Certification and Registration Processes

Title: The Certification and Registration Processes: Stages, barriers and delays

Author: Dr Tammy Boyce; Publisher: RNIB; Year of publication: 2012

Background

Certification and registration bridges health and social care and involves many stakeholders including; Public Health, Primary Care, Social Care and Local Authorities. As we know, the Public Health Outcomes Framework has introduced an indicator for preventable sight loss, which will be based on CVI figures. RNIB commissioned Dr Tammy Boyce to document Certification and Registration processes from the perspective of professionals and patients; examine the relationship between health and social care and the role of these professionals in Certification and Registration; understand related barriers and enablers to Certification and Registration.

Key findings

Impact and process:    

  • Certification is life changing for patients    
  • Numerous people are involved in certification and registration processes. Each of these professionals – ophthalmologists, registrars, optometrists, medical secretaries, CVI administrators, Eye Clinic Liaison Officers (ECLOs), Rehabilitation Officers, social services managers and administrators – have the potential to create barriers and delays or to improve the Certification and Registration processes. 

The main barriers to being certified are:    

  • The uncertainty of when to certify on the part of the ophthalmologist, particularly for people with long term conditions such as AMD, glaucoma or diabetic retinopathy.    
  • External pressures to reduce certification rates.    
  • Clinicians regarding certification as end of process, not a route to services and therefore failing to offer certification when patients are eligible.    
  • Poor awareness of the benefits of being certified and registered leading to failure to offer certification as clinicians saw no need/little value to patients.    
  • Incorrect assumptions about patients’ views and believing patients do not ‘need’ to be certified.    
  • Lack of clarity regarding payment for signing the CVI.

Additional delays can affect the health of patients, and can be caused by:    

  • The length of time for consultants to complete CVIs    
  • Sending incomplete CVIs to SSDs    
  • The length of time for CVIs to be sent to SSDs.