by Eliz Hopkins, West Midlands Coordinator for Street Support Network
It’s a Monday morning at the homelessness support centre, SIFA Fireside in Birmingham, where I have popped in to learn more about the partnership between SIFA Fireside and Vision Care for Homeless People.
The charity, SIFA Fireside, is the main homeless navigator service in Birmingham supporting adults aged 25+ experiencing rough sleeping and other forms of homelessness, to access help and practical solutions to find safe and secure housing.
The centre in Digbeth is open each week day until 1pm welcoming individuals for food, advice and various activities to support their well-being.
Chatting to Michael McMillan, Service Manager, I learn that health is a big focus of the services they provide to clients coming to SIFA Fireside each day.
People experiencing homelessness will often face various barriers or challenges when trying to access primary and secondary care services. A few years ago, a research paper was published by Groundswell and Crisis UK around what these barriers were and how trying to access health care was experienced by those who were sleeping rough or vulnerably housed. Key themes identified in the report included: difficulties registering with a service provider, digital exclusion, financial barriers, stigma and prejudice.
In recognition of these barriers, Michael explains that SIFA Fireside have been able to provide Liver Screening each month, dental care, a weekly nurse led clinic and a weekly optician service in addition to various activities such as cooking classes, music therapy and drama to help emotional and psychological well-being.
Vision Care for Homeless People (VCHP) is a charity founded just over 20 years ago by a group of optometrists who identified a need for a safe space for people experiencing homelessness to come and have eye tests without the barriers of affordability, stigma or registration. There are ten clinics running across England and Scotland with an eleventh opening soon. Each clinic is registered as an opticians practice with the relevant local health authority and is staffed by professional, experienced and qualified ophthalmic prescribing and dispensing clinicians.
Each person who attends a clinic with VCHP receives a free eye test and, should any glasses need prescribing, then the frames and lenses are also provided free of charge. This unique model means that whether someone is entitled to public funds or not, they can have access to free eye health care.
VCHP runs a service in Birmingham at SIFA Fireside every Monday morning except bank holidays from 9:00am to 1:00pm.
I was introduced to Claire Wier who has been volunteering for over two years at the clinic at SIFA Fireside. Claire manages the clinic and gives her time every week as a dispensing optician, ensuring patients choose the right frames and lenses for their individual needs.
On the Vision Care team in Birmingham are four optometrists who work on a rota basis, two dispensing opticians, and lay volunteers with no previous experience, trained up to help patients choose frames and support the clinicians entering results on the computer system. At SIFA Fireside, the VCHP team work from an office off the main common room, providing a private and confidential clinical space for patients to be seen. Out of respect for the patients’ privacy, I was not invited in to observe an eye examination, but chatted with Claire in between patient appointments.
Claire explains “Our service is totally free so we can, if people are on benefits, use the online NHS PCSE system, so we can produce the NHS General Ophthalmic Services form as any high street optician would, these are the forms that confirm that a patient is exempt from paying for their eye tests and prescription lenses. However, if patients we see do not receive benefits, and would typically be required to pay for eye tests either privately or through the NHS, they are still totally free of charge and able to have free eye tests with VCHP. We do not charge anything for the sight test, lenses or glasses. This free eye care offer with VCHP is also available to patients who are non-UK nationals and who have no recourse to public funds.”
“This is only possible due to the great amount of support from the optical industry. Specsavers supply us with a full range of frames and another company called Stepper Eyewear who are a frame company, they help us out as well with some extra frames. Another company called Hoya Lens UK, they supply our lenses. So we are very lucky and have a lot of support.”
All of the equipment used for conducting the various eye tests is donated in either new or used condition to VCHP by optical companies.
Claire adds “We are very lucky in that we do have some brand new equipment donated to us. We have just had a new slit lamp, which was donated by Specsavers, and what the slit lamp enables us to do is look into the eye, and check the health of the eye, which is absolutely crucial when we have people living outside, they are open to the elements. There are different eye conditions that, if we catch them in the early stages, they can be controlled, so it is not just about whether an individual needs glasses or not, it is to give them a full eye health check.”
|| “The eye is just like an opening into the rest of the body, so if there’s a problem with blood vessels, and we can see that in the eye, chances are that might be that they have circulatory problems, heart problems, diabetes, there’s all sorts of things we can pick up on.” ||
If the clinical team suspects something else is going on with a patient’s health following the result of an eye health check, they can refer to primary or secondary care for further treatment.
