What Vision? Mary Bairstow Low Vision Steering Group July 4th 2007

What a history (a reminder) What standards? What’s my opinion? So what’s the local society response ?

Low Vision Services Implementation Late 1990’s More and better services Low vision report Sets standards and suggests Low Vision Services Committees Nalsvi endorsed Late 1990’s More and better services Low vision report Sets standards and suggests lvsc’s as a means to change

It should be easy Get everyone around the table Identify what needs to be done Make plans about how to do it Work with local commissioners (PCTs, social care) Monitor

LVSCs (Blackburn with Darwen newest) Emperor’s new clothes or visionary groups ?

A question of independence (Nov 2006) RNIB and AMD Alliance UK funded McLaughlan, B., Lightstone, A. and Winyard, S

Not relevant? The majority (91%) could see the shapes of furniture in a room (or better) Network % cent of people said they used magnifiers for reading Network % said that they used better lighting for reading tasks Network

But what vision 1/4 of service providers admit their services less than satisfactory or unsatisfactory AMD Alliance 2006 and……… Service users do not know what they can expect from service providers Low Vision Project National Evaluation Report 2005

Accountability 40% - funders no accountability 16 % require yearly audits 14 % ask for accounts 11% variety of different ways AMD Alliance 2006

Setting Standards Some LVSCs lack clarity about their purpose (despite the clear remit given in the 1999 Report) Low Vision Project National Evaluation Report 2005

Seeking a solution? How you would you recognise a good service?

A consensus LV recommendations for future service delivery Working Group 19 members 2 users Nalsvi representation (Ian Atrill) ADSS, Rehab., Vol Orgs

Status Voluntary sector recommendations Endorsements - Loads Foreword - Frank Dobson

1999 standards Who, where, what, when, continued support and monitoring services….. –Not clinical parameters –Close to home –Eye exam…. to certification … to vision enhancement training……... –Within 6 weeks –Returning as required –Monitored

Setting a new Standard Working party set up members Included one rehabilitation worker 4 Optometrists 1 Dispensing Optician 1 Ophthalmologist 1 Orthoptist 1 Department of Health Consultation Launched Jan 2007

Status Recommended by the DH Endorsed by LVSG May be reviewed

The standards 6 Headings Design Principles Referral, assessment and service Information Service improvement, monitoring and evaluation of the service Training Communication

Design Principles Multi-agency approach that coordinates with other services (but its an efficient methodology!) User centred - involving participation Not dependent on registration Evidence based - conforms and contributes to governance Attends to timescales -not defined -need to identify Review of low vision needs

Referral Any care or health professional Self referral Reviews included Warns against strict ‘entrance criteria’ Notes importance of medical diagnosis Recording dissent - particularly if against a persons ‘best interest’

Low Vision Assessment The essentials Eye health - done,doing or included Functional vision assessment Appendices to describe

Desirables Prescription of device Supply and loan - protocols agreed Lighting, contrast, filters Other aids Training and therapy Links to broader rehabilitation A review of benefits, welfare rights, concessions, support groups

Information Appropriate formats Enable informed decisions Communication - ‘colleagues’ with consent All professionals should use a health/care record

Local commissioners - ‘will wish’ Service Improvement, monitoring and evaluation of the service Modernisation techniques Measures - numbers referred/ treated - demographics - inter-professional communications - evaluation data Service user involvement Annual report by commissioners - ‘working towards’ !

Training Suitably trained as part of a local protocol Accreditation - initial - ongoing - reflect lessons learnt Multi-disciplinary CRB checks noted

Appendices Already noted 1 and 2 - eye health and functional assessment Appendix 3 - Personnel Includes carers but forgets teachers! Notes on supply Appendix 4 equipment Appendix 5 benefits + Further reading

User led changes? LV Consensus ‘99 Devices should be loaned Specific times (6w) DH LV ‘07 Loan/supply agreed locally Agreed timetables (though 10 days for contact)

What’s new? Emphasis on ‘booking of appointments’ Reference to service being refused Notes on CRB checks Single contact point (though this is mentioned as an LVSC aim) Directions for commissioners

What’s been lost? Notion of implementation or governance ( LVSCs ) Sense of ‘the essential’ Some specifics - Transport - Issues of geography

So can it work Huge variation in activity and outcomes Mary’s factors for success – A Vision – Self belief – Strong lead - good chair – The right membership – Service user strategy – Commissioning involvement – Reporting routes

Local Society support? Link to or attend LVSC Give advice - pass on expertise Support user involvement Ensure PCT approaches acknowledge multi-agency (LVSC) model

Keeping up to date Link into the national network

Thank You for Listening You can find me at Website lowvision.org.uk