1. Royal National Institute of Blind People
An evaluation of patient information and support services in UK eye clinics
Royal National Institute of Blind People
Evaluation team:
Welsh Institute for Health and Social Care, University of South Wales
and
Swansea Centre for Health Economics,
Swansea University

2. 3 4 24 30 98 141 259 + 106 26,287 Areas of impact Countries
Categories of patient 24
ECLO services researched 30
Site Visits 98
Staff activity proforma
141
In-depth interviews
HRQoL patient questionnaires completed
26,287
ECLO appointments analysed

3. Key study questions – impact of ECLOs on...
Patients
How does the ECLO ‘value add’ for the patient?
How does contact with the ECLO impact on the quality of life for patients?
Are ECLOs targeting the right people?
Clinics
How do ECLOs operate within the clinic setting?
What is the impact of an ECLO on clinic activity?
Services
What are the service benefits for having an ECLO present in clinic?
Are there cost-savings to the NHS when an ECLO is part of the care team?
What would happen if ECLO services were expanded?

4. IMPACT ON PATIENTS How does the ECLO ‘value add’ for the patient?
How does contact with the ECLO impact on the quality of life for patients?
Are ECLOs targeting the right people?

5. Impact on patients – ECLOs...
provide appropriate support
impact on health-related quality of life
target the right people
integrate services – health, social services and others
are proactive patient-centred advocates
help people to deal with their worries and concerns
bring together professionals in bi-directional information flows
thrive on relationships of trust

6. Impact on patients
ECLOs help those patients with the greatest needs and appear to maintain their health- related quality of life by providing a wide range of well-targeted, well-appreciated services.

7. IMPACT ON CLINICS How do ECLOs operate within the clinic setting?
What is the impact of an ECLO on clinic activity?

8. Impact on clinics – ECLOs...
enhance efficiency within clinics and streamline processes
are experts in joining the dots
make clinics better places for patients
turn the routine into the efficient, and the regular into the effective
stimulate change that improves the offer of clinics
are proactive catalysers of change
provide safe and meaningful ‘departure points’
offer continuous specialist expertise

9. Caring, holistic, ‘embodied’ practice
ECLO
Caring, holistic, ‘embodied’ practice
Pastoral ECLO
Advocate ECLO
Experiential ECLO
Educational ECLO
In-betweener ECLO
Harm reduction ECLO
Entrepreneur ECLO

10. Impact on clinics
Across the UK, we can describe seven broad types of valued service and support provided by ECLOs, working in ways which reflect the individual circumstances of different clinics and hospitals.

11. IMPACT ON SERVICES
What are the service benefits for having an ECLO present in clinic?
Are there cost-savings to the NHS when an ECLO is part of the care team?
What would happen if ECLO services were expanded?

12. Impact on clinics – ECLOs...
enhance efficiency within clinics and streamline processes
are experts in joining the dots
make clinics better places for patients
turn the routine into the efficient, and the regular into the effective
stimulate change that improves the offer of clinics
are proactive catalysers of change
provide safe and meaningful ‘departure points’
offer continuous specialist expertise

13. Impact on services – ECLOs...
provide support that others do not/cannot provide
may reduce burden of falls and depression
address negative impacts on health and social functioning
ECLOs enhance and broaden the care which clinical services provide, thereby potentially reducing patients’ longer-term care needs, and release NHS staff to perform their clinical roles. Evidence of their impact on productivity and efficiency is less clear, but they do make a contribution to various other NHS objectives relevant to all four nations.

14. Perspectives on implementing ECLO services
Meeting quality standards “Quality first”
Ensuring equity – commissioning “Minimal variation”
Ensuring equity – provider “Hospital financed”
Clinical aspiration “Professional ambition”
Cost effectiveness “Resource optimisation”

15. TO SUMMARISE...

16. Key messages from findings
Impact of ECLOs on patients
ECLOs help those patients with the greatest needs and appear to maintain their health-related quality of life by providing a wide range of well-targeted, well-appreciated services
Impact of ECLOs on clinics
Across the UK, we can describe seven broad types of valued service and support provided by ECLOs, working in ways which reflect the individual circumstances of different clinics and hospitals
Potential impact of ECLOs on services
ECLOs enhance and broaden the care which clinical services provide, thereby potentially reducing patients’ longer-term care needs, and release NHS staff to perform their clinical roles.  Evidence of their impact on productivity and efficiency is less clear, but they do make a contribution to various other NHS objectives relevant to all four nations

17. Learning points / next steps
ECLO activity data collection serves many purposes – fine tuning? could help it become:
Some people that have needs are not getting support – challenge?
Activity of the ECLO is appropriately targeted and is preserving HRQoL BUT sample size is relatively small
Ensure that the evidence collected / impact expected is within the gift and remit of ECLOs

18. Thank you for listening
Any questions?
Welsh Institute for Health and Social Care (WIHSC)
University of South Wales
Swansea Centre for Health Economics (SCHE)
Swansea University
©University of Glamorgan