Consultation on the draft UK Vision Strategy
Setting the direction for eye health and sight loss services
Print, braille or audio copies of this document may be obtained from Harsha Gajjar, Project Manager, RNIB, 105 Judd Street, London WC1H 9NE. Telephone: 020 7874 1308.
Contents
Foreword by Sir Derek Wanless
Foreword by Lesley-Anne Alexander
Introduction
Executive Summary
Strategic Area 1: Eye health awareness and the prevention of blindness
Strategic Area 2: Correction, treatment and the eye care journey
Strategic Area 3: Support for independent living
Strategic Area 4: Empowerment and the inclusive society
Appendix A – Consultation and feedback
Appendix B – Strategic Area 1: Working team members and references
Appendix C – Strategic Area 2: Working team members and references
Appendix D – Strategic Area 3: Working team members, definitions and references
Appendix E – Strategic Area 4: Working team members and references
Appendix F – Key advisers
Appendix G – International frameworks and UK disability legislation
Appendix H – Glossary
Foreword by Sir Derek Wanless
Sight is one of our most vital and valued senses. Never has it been more important. More than ever we are bombarded every day with visual images and information; for example, the internet and mobile telephone now increasingly dominate the way we communicate. So, it is understandable that sight is a sense many of us fear losing.
Given the serious consequences of blindness or partial sight, why do so many of us fail to treat the health of our eyes as an important matter? Why do we persist in assuming that we will know if something is going wrong, when in fact the major sight conditions can creep up on us before we are aware of them?
By building on existing knowledge and experience about sight loss, its prevention and treatment and the services necessary to support blind and partially sighted people, we could do so much more to prevent avoidable sight loss and to empower those with sight problems to lead full lives.
To achieve this ambition, a wide range of individuals from across central governments, health and social care bodies, voluntary organisations and professional groups has come together to provide a framework for change by creating a UK Vision Strategy.
This powerful alliance spans eye health and sight loss and has developed a draft UK Vision Strategy, which sets out the priorities for achieving positive change.
The following pages set out the draft UK Vision Strategy for consultation. I urge you to take the opportunity to consider and comment on this landmark strategy. This will ensure that it provides a strong and powerful platform from which we can radically improve the prevention of avoidable sight loss and the support and inclusion of those with sight problems.
Sir Derek Wanless
Author: ‘Our Future Health Secured?’ (King's Fund 2007)
Foreword by Lesley-Anne Alexander
Over the last nine months, I have had the privilege of chairing the Strategic Advisory Group that has led the development of this draft UK Vision Strategy. Under the auspices of this Group, four working teams were set up to shape the strategy building on extensive output from the symposium “Developing a UK Vision Strategy” held on 4 April 2007.
I would like to take this opportunity to say a heart-felt thank you to all the members of the Strategic Advisory Group and to the members of the working teams and others who have supported our ambitions. In addition, I would like to thank the project team and others within RNIB for all the hard work they have put in to help us reach this point.
The proposals outlined in the following consultation document are designed to build on the positive work already going on and to radically improve outcomes in three specific areas:
· the prevention of avoidable sight loss
· the improvement of eye health and support services
· the increased support and inclusion for those with permanent sight loss
We are asking for your thoughts and comments on the document, including whether we have identified the most important things that need to change.
The magnitude of the challenge we have set ourselves must not be underestimated. If we are to bring about the changes we seek we must unite as a strong and determined sector. The implementation of a dynamic UK Vision Strategy will bring about widespread and lasting change. It will reduce the number of people who suffer preventable sight loss, enable people to access eye care services as and when they need to and will provide the very best support for blind and partially sighted people today and empower more independent lives tomorrow.
My experience tells me that we are ready to meet this challenge. The outcome must be universally accessible, world class services for maintaining sight and supporting those with sight loss across the whole of the United Kingdom.
Lesley-Anne Alexander
RNIB chief executive
Introduction
The purpose of the UK Vision Strategy is to establish a unified framework for action on all issues relating to vision, across the UK and across all stakeholders. Its aims are:
· The improvement of the eye health of the nation.
· Prevention of sight loss and radical improvement of services.
· Support and inclusion for those with sight loss.
This document provides a strategic framework for the UK response to the VISION 2020 resolution, passed at the 56th World Health Assembly in 2003. The resolution urged member states to develop, implement and adopt national plans for tackling vision impairment. The UK government has pledged its support for the resolution and the UK Vision Strategy will apply this resolution to the needs of people living in the UK.
In the early stages of the Strategy’s development, the decision was taken to have one over-arching strategy for children and adults, but following consultation feedback, this will be reviewed.
Current estimates indicate that there are around two million people in the UK with some form of sight loss that disrupts their lives. A significant proportion of this is correctable or avoidable, either through wearing spectacles or contact lenses, or medical intervention. In addition, there are many more people, who either have never had their eyes tested or not had a recent sight test. They may have early eye disease and/or vision that needs correcting.
Across the UK, 378,000 people are registered as blind or partially sighted; 315,000 in England, 38,000 in Scotland, 20,000 in Wales and 5,000 in Northern Ireland. Around 25,000 children in the UK have serious sight loss and, in future, the incidence of sight loss among young adults due to diabetic retinopathy is likely to increase, as more children become affected by diabetes. At the other end of the spectrum, the UK population is ageing and the proportion of over-85s is expected to increase by 25per cent by 2011. This demographic shift will also mean higher demand for eye care and support services, as the incidence of sight loss increases with age (one in eight over-75s and one in three over-90s have serious sight loss).
Although there can be no doubt that demand for services will increase, there continues to be a lack of public prioritisation and awareness of eye health in general, and much room for improvement in the way services are delivered. Those who are already living with sight loss are also living with considerable barriers to inclusion across all areas of society.
