, and enhanced services, and it is crucial that the move to Universal Credit does not prevent people at most need from accessing essential primary care optometry services.

Leon Davies FCOptom
President, The College of Optometrists

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

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