Andrew Gibson, Research Fellow, Institute of Health, University of Warwick

Improving services for people with low vision: an evaluation of the work of the Low Vision Services Committees Andrew Gibson, Research Fellow, Institute of Health, University of Warwick Professor Gillian Hundt, Institute of Health Dr Maria Stuttaford, University of St Andrews

Growing awareness of the need for change in LV Services • Fragmented services • Difficult to access • Wide disparity in the quality and quantity of services • Lack of information for those who would benefit from these services • Lack of multi-disciplinary and multi-professional working

Origins of Low Vision Service Committees • ‘Consensus Conference’ held in March 1998, chaired by Lord Jenkin • The Low Vision Services Consensus Group was set up • Reported in 1999. Set standards and suggested LV Committees to implement them

Origins of Low Vision Service Committees • National steering group set up • Implementation Officer appointed in September 2000 • 11 in 1999, now 73 (September 2005) • Generally meet on a quarterly basis • Average attendance of 10 people (of whom 2 are service users)

Focus of the evaluation: • The role and activities of the LVSC in terms of the development of new services • The improvement of current services • The role of service users and the development of joint working

Focus of the evaluation: • Factors facilitating the functioning of LVSCs • Barriers and constraints • Strengths and areas for improvement

Evaluation design • An analysis of policy documents and minutes of meetings • Group and individual interviews with key stakeholders • A questionnaire sent out to all LVSCs • The selection of three regions – West Midlands, London and the South West - to take part in a series of in-depth regional workshops

Findings • Structure and functioning of the commitees • Service user involvement • Promoting multi-agency working • Improving services

Structure and functioning of the committees • The main point of contact is via the Implementation Officer • Only 22% of committees circulate Bold View to their wider membership • Many committees lack clarity about their purpose

Structure and functioning of the committees • The setting up of a LVSCs website • The twinning of LVSCs to facilitate communication and the sharing of good practice • The holding of annual regional events or workshops to bring together members of different LVSCs to share experiences and exchange ideas.

Improving service user involvement (methods used) • Ensuring that information is passed on to service users in an accessible format (81%) • Developing links with local service user groups (78%) • Involving service users in the mapping of services (78%) • Involving service users in planning local services (68%)

Barriers to service user involvement • Service users do not know what they can expect from service providers • They often have low expectations of services • They lack the confidence to challenge service providers • The term “low vision” covers a very broad range of people and problems.

Improving service user involvement • The development of a pack of information to raise service users’ awareness and expectations of service provision • The development of an induction pack that provides guidance on the role of service users in LVSCs • The use of service user sub-groups that allow service users to debate and clarify issues before meeting with professionals in the main LVSC

Dealing with specialist needs • Actively inviting people to join who have an interest in a specific issue • Having a key person to deal with specific issues • Creating a slot on the agenda to address specific needs, for example children’s issues • Create a sub-group to deal with a specific issue

Promoting multi-agency working A majority of committees are actively working with one or more of the following service providers: • Social Services (92%) • PCTs (70%) • Hospital Services (86%) • The Voluntary Sector (70%) • Education Services (51%)

Barriers to promoting multi-agency working • Conflicts between service users and service providers • Conflicts between different service providers • The important role of LVSC chairs

Improving multi-agency working • Developing a network of LVSC chairs • The development of a pack of information which provides guidance on the role of chairs in LVSCs • Guidance on developing clearer reporting pathways to relevant organisations in an effort to raise the profile of the LVSC and improve communication

Improving services • Improving the dissemination of information about local services to the community (70%) • Developing links with optometrists based in primary care (65%) • Involvement intheNational Eye Care Services Steering Group Pilot Projects

Barriers toimproving services • 76% of LVSCs report that accessing funding has been the main difficulty they face in improving services • 46% indicated that influencing the planning process is a major problem when attempting to improve services • 41% reported that implementing a joint plan of action with service providers is another

Accessing funding • Producing a guide to sources of funding • Guidance on PCT funding procedures and local development plans • Guidance on developing multi-agency service proposals

Strengths of LVSCs • The range of expertise brought together by the committees • The networking opportunities created • The ability to jointly work with service users to plan local services and meet local needs • Raising the profile of low vision services generally

Challenges • Accessing funding • Widening the base of service user involvement • Engaging key stakeholders

Conclusion • There is evidence that the LVSCs have made significant progress since their inception in 1999 • However, a significant commitment from local and national statutory services is also needed if this progress is to be continued

Further information Contact Mary Bairstow Low Vision Services Implementation58-72 John Bright StBirminghamB1 1BNTelephone 0121 665 4248/49mary.bairstow@rnib.org.uk

Andrew Gibson, Research Fellow, Institute of Health, University of Warwick