The need for research underpins all aspects of the UK Vision Strategy as a sound evidence base is essential, not only for new treatment of eye disease, but to plan community services and transform the lives of people with a vision impairment. The strategy must be flexible so that it can promote, respond to and accommodate research-generated advances. During the consultation process, priority areas of research will be identified and incorporated as well as analysis of the financial investment required and the potential cost benefits of the strategy.
The development of the UK Vision Strategy is being led by a Strategic Advisory Group, representative of all stakeholders, including support from the governments across the UK. This consultation document was assembled by working teams with representatives from all stakeholder sectors, as well as service users. It is not intended as a long and detailed ‘shopping list’ but rather as a strategic document that points the way forward.
The Strategic Advisory Group invites all interested parties to comment on the consultation document and to assist this a set of questions is included in Appendix A at the end of the document.
The consultation period commences in November 2007 and will continue to 17 January 2008. During this time, responses can be submitted using the processes outlined in Appendix A. In addition, there will be eight consultation events around the UK, where it will also be possible to discuss and respond to this document; details of the dates and venues for these events and how to register can be found in Appendix A.
All comments from the consultation process will be collated and reviewed and the strategy will be revised prior to its launch in April 2008.
The Strategic Advisory Group members are as follows:
Chair: Lesley-Anne Alexander, chief executive, RNIB
Committee:
· Nick Astbury, consultant ophthalmologist, representing the Royal College of Ophthalmologists
· Rosie Auld, chairman, British and Irish Orthoptic Society
· Mike Brace, chief executive, VISION 2020 UK
· Anne Bristow, corporate director of adult and community services, London Borough of Barking and Dagenham
· Bob Hughes, chief executive, Association of Optometrists, representing the Eye Health Alliance
· Stephen Remington, chief executive, Action for Blind People
· Malcolm Swinburn, immediate past chair, National Association of Local Societies for Visually Impaired People (NALSVI)
· Bridget Warr, chief executive, Guide Dogs
· Jo Webber, deputy policy director, NHS Confederation
Project support team:
· Fazilet Hadi, group director policy and advocacy, RNIB
· Anita Lightstone, head of service development and research, RNIB
· Harsha Gajjar, project manager, service development, RNIB
Executive Summary
The UK Vision Strategy consultation document is divided into four Strategic Areas, each addressing a distinct range of issues. Strategic Area 1 concentrates on eye health awareness and the prevention of blindness; Strategic Area 2 looks at correction, treatment and the eye care journey; Strategic Area 3 considers support for independent living for blind and partially sighted people and Strategic Area 4 investigates empowerment and the inclusive society. Each comprises a brief abstract, the reasons for change and suggests key priorities, supported by some proposed actions for implementation.
Strategic Area 1: Eye health awareness and the prevention of blindness
This section addresses two of the purposes of the UK Vision Strategy: the improvement of the eye health of the nation, and the prevention of sight loss.
Key Priority 1: Elimination of correctable sight loss and reduction of preventable blindness
Outcome: no one having to live with sight loss that could have been prevented.
Key Priority 2: Raising public awareness of maintaining eye health
Outcome: reduction in preventable blindness through an increased understanding of the importance of eye health, regular sight testing, and the impact of sight loss.
Key Priority 3: Prioritisation of eye health and sight loss by the creation of a nationally recognised body for each of the UK countries
Outcome: higher recognition of the importance of eye health and sight loss and these bodies’ support for the implementation of the UK Vision Strategy.
Strategic Area 2: Correction, treatment and the eye care journey
Strategic Area 2 addresses the radical improvement of eye care and support services. Both adults and children need eye care services that provide appropriate treatment and support, whether from health services, social care, the voluntary sector or informally. These must be structured to meet the needs of the individual and be accessible to all.
Key Priority 4: Services centred on the needs of the individual
Outcome: barriers to accessing services are minimised, leading to greater uptake.
Key Priority 5: Establishing equity of access to eye health and support services
Outcome: services are easily and fully accessed by all members of society.
Key Priority 6: Establishing effective eye disease management centred on the needs of the individual
Outcome: following diagnosis, further deterioration of sight is minimised or entirely prevented.
Strategic Area 3: Support for independent living
Strategic Area 3 addresses the support of people with sight loss to facilitate independent living. It also acknowledges that sight loss is often a single aspect of a range of needs, and that knowledge of sight loss must be brought further into the mainstream. Blind and partially sighted people should be more involved in planning and auditing services. All measures to support independent living must be supported by enforceable and measurable standards, which guarantee the right to information, emotional support, assessment and reassessment, and resources that include a realistic system of personalised budgets.
Key Priority 7: Enforceable and measurable outcomes to ensure effective services and support for individuals experiencing sight loss
Outcome: blind and partially sighted people have the information and services that enable them to exercise choice and control over their lives.
Key Priority 8: Greater sight loss expertise in health, social care, education, housing and employment to facilitate integrated support and services
Outcome: the needs of people with sight loss are fully recognised, hence services provided are fit for purpose.
Key Priority 9: Strengthening user voice
Outcome: people who are blind and partially sighted play a key role in service design and delivery.
Strategic Area 4: Empowerment and the inclusive society
Strategic Area 4 looks at the inequalities that contribute to the social exclusion of blind and partially sighted people and the ways that these might be addressed. More positive attitudes and increased awareness will enable people who are blind and partially sighted to benefit from the education system, enter the workplace and participate in all areas of society and culture. Benefit levels should ensure similar financial security for those unable to work. The adoption of universal design principles will ensure that environments and products are accessible to blind and partially sighted people.