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Department of Health

Care Act 2014: How should local authorities deliver the care and support reforms? Please give us your views


Question 79: Should certification of CVIs be extended to senior ophthalmologists, or should this continue to be carried out by consultant ophthalmologists as is currently the case?

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7 comments

  1. Anonymous says:

    I support the recommendation to extend certification of CVIS to senior ophthalmologists as defined above. This is to prevent delays for patients but not to lower service standards. So this person must be experienced and have the skills firstly to verify that the patient has a visual impairment which meets the legal definition of sight impairment or severe sight impairment, and secondly to diagnose the cause of the patient’s visual impairment accurately, ensuring that no treatable cause has been overlooked. This means that the person should not be able to do this when just appointed but have several years in post.

  2. Anonymous says:

    From Healthwatch Northumberland
    This should be extended to ensure access to CVI is speedy for individuals.

  3. Anonymous says:

    The level and quality of information currently received by the Local Authority from consultant ophthalmologists continues to be of an appropriate and high standard. There is no evidence that the current arrangements are failing or that they are not meeting the expected outcome. Therefore there would be no obvious benefit to the local authority or to the patient for the current arrangements to change.

  4. Anonymous says:

    The Certificate of Visual Impairment is an important legal document which confirms that someone has a visual impairment of sufficient severity to meet the legal definition of sight impairment or severe sight impairment and which is expected to be permanent. Certification also represents a point in time at which the patient and the ophthalmologist acknowledge that the patient’s visual impairment is expected to be permanent and as such is a momentous event which has important consequences for the remainder of the patient’s life.

    It is therefore important that the ophthalmologist who completes the CVI has the experience and skills firstly to verify that the patient has a visual impairment which meets the legal definition of sight impairment or severe sight impairment, and secondly to diagnose the cause of the patient’s visual impairment accurately, ensuring that no treatable cause has been overlooked. It is appropriate that the consultation at which certification of visual impairment takes place is conducted by a senior ophthalmologist because of the significance of this event for the patient. Often this will be a consultant ophthalmologist, but it may be that an associate specialist or senior specialty doctor in ophthalmology completes and signs the form. Ophthalmologists in training may also take part in discussions with patients leading to CVI under the supervision of a senior ophthalmologist.

    The Certificate of Vision Impairment Committee (CVIC) is recommending that senior ophthalmologists e.g. Associate Specialists or specialty doctors, senior doctors in training within 6 months of their CCT date (which is the date they are eligible to apply for a consultant ophthalmologist’s post) should also be allowed to complete and sign CVI forms as they should fulfil the above criteria. We believe that a doctor who can make the appropriate diagnosis, inform the patient of the consequences of sight loss, who understands the importance of certification as well as assess that available treatment will not result in improving vision to the level that the patient does not meet the certification, should be competent to perform this task.

    A restriction of certification by consultants only, can result in delays in the certification and registration process that may have negative consequences for patients. It is expected that this will expedite patients (who will already be affected both functionally and emotionally by their sight loss) accessing available support and welfare benefits. Public Health Preventable Sight Loss Indicator used to commission clinical services is linked to certification data, it is more important than ever that no unnecessary delays occur.

    In summary therefore, CVIC is supportive of the recommendation to extend certification of CVIS to senior ophthalmologists as defined above.

