CONTENTS

politics first | Corridors
September / October 2016 | www.politicsfirst.org.uk
Preventing avoidable sight loss
will be the focus this autumn
Securing employment opportunities
for deaf people
Lord Colin Low, Co-Chair of the All-Party Parliamentary Group on Eye
Health and Visual Impairment and a Crossbench Peer
It is a surprising fact that people are needlessly losing
their sight in today’s NHS. That is not down to the
doctors who are working tirelessly, around the clock, to
save the sight of their patients. It is due to the continued
pressure being placed on the system by rising demand
for services.
Dr Eilidh Whiteford, Scottish National Party Group Leader on
Social Justice and SNP MP for Banff and Buchan
Reducing the disability employment gap is a huge
challenge, so all steps to tackle it are welcome.
Progress, however, will require more than a change
in tone from policymakers. Over the last decade, the
disability employment gap has grown whilst the overall
employment rate has increased. That tells us that
something is going badly wrong.
Financial pressures are also having an impact,
with NHS staff being asked to do ever more with
fewer resources - a formidable challenge!
The impact of sight loss on everyday life can
be enormous. It can prevent people from driving
and can lead to social isolation; it can stop them
from continuing in paid employment and having to
rely on benefits; and it can hamper their ability to
self-administer medications for other conditions.
Currently, there are almost two million people
living with sight loss in the UK and this is set to
double to around four million by 2050. The ageing
population is the main reason for that increase,
as the risk of developing a sight threatening eye
condition increases with age. While that puts
pressure on hospital eye departments, it is not
the only factor. The rapid increase in the number
of new eye treatments that are available is the
other factor. That is a welcome development but
it does mean that even more people are in the
NHS system being treated for sight conditions.
Since 2008, the number of new eye treatments
approved for use on the NHS has outstripped
many other specialties. Previously blinding
conditions - many of which are chronic such
as wet Age-related Macular Degeneration and
Glaucoma - can now be treated. Those patients
need to be monitored and treated regularly, often
at four weekly intervals. That explains why there
has been a 30 per cent increase in demand for
hospital eye care services over the past five
years, and why ophthalmology has the second
highest number of outpatient attendances for any
specialty across the NHS.
So what is the impact of the increased
demand on patient care?
It is clear that the number of follow-up
appointments required to manage chronic
eye conditions is putting a strain on eye
departments across the UK. Recent RNIB
research showed that many return patients
experienced hospital initiated delays to their
appointments. So, for example, a number
of wet AMD and Glaucoma patients were
interviewed for the study and reported that
their appointment was rescheduled (29 per
cent of respondents) or cancelled altogether
(12 per cent of respondents) during a 12
month period.
So do those delays result in needless sight
loss?
Evidence suggests that the answer to that
is yes. Data from the National Reporting and
Learning System, which collates patient safety
incident reports, showed an eleven-fold rise in
patients coming to harm between 2013 and
2014. The data means that patients will have
experienced unnecessary sight loss in one
way or another.
This March, The President of the Royal
College of Ophthalmologists commented
on a national study being conducted by the
College. Its aim is to identify patients who have
come to harm due to hospital initiated delays
to follow-up appointments. Preliminary results
indicate that 20 patients per month are coming
to harm, suffering severe and needless sight
loss, as a result of delays.
Clearly, that situation cannot continue and
something must be done.
So far, the eye care sector has responded by
publishing a number of guidelines, frameworks
and calls to action to help address the problem.
They include the recent Royal College of
Ophthalmologists’ three step plan to help
overwhelmed hospital eye departments cope
with demand for services.
Many of those documents, however, do
not offer what providers and commissioners
desperately need - workable solutions which can
be implemented in their area. They want proven
examples of where new models of care have
improved patient outcomes and helped meet
efficiency savings targets.
That is why the All Party Parliamentary Group
on Eye Health and Visual Impairment, which
I co-chair alongside Nusrat Ghani MP, will be
launching an inquiry this autumn. The aim is to
identify practical solutions, share them with NHS
providers and commissioners, and help them
create sustainable improvements for NHS eye
care and patients.
The inquiry, and an upcoming Parliamentary
reception, will provide parliamentarians with the
opportunity to engage with this issue on behalf of
their constituents. I hope they will join me in this
endeavour to protect the sight of people living in
the UK.
People who are deaf or have hearing loss
often face barriers when trying to access
the Labour market. Research by YouGov
commissioned by Action on Hearing Loss
suggests that 35 per cent of businesses would
not feel confident in effectively employing a
person who is deaf or has hearing loss, while
57 per cent of employers surveyed feel that
there is a lack of support for those employing
a person who is deaf or who has hearing loss.
Yet, worryingly, 63 per cent of employers
have never heard of Access to Work – the fund
that is supposed to help employers meet the
extra costs of employing disabled people.
Maybe we should not be too surprised - the
Work and Pensions Select Committee once
dubbed the scheme as the “DWP’s hidden
secret.” It is a missed opportunity. If the
Government is really committed to halving
the disability employment gap, it needs to
provide employers with the support they
need, and needs to publicise more widely
existing measures like Access to Work that
already work well.
The vast majority of disabled people are
able to work and want to work. Enabling them
to access the labour market more easily
should be pushing at an open door, but the
‘one size fits nobody’ approach of recent
years - like the Work Programme - have been
far less successful than tailored, personcentred
employment support services, like
Action of Hearing Loss’s unique “Moving On”
programme, which has delivered a 60 per cent
success rate in leading people who are deaf
or have hearing loss to positive destinations
in employment.
Jobseekers who are deaf or have hearing
loss need personalised employment support,
but the current system fails to provide
adequate tailored support consistently. The
Government’s long awaited new Work and
Health Programme provides an opportunity
to overhaul the barriers to work for many
disabled people, including those who are
deaf. Consideration must be given to the role
that third sector providers - who are able to
offer a more specialist, personalised service
– can play, and their expertise in developing
the new programme.
If good quality employment support for
jobseekers can be matched with quality
support for employers, there is a winwin
situation. There are tangible personal
economic and social benefits to be gained
from employment – but we need to provide
practical support and advice to employers to
improve their confidence in overcoming their
preconceptions and making any adaptations
which might be required. Encouraging
small and medium-sized businesses to take
on more disabled staff will be essential to
reducing the employment gap but will only
happen if the right support is available.
Yet there are threats to progress. By 2018,
employees in receipt of Access to Work grants
will have their awards capped, which will have
a disproportionate impact on people who are
deaf, or have hearing loss. Those people
benefit from Access to Work, providing BSL
interpretation and communication support to
allow them to be actively involved in all types
of business.
The UK Government is due to publish
its long awaited Green paper on disability
employment. The SNP will use this
consultation process to talk about the real
benefits of Access to Work, and tailored,
personalised employment support services
like Moving On. It is time that the UK
Government matched that ambition and
becomes truly committed to providing support
to help disabled people into employment.
In Scotland, we have a unique opportunity
to change the ethos of social security. Our
government has already committed to putting
fairness, dignity and equality at the heart of
our social security service – the devolved
powers in this area may be limited, but it
will be important to use them for maximum
impact.
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