Waltham Forest Vision Strategy Group presentation to Health and Wellbeing Board 15 September 2015 Roger Clifton, Strategy Group Chair
The picture in Waltham Forest The population of visually impaired adults registered in Waltham Forest is • expected to increase from 1330 to 5250 by 2020 If spending on ‘Problems of Vision’ increases at the current rate, the costs • will increase from £11.41 million to £13.92 million over the next 7 years. 50% of this sight loss, and expenditure, is avoidable through the • modification of lifestyle and increased awareness of sight loss. The Whipps Cross eye Treatment Centre sees 200 patients a day, or 4,000 • a month, yet the Council’s Social Services Team has only one rehabilitation worker responsible for visually impaired people. Only 19% of visually impaired people of working age in the borough are in • any kind of employment. No Council funding is directed at the voluntary sector specifically to • provide services to people experiencing sight loss. There appear to be a number of issues with the registration of children as • visually impaired, making it difficult to ensure that they receive the required level of support during childhood and also in being able to effectively transfer them through the transition process into adult services.
Experiences of people with visual impairment Whipps Cross : ‘I have Glaucoma and have check ups about every 5 or 6 months. • These are not regular enough. On the last 3 occasions I have needed emergency treatment immediately after a check up. I have asked for more regular appointments but they refuse. On this last occasion the pressure in my eyes was so high they have called me in for an operation under general anaesthetic tomorrow. This is my eyesight, and impacts me hugely. There is no prevention (despite my requests for more frequent checks) only emergency measures when things are at crisis point. • GP : GP Surgeries not using email to correspond, despite requests; Staff at GP surgeries are not aware of VI people being unable to use touch screens; Majority of GP’s still using visual effects to call people to their appointments. Social services : ‘The LBWF sensory team can no longer provide appropriate • mobility training for those with sight loss/blindness. Sometimes it is done for urgent needs only, but generally you are put on a waiting list and nothing happens. You are not allowed to get mobility training for social needs like going to a friend’s house or popping around the corner for milk - being able to do this basic activity is crucial to my mental health and wellbeing. Where is the support to enable us to live independent lives ?’ Leisure facilities : lack of disabled parking bays; no support to use facilities and • equipment and follow fitness programmes; lack of VI awareness amongst frontline leisure centre staff.
Good practice • GP: Highams Park Practice has a flagging system letting the surgery know of patient needs. • Social services: Has liaised with the voluntary sector, East London vision, to contact all 1,365 people on the vision impaired social services register. • Leisure facilities: A ssistance is given to VI people to help them find a course at Waltham Forest Adult Education.
Background to development of the user led Vision Strategy • Waltham Forest’s Vision Strategy 2013 -16 was developed in consultation with health and social care professionals, voluntary sector support organisations and service users. • It forms part of the wider UK Vision Strategy (developed by World Health Organisations (WHO) and Royal National Institute of Blind People (RNIB)) • It aims to ensure that: – Everyone looks after their eyes and their sight; – Everyone with an eye condition receives timely treatment and, if permanent sight loss occurs, early and appropriate services and support are available and accessible to all; – People with sight loss can fully participate in society
What service users want A coordinated, ongoing and sustainable programme of Visual Impairment • Awareness Training for all service providers. • Availability of accurate personal information and the existence of efficient data collection and analysis processes, leading to effective reporting throughout the sight loss pathway, including accurate CVI information being shared with the service user. Provision of ongoing emotional and rehabilitation support, to be accessed • as and when required at each stage of the sight loss pathway. • Improved access to a wide range of leisure opportunities (including those not just available to visually impaired people), through more information in an accessible format being available, better training for leisure providers and the design and delivery of appropriate programmes of activity. Sustainable and effective voluntary sector support to complement services • provided by statutory agencies to provide advice and information, peer support, help with daily living and the opportunity to increase independence.
What the Strategy proposes Health and Wellbeing : Embed the Vision Strategy into the Health and Wellbeing framework , and achieve a user led partnership approach to the planning, delivery and evaluation of eye health and sight loss support services. Prevention : Maximise the uptake of eye examinations and raise awareness of eye health to ensure that avoidable sight loss is prevented wherever possible. Joined up data : Ensure that comprehensive cross sector data on sight loss and local demographics is collected and shared to inform resource allocation across Public Health, NHS, Optometry, Social Care and Voluntary organisations. Joined up and improved services : Ensure that an effective and efficient service provision is available, resulting in a clear pathway for people experiencing sight loss from diagnosis through to independent living . This will include optometrists, GPs, eye clinics, social care teams and voluntary services. Social inclusion and independence : Ensure that people with sight loss have good access to key local services - information, transport, leisure, employment, education and welfare rights to obtain and maintain independence and not experience social exclusion, inequality or isolation. Children’s services : Develop and embed into the main vision strategy considerations for children and young people , including evidence of current and future need, sight loss pathway, arrangements for transition to adult services and an action plan to address gaps and need. Visually Impaired people with complex needs : Ensure that the needs of people with visual impairment as a secondary presenting condition are recognised . Visual impairment is often overlooked in those with, for instance, Dementia, Parkinson’s, Learning Disabilities, etc. Involve local People in Sight Loss Priorities : Involve people with sight loss in defining priorities and ask them for feedback on our work.
Progress to date Vision Strategy Group meets quarterly and has good cross-sector • representation…facilitating opportunities for the join -up and cohesion of the sight loss pathway. The Vision Strategy provides a viable eye health needs assessment: • an evidence base together with a mapping & gapping of services. • Links with consultation bodies are starting to become embedded: the VS Group has fed into – JSNA Obesity Strategy (April 2014) – Urgent Care consultation (May 2015) – Self-Care consultation (May 2015) – Ophthalmology Review prioritisation (May 2015) East London Vision (ELVis), which was set up in October 2013 to • support VI people across east London and address the issues arising out of the Vision Strategies in each borough, is supporting Waltham Forest Vision, providing VI Awareness Training to frontline staff, supporting the updating of the VI Register.
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