Where have all the old folks gone? A report on access and uptake of NHS sight tests in the over 60s

Aim Visual impairment affects people of all ages, but its prevalence increases with age. The aim of this initiative was to better understand the uptake of NHS sight tests in Walsall in the over 60s age group. Methods The following data were analysed: i) NHS sight tests for England and Walsall Healthcare NHS Trust; ii) ophthalmic manpower in England and Walsall from April 2008 to March 2013; iii) the location of practices in the borough of Walsall. Results We noted a steady increase in the uptake of NHS sight tests (9%) and domiciliary sight tests (17%) in England from April 2008 to March 2013. In Walsall, the uptake of NHS sight tests was marginally lower for the same period (8%), but showed an increase of 11.7% in domiciliary sight tests. There was a significant reduction in the uptake of NHS sight tests from the over 60s in Walsall, from 42.58% in 2008/09 to 23% in 2012/13. This in contrast to a steady uptake of about 44% over the same period in England for the same age group. We noted fewer practitioners per 100 000 population in Walsall compared with the national picture and a neighbouring statistically equivalent primary care trust. Fewer practices are located in the east of the borough and outside the inner ring road, and considerable areas of Walsall are not within a 15-minute walking distance of an optometric practice—a significant factor for attenuation of attendance. Conclusions There has been a substantial decrease in the uptake of NHS sight tests in the over 60s in Walsall over a five-year period. The low uptake of sight tests among older people is a major shortcoming of present arrangements at meeting the eye health needs of Walsall residents. This is exacerbated by a lower than national average of ophthalmic practitioners per 100 000 population in Walsall.