Reflections on sight loss - RNIB

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Viewpoint ➜ Patient experiences vary so much. Those who are lucky will have a compassionate consultant who recognises the devastating effect that sight loss can have on a person’s life. He/she will think carefully about what they say, and spend a few moments talking about their social care needs. If they are very lucky, the consultant will pass them onto an eye clinic liaison officer (ECLO) or information and support worker for the next, very important part of the journey back into the real world. The real world is immediately outside the hospital. It is our home and local community, where we live independently, being carers, or cared for, working or retired, having active social lives or in danger of slowly becoming isolated through ill health and lack of community facilities. And now, we have to contend with visual impairment too. How are we going to manage that which now threatens life as we know it? What is there to stop us becoming isolated, allowing our loss of vision to impact negatively on everything we do? These are the questions the ECLO can deal with. “How much better if they also know that there is a local society for visually impaired people down the road, which is there, willing and able to support them now and for as long as they want it” There is so much help available, so many local and national organisations, and a profession whose role it is to help people to successfully adjust to life with a visual impairment (ROVI). Social services departments, local societies for visually impaired people, employment, education, arts, all there and able to help 22 anyone who has a visual impairment – registered or not. And that is an important point. Why should people have to wait for registration before they are offered help? The short answer is – they shouldn’t. As soon as people are finding that their vision loss is causing them problems, then they should be offered a route into the services they need. “The one thing they all have in common is that, after hearing those awful words, they now have to go home and live their lives, knowing they have a visual impairment for which there is no ‘cure’” And where is the best place to offer that route? – in the eye clinic. Every person who experiences difficulties with their vision will visit the eye clinic. Every person has a right to whatever information, support and services they need to help them adjust successfully to a life with a visual impairment. Every person has a right to talk to someone who understands the emotional and practical difficulties, who can ensure that they don’t have to make that long and lonely walk down the corridor – out into the real world – not knowing that there is hope for the future, and that life will be worth living. And how much better if they also know that there is a local society for visually impaired people down the road, which is there, willing and able to support them now and for as long as they want it. Surely every person has a right to that? Diane Roworth is Chief Officer of York Blind and Partially Sighted Society (YBPSS). The society offers an eye clinic and liaison officer (ECLO) service at York Hospital.
Viewpoint Simon Labbett: “Referral routes are the acid test” I think some people have this image of health and social care workforces as like two dysfunctional parents arguing over the best way to look after their child and that everything would be fine if we both just sat down, listened to each other and talked. Actually health and social care do talk to each other. Ask any of us who work with Low Vision Service Committees or on the UK Vision Strategy. For frontline workers the acid test of all the fine rhetoric of joint-working is: do the referral routes actually work? In this respect the focus tends to be on the crucial liaison between hospital and social work teams at Point-of-Diagnosis (POD). This is where the bulk of joint-commissioned sight services lies and is evidently where RNIB sees the strategic need. It would be foolish to argue with this priority. There are also encouraging, though rare, models of joint-commissioning and co-operation in the field of low vision provision. However, we neglect other health/social care “border points” at our peril. Two spring to mind immediately: One is the referral at hospital discharge i.e. from hospital social workers, occupational therapists and physiotherapists. This is problematic, in part, because referrals often go to the older people’s team, and not the sensory needs or disability team. Second is the woeful liaison between hospital stroke care and visual impairment teams – in hospital and social care. In both these situations the loser is often a person without diagnosed sight loss or someone with longstanding sight loss, and in these situations the solution lies not through a new commissioned service: it lies in old-fashioned cross-team talking and awareness training – the sort of stuff most workers never quite have enough time for. And the reward for those that do make the time is more referrals! There are still plenty of indications that eye clinic staff do not understand what social care is about, and indeed you could argue that the provision of eye clinic liaison officers (ECLOs) or PODs run the risk of making consultants and nurses less empathetic. But it works both ways – I have to admit that, until I spent a day shadowing an ophthalmologist’s surgery, I had a rather false idea of what an outpatients clinic was actually like. Suffice it to say, not every patient they see actually needs social care (or RNIB)! Frankly, even if health and social care was fully joint-funded there would still be communication problems; wherever two professions are gathered together their training will lead them see “problems” differently. Which leaves us wondering where the visually impaired person comes in? I think they are the ones to knock heads together. I believe one good outcome of rehabilitation work is to empower people to get involved in decision-making that affects them. To stretch the parenting analogy a bit, it’s a bit like when your teenage children start pointing out your own poor parenting. Simon Labbett is a rehabilitation worker in Bradford 23
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Reflections on sight loss - RNIB

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