Diabetic eye screening: commission and provide

Operational guidance for the NHS diabetic eye screening (DES) programme.

This publication explains the process of offering a high-quality diabetic eye screening programme.

The Royal College of Opthalmology also has diabetic retinopathy guidelines for healthcare professionals.

Commission screening services

The NHS public health functions agreement 2015 to 2016 explains the funding available for NHS England to commission DES services.

Service specification number 22 sets out the details for commissioning and delivering DES services.

Commissioners must also refer to the:

DES: working standards and eligible populations

Provide diabetic eye screening

Screening staff administer eye drops to dilate the pupil so the retina can be seen more clearly.

They then take digital photographs of the retina in each eye, followed by a 2- or 3-stage image grading process to identify signs of diabetic eye disease.

Screening staff send the results to the patient and GP within 6 weeks.

DES limitations and risks

Screening does not replace regular eye examinations and patients should attend both.

The screening photograph is painless and the camera does not come into contact with the eye.

Eye drops may cause stinging for a few seconds and blurred vision for between 2 to 6 hours after the test.

Patients should not drive after their appointment.

On rare occasions screening can miss changes that could threaten sight, although every effort is made to reduce the risk of this happening.

Retinal imaging

DES: equipment guidance

This guidance defines how to use screening equipment safely.

DES: communicating with patients

Patient screening data and engagement

Every person who attends for screening must agree to the NHS keeping and using their personal information. Screening cannot take place if the person does not give their consent.

Depending on the results, staff should:

  • recall patients for annual screening
  • invite them back for more frequent surveillance
  • refer them to hospital eye services

Local provider quality assurance

Diabetic eye screening data and research

  1. Diabetic eye screening: 2016 to 2017 data
  2. Diabetic eye screening: 2015 to 2016 data
Published 2 January 2015
Last updated 3 March 2020 + show all updates
  1. Added Diploma for Health Screeners Rules of Combination.

  2. Added Diabetic eye screening: audit schedule.

  3. Added 'Diabetic eye screening: identifying differences in grading outcomes' document.

  4. Added 2016 to 2017 data tables.

  5. Added 'collection of demographic information'.

  6. Added 'Diabetic eye screening (DES): national data reporting specifications' and removed performance template.

  7. Added data and research group to document collection.

  8. Added Diabetic eye screening: competencies for administrative staff.

  9. Addition to collection of Diabetic eye screening: management of patients not included on the screening register

  10. Added Diabetic eye screening: consent and cohort management.

  11. Added quality assurance of grading guidance to DES document collection.

  12. First published.