Deprivation and NHS General Ophthalmic Service sight testing activity in England in 2022-2023

Area of Science:

• Ophthalmology
• Public Health
• Health Services Research

Background:

• Socioeconomic deprivation is linked to higher rates of vision impairment.
• Understanding patterns in General Ophthalmic Services (GOS) sight testing is crucial for addressing eyecare disparities.

Purpose of the Study:

• To analyze General Ophthalmic Services (GOS) sight-testing activity in England.
• To investigate the relationship between socioeconomic deprivation and uptake of National Health Service (NHS) sight tests.

Main Methods:

• Utilized NHS sight-test claim data from 2022-2023 for GOS contractors in England.
• Assigned Index of Multiple Deprivation (IMD) scores to practices and calculated sight-testing rates per 1000 population by deprivation decile.
• Employed Odds Ratio (OR), Slope Index of Inequality (SII), and Relative Index of Inequality (RII) to assess disparities.

Main Results:

• Over 12.94 million NHS sight tests were conducted by 5622 GOS contractors.
• Contractors in the most affluent areas performed approximately twice as many sight tests as those in the most deprived areas.
• Individuals in affluent areas were over five times more likely to access NHS sight tests compared to those in deprived areas (OR: 5.29).
• Significant inequalities in sight-test uptake were confirmed by SII (333.5) and RII (6.4) measures.

Conclusions:

• Substantial and unwarranted variations in NHS sight-test uptake persist, favouring more affluent populations.
• Urgent strategies are needed to promote equitable access to primary eyecare services, particularly for individuals in deprived communities.
• Primary care optometry must play a key role in facilitating equitable access to essential eye examinations.