Gateshead: Low Vision Pilot
Aim of your project
The provision of a local, integrated, multi-disciplinary, multi-agency, one-stop Low Vision and Rehabilitation Service for the people of Gateshead, in line with the design principles set out in the draft Baseline Standards for Low Vision Services (referred to as the standards). This will minimise the need for people to travel outside their community (domiciliary services will be provided where appropriate) and will deliver effective, consistent services and support to meet individual needs. Users will have a key role in monitoring. There will be a significant improvement in the provision of services for people with learning disabilities.
What organisations will be involved in and supporting this application? Why do you believe they are crucial to your proposal?
Gateshead and South Tyneside Sight Service, RNIB, Gateshead Local Optical Committee, Gateshead Council, Gateshead PCT, Hospital Eye Services at RVI, Newcastle and City Hospitals, Sunderland will all work in partnership with service users, including the Gateshead Low Vision Group.
This proposal arose out of consultation with service users about their needs and their involvement is at the centre of our planning (standard 2). We need the support of all the organisations listed to ensure delivery of safe and efficient low vision services in Gateshead.
Objectives of the project - why do you want to be a Pilot Scheme?
- To deliver user demands as quickly as possible.
- To develop an innovative service in line with the low vision service standards.
- To build on the benefits of multi-agency working eg Integrated Community.
- Equipment Services, Direct Payments and to share our experiences.
- To improve choice and accessibility.
- To help meet NSF standards, eg. falls.
Where to you want to be in 2 years' time? Describe your vision for delivery of Chronic Eye Disease Services
- A low vision service in Gateshead accessible to everyone who needs it – welcoming to people with learning and/or physical disabilities and with no cultural barriers (standard 3). (A HAZ funded research project into the low take-up of services by people from
- Wider awareness and choice of services for local people (standards 5 and 10).
- Clear, simple pathways of care.
- Single assessment process (hopefully supported by integrated IT systems) (standards 7 and 12).
- Wider knowledge of the above among local professionals (standards 6 and 11).
- Increased range of awareness training and understanding among health, social and home care staff (standard 11).
Scope and focus of the project - what aspects of Chronic Eye Care services do you want to develop? What new ideas do you want to test?
- We want organisations and users to work together to develop and test new ideas.
- Our plans will provide local, innovative, open-access services which are strengthened by the ability to refer into specialist services quickly. We will continue to review and streamline referral arrangements between all agencies (standards 4, 5, 6, 7, 8 a
- We want to have a very flexible appointments system to encourage people to use the services and to increase confidence (standard 5).
- We want to work with the RNIB Education Service to scope demand for low vision services for children – we need to know if the current low demand reflects need or if children are slipping through the net.
- We would like to explore the development of a local protocol to pilot optometrists undertaking registration.
How can being a pilot help you to achieve your vision?
It will act as a catalyst for a step change in our on-going partnership working.
It will enable us to focus existing enthusiasm and energy. Local people will benefit from a local service more quickly.
What are the short, medium and long term benefits for:
a) Patients:
- Local, flexible service with outreach improves access to all including hard-to-reach patients in ethnic minority communities (standards 3 and 5).
- Increases patient choice (standards 3 and 5).
- Promotes and supports independence.
- Simplified care pathway with consistency of care via support of a key worker.
- Information provided in appropriate format – by paper, e-mail, telephone (standards 6, 7, 8 and 9).
- Shorter waiting times (standard 5).
- Responds holistically to the needs of people with learning disabilities (standards 3 and 7).
- Reduces falls.
- Patients are tracked and changing needs are met (standard 12).
b) Staff:
- Joint training and service delivery (with all the rehabilitation staff working as an integrated team) encourages learning about and between disciplines and organisations (standards 1 and 13).
- Greater awareness of the overall needs of people with low vision and improved ability to respond appropriately (standards 11 and 12).
- Job satisfaction from working in an innovative patient-led service.
c) Organisations/local health economy:
- Increases capacity and choice.
- Reduces health inequalities.
- Shifts services from secondary care to community settings.
- Supports delivery of NSF targets.
- Develops and broadens partnership working.
- Makes effective and efficient use of resources.
- Releases secondary care services to meet specialist needs.
Who are the key stakeholders and potential leaders in your scheme and why?
Service users lead our scheme. It responds to their expressed need and they are involved in the planning of the new service and will be a key part of service evaluation. Sight Service provide vital local expertise, knowledge and support and RNIB complement this at the national, leading-edge level. This has enabled the statutory sector to co-ordinate plans for a strong multi-agency development.
Proposed project management arrangements
The User-led Gateshead Low Vision Group will act as the Steering Group to monitor the progress of the project overall (standard 2). Reporting to the Steering Group will be a Management Group, comprising representatives from the Sight Service, RNIB, PCT and Council Social Services which will lead on project development.
Representatives of the Local Optical Committee and Hospital Trusts will also be members of the Management Group although it is unlikely that they will be able attend all meetings. The Centre Manager and Project Lead will be responsible for the day to day management and performance reports.
Detailed monitoring and evaluation/re-evaluation will be key to ensuring an effective, responsive and sustainable service and there will be a clear programme (see Section 12) of such work (standard 13).
An outline project implementation plan is included with the bid form.
How will the success of the project be measured?
By user-led review and evaluation including the following:
- Numbers of people receiving the service.
- RNIB questionnaire - developed by Aston University to ensure independence.
- Focus groups for “softer” quality of life issues such as, acceptance of situation, increased confidence and ability to undertake more.
- Appropriateness of referrals to specialist hospital services.
- User involvement in repeated service mapping and PDSA cycles to maintain service effectiveness and innovation.
(all of the above meet standard 13)
What are the challenges and barriers to the success of the project? How will these be overcome?
- Staff recruitment may be difficult as some disciplines are hard to attract. However the flexible, integrated multi-agency service is felt to be attractive and there is enthusiasm among local staff and practitioners. It is proposed to collectively develop
- Initially the service could be swamped by people who have been reluctant to travel. However social work staff will prioritise and actively manage the backlog and people who do experience an initial delay in receiving rehabilitation will have received help
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