1. 1 Overcoming barriers to accessible eye care David Allen, Head of Sight Loss Prevention, RNIB Carol Hayden, Director, Shared Intelligence

2. 2 Developing evidence of what works Evidence review Eye health equity profiles Qualitative research Trial interventions (18 - 22 months) Independent evaluation - London School of Hygiene & Tropical Medicine (LSHTM)

3. Evidence review De Montfort University conducted a review examining evidence of the effectiveness of intervention strategies to address inequalities in eye health care. Johnson et al, 2011 3

4. Eye health equity profiles Local public health specialists conducted a systematic review of data in each of the five CEP sites to explore service provision, uptake and outcomes. 4

5. Community engagement projects 5

6. Qualitative research - our research aims Through a community engagement approach: Identify the barriers that prevent access to primary and secondary eye care services among people most at risk of developing avoidable sight loss. Design and develop intervention strategies to increase the uptake of eye care services among these people. In Bradford, Glasgow (Pakistani population/diabetic retinopathy) Cwm Taf, West Belfast (White working class/glaucoma), Hackney (Caribbean/glaucoma) 6

7. Qualitative research - what we did Approach Local collaboration Community based participatory research Co-production of change Methods Community focus groups Interviews with service providers, professionals and stakeholders Focus groups and interviews with Diabetic Retinopathy Screening Service target users Interviews with secondary care service users 7

8. Qualitative research - what we found (1) Eye health Understood in relation to sight and fear of blindness Poorly compared to other health promotion information Mixed understanding of risk factors Primary care and eye examinations Symptom – led demand from most people Retail environment and perceived cost of glasses a barrier Positive experience with optometrist an enabler 8

9. Qualitative research - what we found (2) Secondary care - barriers Complexity of eye care pathway Lack of understanding or trust Service response to inequalities Specific barriers in some areas e.g. transport, costs Secondary care – enablers Appointment reminders Constructive approach to managing non-attendance Positive relationship with clinician Role of ECLO's Access to social and community support 9

10. Qualitative research - what we learned Important to: Work closely with local/target communities Work in partnership e.g. with Local Advisory Groups Invest in staff skills and capacity - and service monitoring For: Raising awareness of eye health User-focused, pathway approach to service redesign and development Addressing health inequalities and preventing avoidable sight loss 10

11. Community engagement projects 11

12. Independent evaluation London School of Hygiene & Tropical Medicine Outcome Process Economic More information: rnib.org.uk/healthprofessionals Contact us: david.allen@rnib.org.uk carol.hayden@sharedintelligence.net 12

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