Guidance

DES: Diploma for health screeners rules of combination

Education and training requirements for staff groups in diabetic eye screening (DES) studying for the diploma for health screeners.

• From: NHS England
• Published: 12 March 2020
• Last updated: 29 April 2026
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  1. 29 April 2026

     1. Minor wording and grammatical changes in the Overview section to improve usability. 2. Changes to the Generic Units section. Removed the previous unit numbers and names and replaced with a generic reference to the requirement to complete the generic units, this will mean that the guidance will not need to be changed every time there is a change to the unit names and numbers. 3. The removal of the children's safeguarding unit from the section named role specific units because this unit no longer exists within the diploma. 4. Additional text also added to the role specific units section, acknowledging the additional requirement to complete the newly created OCT in Digital Surveillance unit within the diploma. 5. Minor changes to wording under the Screener section to reflect that there are no longer 13 generic units. We have removed the number of units so that this guidance won't need to be updated every time there is a change to the diploma structure. 6. Minor grammatical and wording changes under the Grader section to improve readability. 7. The list updated under the Non clinical grading staff section to make it clear that, although these clinicians don't need to complete the diplomas generic units, that there is still an expectation to complete their organisations mandatory training. 8. Removal of the reference to previous unit "principles of health screening" within the Optometrist section because this unit no longer exists and replaced with a generic reference to the role specific rules of combination. 9. Adjustment to the previous section 3.6 Assistant and support workers this section has now been name 3.6 Assistant and support workers within an Optometry practice and a section 3.7 Assistant and support workers not working within an Optometry practice. These sections have been redesigned to be explicit and reflect the difference in the roles and the different requirements of units that need to be completed as part of the rules of combination. 10. The rules of combination table has been completely redesigned to reflect the new qualification structure and add in additional rules of combination rules for the roles of "Assistant and support workers not working within an Optometru practice", and "Non-clinical Grader" which were not previously reflected within this table.

  2. 5 April 2022

     Guidance updated to reflect the fact that optometrists no longer have to complete the ‘Prepare for Diabetic Retinopathy Screening’ unit as part of the health screener diploma.

  3. 21 October 2020

     Updated section 3 to clarify unsupervised screening requirements for trainee screeners.

  4. 5 October 2020

     Updated section 3.1: Screener.

  5. 4 September 2020

     Updated section 3.6: Assistant and support workers.

  6. 12 March 2020

     First published.

Documents

Diabetic eye screening: Diploma for health screeners rules of combination

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Details

This guidance provides local diabetic eye screening (DES) providers with information about the appropriate units in the Level 3 Diploma for health screeners that DES staff must complete.