  5. Anonymous says:

    The Certificate of Visual Impairment is an important legal document which confirms that someone has a visual impairment of sufficient severity to meet the legal definition of sight impairment or severe sight impairment and which is expected to be permanent. Certification also represents a point in time at which the patient and the ophthalmologist acknowledge that the patient’s visual impairment is expected to be permanent and as such is a momentous event which has important consequences for the remainder of the patient’s life.
    It is therefore important that the ophthalmologist who completes the CVI has the experience and skills firstly to verify that the patient has a visual impairment which meets the legal definition of sight impairment or severe sight impairment, and secondly to diagnose the cause of the patient’s visual impairment accurately, ensuring that no treatable cause has been overlooked. It is appropriate that the consultation at which certification of visual impairment takes place is conducted by a senior ophthalmologist because of the significance of this event for the patient. Often this will be a consultant ophthalmologist, but it may be that an associate specialist or senior specialty doctor in ophthalmology completes and signs the form. Ophthalmologists in training may also take part in discussions with patients leading to CVI under the supervision of a senior ophthalmologist.
    The Certificate of Vision Impairment Committee (CVIC) is recommending that senior ophthalmologists e.g. Associate Specialists or specialty doctors, senior doctors in training within 6 months of their CCT date (which is the date they are eligible to apply for a consultant ophthalmologist’s post) should also be allowed to complete and sign CVI forms as they should fulfil the above criteria. We believe that a doctor who can make the appropriate diagnosis, inform the patient of the consequences of sight loss, who understands the importance of certification as well as assess that available treatment will not result in improving vision to the level that the patient does not meet the certification, should be competent to perform this task.
    A restriction of certification by consultants only, can result in delays in the certification and registration process that may have negative consequences for patients. It is expected that this will expedite patients (who will already be affected both functionally and emotionally by their sight loss) accessing available support and welfare benefits. Public Health Preventable Sight Loss Indicator used to commission clinical services is linked to certification data, it is more important than ever that no unnecessary delays occur.
    In summary therefore, CVIC is supportive of the recommendation to extend certification of CVIS to senior ophthalmologists as defined above.

  6. Anonymous says:

    The Certificate of Visual Impairment is an important legal document which confirms that someone has a visual impairment of sufficient severity to meet the legal definition of sight impairment or severe sight impairment and which is expected to be permanent. Certification also represents a point in time at which the patient and the ophthalmologist acknowledge that the patient’s visual impairment is expected to be permanent and as such is a momentous event which has important consequences for the remainder of the patient’s life.

    It is therefore important that the ophthalmologist who completes the CVI has the experience and skills firstly to verify that the patient has a visual impairment which meets the legal definition of sight impairment or severe sight impairment, and secondly to diagnose the cause of the patient’s visual impairment accurately, ensuring that no treatable cause has been overlooked. It is appropriate that the consultation at which certification of visual impairment takes place is conducted by a senior ophthalmologist because of the significance of this event for the patient. Often this will be a consultant ophthalmologist, but it may be that an associate specialist or senior specialty doctor in ophthalmology completes and signs the form. Ophthalmologists in training may also take part in discussions with patients leading to CVI under the supervision of a senior ophthalmologist.

    The Certificate of Vision Impairment Committee (CVIC) is recommending that senior ophthalmologists e.g. Associate Specialists or specialty doctors, senior doctors in training within 6 months of their CCT date (which is the date they are eligible to apply for a consultant ophthalmologist’s post) should also be allowed to complete and sign CVI forms as they should fulfil the above criteria. We believe that a doctor who can make the appropriate diagnosis, inform the patient of the consequences of sight loss, who understands the importance of certification as well as assess that available treatment will not result in improving vision to the level that the patient does not meet the certification, should be competent to perform this task.

    A restriction of certification by consultants only, can result in delays in the certification and registration process that may have negative consequences for patients. It is expected that this will expedite patients (who will already be affected both functionally and emotionally by their sight loss) accessing available support and welfare benefits. Public Health Preventable Sight Loss Indicator used to commission clinical services is linked to certification data, it is more important than ever that no unnecessary delays occur.

    In summary therefore, CVIC is supportive of the recommendation to extend certification of CVIS to senior ophthalmologists as defined above.

  7. Anonymous says:

    certification could be carried out by ANY ophthalmologist.
    There is also a case for this function to be carried out by suitably trained community optometrists. This would remove the need for patients with progressive eye disease such as dry form Macular Degeneration having to be referred to eye clinic merely for certification.