GOC publishes research on inequalities in access and experiences of eye care services
The General Optical Council (GOC) has published new qualitative research – known as ‘lived experience’ research – with vulnerable groups of patients looking at inequalities in access and experiences of eye care services.
Carried out by Explain Market Research, the research includes 38 in-depth interviews with patients and non-patients (who had not had a sight test in the past two years). All had at least one ‘vulnerability’ such as having a disability, a low annual household income or going through a difficult life circumstance.
The case studies identified some of the challenges that people with vulnerabilities face when accessing eye care services, including:
- Low importance of maintaining eye health: Participants were often unaware of the benefits or recommended frequency of sight tests in maintaining good vision and eye health.
- High tolerance for, and self-management of, symptoms related to sight or eye health: Participants had a high tolerance for symptoms related to worsening vision (i.e. headaches, blurry vision and eye strain) and self-managed by buying off the shelf ready readers rather than going for a test.
- Psychological barriers: The ‘open nature’ of the retail environment, seeing multiple people, concerns over length of the wait and feeling uncomfortable trying on glasses in front of others were some of the barriers mentioned by participants, particularly those with mental health difficulties.
- Cost-related barriers and pressure to buy: The cost of the sight test and glasses were seen as inhibiting for the majority of participants. They also worried about the pressure to buy eyewear, and many were unaware of the financial help, such as NHS vouchers, that might be available.
Participants also discussed having specific needs that influenced their sense of satisfaction with their experiences of having a sight test/eye examination:
- The need to recognise and cater for hidden vulnerabilities and concerns: Participants with more visible forms of physical disabilities discussed needing care that was more accommodating to their needs. Patients with more hidden vulnerabilities discussed more complex and problematic interactions with eye care services.
- The need to feel a ‘thorough job’ has been done: For many, a sense of dissatisfaction was rooted in feeling that they had been ‘rushed through’ their sight test/eye examination, which led to a sense of being poorly cared for, not listened to and, in some cases, concern that their test had not been performed thoroughly.
- The need for an empathetic approach: The ability to support people with vulnerabilities and quickly identify their needs was viewed as an important skill amongst optometrists and dispensing opticians.
- The need for continuity of care: Some wished to be able to develop a sense of connection to their optometrist. Others were concerned that there was a lack of communication between hospitals and different optometrists involved in their care, resulting in delays in diagnosis.
- The need for transparency on costs and less pressure to buy: Participants wished for more clarity on the cost of glasses, contact lenses and any add-ons during the sight test and clarity about any help available with costs. Reducing the pressure to buy was also cited.
Participants suggested steps for potential improvements which could improve vulnerable people’s access to and experiences of eye care services, including:
- Improving awareness and knowledge of eye health and the benefits of routine sight tests
- Greater transparency around costs
- Considering how to provide care for patients with both visible and hidden vulnerabilities, for example, by asking about additional needs during the booking process or offering more tailored appointments
- Where possible, providing greater continuity of care so that patients and professionals can build relationships and address any concerns more easily.
Steve Brooker, Director of Regulatory Strategy, said:
“We know from our public perceptions research that vulnerable patients are more likely to have poor experiences accessing eye care services. This research has further delved into the ‘why’, providing us with a greater understanding of some of the factors impacting vulnerable patient groups.
The voices in this research provide powerful examples of some of the challenges the most vulnerable in our society face when accessing eye care including very real worries about the cost of treatment and eyewear and the severe impact that living with hidden disabilities can have on access and experiences of treatment.
Importantly, the research also shows some of the things the sector could do to improve patient experiences, including raising awareness of the benefits of regular tests, reducing pressure to buy, providing greater cost transparency and better adapting services for patients with a disability or mental health issues.
The GOC is currently consulting on new guidance for registrants on caring for people in vulnerable circumstances, having strengthened our standards in this area earlier this year. However, there is a still a long way to go and we need to work together as a sector to address these inequalities and ensure that everyone, regardless of their background, has access to safe and effective eye care.”
