The Sutton Merton & Wandsworth
Low Vision Project
End of Project Conclusion and Recommendations
1. Aims of the project
“To develop integrated and accessible eye care services making best use of the available resources from across agencies, in order to enable independence to be maintained for vulnerable people with low vision”.
2. Objectives
To develop a patient focused community-based multi-disciplinary low vision service, which provides the patient with greater accessibility and a choice service provider within the participating boroughs.
To test the patient held record as the means of linking with other services as appropriate and communicating patient information across the organisations.
Identify and share good organisational practice within Low Vision Services
The project went live across the three boroughs between March and June 2005. Merton launched at the end of February, Sutton in April and Wandsworth in June 2005. A communication strategy was undertaken to ensure residents of Sutton, Merton, & Wandsworth were aware of the service. Optometrists were recruited to refer patients following an agreed pathway to the project for a low vision assessment, using a referral form designed by the project.
The project introduced two pathways for accessing low vision services; patients could either have a low vision assessment at a participating optometrist’s practice, or attend a community-based centre in the voluntary organisation’s premises for combined assessment by an optometrist and a rehabilitation worker. Both pathways included an overall assessment from a rehabilitation worker and if necessary a home visit.
3. Option Appraisal
An option appraisal was completed and presented to the project board in December 2005. The option recommended to the PCT’s was to fund clinics in the voluntary sites on a once a month basis that would operate from 9.30 to 1.30 on a set day in the month. The referrals by optometrists should continue to be funded at the amount of £20 for each new referral.
Throughout the pilot the patient numbers did not reach estimated levels, with spare capacity at weekly clinics. The recommendation for clinics to be held on a once a month basis should ensure the clinics would be fully utilised with capacity for both new referrals and follow up appointments (for those patients who require an annual assessment.) It would also enable further discussions with the Acute Trusts to offer choice of this service to patients based on the agreed criteria.
Both PCT’s have committed to funding a community based low vision service based in the voluntary sector sites on a once a month basis post 1 April 2006.
The centres in Sutton & Merton PCT will be held on the 1st Tuesday of the month in Merton Vision and the 3rd Tuesday in the month at Sutton Association for the Blind.
The centre in Wandsworth PCT will be held in the Pocklington Resource Centre in Balham on the 1st Wednesday in the month.
4. Benefit Realisation
The benefits of continuing to fund the service include:
The patient journey which patients found easy to use is preserved.
The service can be evaluated further (including the patient held record and the impact on hospital low vision services).
An opportunity to transfer patients who are currently managed in the hospital setting to a community setting.
The overall quality of the patient’s life can be improved by simple measures, e.g. reading, watching television, nutritional improvements, and social needs met which impacts on patient’s mental welfare.
By continuing the service patients who have low vision will be offered services that will enhance their lives and assist them in remaining independent and should assist with reductions in numbers of requests for nursing home beds and pressures on both primary and secondary care.
5. Conclusion
The aim of the project was to develop integrated and accessible eye care services. This has been realised within the community based multi-disciplinary low vision service. Whilst the numbers of patients referred into the service was lower than predicted, it is hoped that the reduction in clinics and the review of patients currently in the hospital service will result in a cost effective model, which is viewed, positively by both users and professionals.
April 2007