“Referral can be quite a difficult process at times as a lot of our patients are not registered with a GP, so we do use the Homeless Health Exchange, or if they are new in the country and are not registered with a GP then SIFA Fireside, with the assistance of other agencies, facilitate the referral process.”
Claire told me a story about one gentleman who came to the Monday morning eye clinic, who was not a glasses wearer, however, on testing his eyes it was discovered that his eyesight was extremely poor. He was so shortsighted, he could not see the biggest letter on the board. His sight measured -12.00, If it’s negative (e.g. -2.00) you are short sighted, while a positive number (e.g. +2.00) indicates long-sightedness. So with the negative number being so high, this indicated just how impaired his shortsighted vision was. To come across a patient with such an extreme sight loss is really rare. The patient was living totally homeless, sleeping rough on the street with this sight loss.
“We got his glasses, well, he made me cry, because it just brought his world into focus… Just unbelievable the difference, and I think that this is one of the biggest things for us”.
Claire also told me about patients who they have been able to diagnose with glaucoma, cataracts, a macular hole and all were referred to specialists in Birmingham for treatment.
Claire impressed on me how they ensure that their patients are treated with respect and dignity when they attend the clinic at SIFA Fireside. Asked whether her patients have voiced any reticence to attend an optician on the high street, Claire confirmed that there have been comments that patients would not attend those clinics due to the fear of being judged, not necessarily by the staff, but from other patients.
Infographic below from: People affected by homelessness need better access to eye tests and glasses in England. David Brown, Elaine Styles, Stan Burridge pub. May 2023
“I think that this is changing slightly as one of the big multiples is getting involved with VCHP and they are recognising the challenges and are opening up their venues after hours to provide that safe space. There is only so much that we as a charity can do with only around ten venues across the UK, and with only one clinic in Birmingham for four hours once a week, that isn’t really enough to support the number of patients that need to be seen. We do hope that when patients come to VCHP that they are welcomed and feel totally treated with respect. I have had patients thank me just for being kind, and it makes me feel quite emotional”.
While I was at SIFA, I was introduced to Robert, a Polish national [not pictured] who recently had an eye test with VCHP. Robert I could see was a glasses wearer, so I chatted to him about why he wanted an appointment and his experience in the clinic.
“I have been homeless for two weeks, and I have been sleeping at the train station. While I was there, someone stole my bag, which had my glasses in. So I need more glasses, I need glasses for reading. I didn’t want to go to the high street optician, only SIFA. It is easier for me, as I am here everyday, to have my eyes checked by Vision Care. I am very happy, it is a good service and I have good glasses.”
I’m experiencing homelessness or vulnerably housed, can I have a free eye test?
Absolutely you can! Vision Care for Homeless People run their clinics every Monday morning from 9am until 1pm at SIFA Fireside in Digbeth. Just go along if you would like to book an eye test. It is completely free of charge, as are any frames or lenses if the optician finds that you are long or short sighted. To find out when the next clinic is running or to make an appointment call 0121 766 1700, visit the SIFA Fireside reception desk or send an email to office@sifafireside.co.uk
I work within the homelessness or supported housing sector and assist clients who could benefit from this service, can I refer them to the clinic?
Definitely, yes. To find out when the next clinic is running or to make an appointment call 0121 766 1700, visit the SIFA Fireside reception desk or send an email to office@sifafireside.co.uk
I’m an optical clinician, and I would love to give my time to help support this service.
Awesome news, VCHP are looking for more qualified optical practitioners to volunteer with them. If you would like to join VCHP as an Optometrist or a Dispensing Optician, then get in touch via their “Tell me more” form found on the VCHP website
I don’t have any experience with optical care, but I would love to volunteer anyway.
Brilliant, they would love to have you on board too. In Birmingham, VCHP are advertising for clinic assistants and administrators to support the service on a Monday morning. Again, you can find out more by getting in touch via their “Tell me more” form found on the VCHP website.
I cannot give my time through volunteering, but I would be willing to donate money to support the running of this service.
That would be wonderful. Vision Care for Homeless People is a registered charity and you can donate via their fundraising page. You can choose whether you would like to give a one-off gift or to set up a regular donation to keep services running.