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COVID-19 information sheet and updated letter templates support safe provision of NHS diabetic eye screening

Posted by: , Posted on: - Categories: NHS Diabetic Eye Screening Programme
A woman having an eye test taken.
A diabetic eye screening test taking place before the coronavirus pandemic (photo courtesy of British Association of Retinal Screening / Kamran Rajaby),

Public Health England (PHE) and NHS England and NHS Improvement (NHSEI) have been working together to support the safe restoration of NHS diabetic eye screening (DES) services that have been impacted by the coronavirus pandemic.

PHE and NHSEI have developed and approved a COVID-19 information sheet for local NHS DES services to enclose with all screening invitations until further notice.

The sheet provides guidance on staying safe while travelling to and from appointments, advice on the use of face coverings, and safety measures to expect at screening clinics.

NHS DES services can download the information sheet from GOV.UK along with updated national invitation and result letter templates.

Thank you to Diabetes UK focus group

In addition to the COVID-19 information sheet, PHE has updated the invitation and result letter templates used in the DES programme.

We linked up with Diabetes UK to ask people with diabetes to help us finalise the new templates to make sure they meet the needs of people who will receive them.

Diabetes UK recruited a small group of volunteers to participate in our ‘virtual’ video focus group and these enthusiastic participants provided invaluable feedback that we have incorporated into the final templates. This included the:

  • use of softer alternatives to wording in previous versions that was potentially scary, such as ‘sight-threatening’
  • highlighting of the QR codes and web links in tinted panels to draw attention to them
  • addition of advice that you may want to bring someone with you to your screening appointment

Letters signpost to digital information to reduce use of printed leaflets

Services should use the updated templates when inviting people with diabetes for screening and informing people and their GPs of their screening results.

The updated DES invitation and result letter templates include web links and QR codes that signpost people to more information online about screening, diabetic retinopathy, monitoring and treatment.

This is part of our work to reduce the use of printed leaflets by NHS screening services and make the most of digital information opportunities.

DES services now only need to send hard copy printed screening invitation leaflets with invitation letters to people who have not previously attended. These are known as ‘prevalent invitations’. Invitations to people who have previously attended are known as  ‘incident invitations’.

The short animation below explains the difference. The small notepad icon above the first 2 dates represents a printed leaflet sent with the invitation. The link icon above the subsequent 3 dates represents a link to digital online information. The abbreviation ‘DNA’ is short for ‘did not attend’.


All ‘incident’ screening invitations and all result letters should now direct people to information online. However, individuals who cannot access the internet can still ask local services to send them a printout of any relevant digital leaflet so they do not miss out on important information.

Next steps for DES providers

Services should enclose the COVID-19 information sheet with all screening invitations until further notice. The sheet is available both as a printable PDF and in digital HTML format.

We are also asking local services to implement the following actions as soon as possible and by the end of August at the latest.

  1. Work with your software suppliers to make sure the updated national letter templates are available on your IT system.
  2. Use the updated templates for all your screening invitation and result letters.
  3. Work with your printing provider (if applicable) to enclose the printed DES invitation leaflet Your guide to diabetic eye screening only with prevalent invitations. Your software supplier can advise on how to identify prevalent invitations if required.
  4. Stop enclosing printed copies of Your guide to diabetic retinopathy or Closer monitoring and treatment of diabetic retinopathy with positive screening result letters. Links to digital versions of these leaflets are now included in the relevant result letter templates.
  5. Print out a copy of the appropriate digital leaflet if an individual contacts your service to say they still need the information provided in a hard copy printed format.

Please note, the above changes will mean providers should in future only order enough hard copies of the Your guide to diabetic eye screening leaflet from national print provider APS Ltd to accompany first-time invitations.

Printed copies of the remaining 3 national public information leaflets, Diabetic eye screening: slit lamp examination, Your guide to diabetic retinopathy or Closer monitoring and treatment of diabetic retinopathy will not be available to order once current stocks run out. Services should then signpost people to the digital versions of the leaflets on GOV.UK.

Thank you for your help in implementing this change.

PHE Screening blog

The PHE Screening blog provides up to date news from all NHS screening programmes. You can register to receive updates direct to your inbox, so there’s no need to keep checking for new blogs. If you have any questions about this blog article, or about population screening in England, please contact the PHE screening helpdesk.

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