This paper presents preliminary findings from a research project aiming to assess the health and social care needs of older people with visual problems and to consider the implications of the data collected for the new commissioning authorities in the National Health Service. The project was based in four District Health Authorities in the North West of England. The needs assessment work consisted of a number of related elements: a review of the literature on visual impairment and disability; a survey of 1660 people aged over 64 years; a clinical assessment of visual problems among a sub-group of the survey sample; and a review of service provision. To explore the commissioning implications, a number of inter-agency workshops have been held across and within the participating districts. The preliminary findings are discussed within the framework of Maxwell's six dimensions of quality.