Newsletter: July 2011 - Conference issue



Issue 14: Vision UK 2011

Vision UK 2011 illustrated the support and belief that working together to reduce avoidable sight loss by 2020 is a target in sight.

Over 450 delegates attended the event and comments from delegates included, 'very good content and just the right tone balancing realism, practicality and enthusiasm' to 'I attended the children and young people masterclass - wow, what an inspiration that lot were!' Hear from delegates who spoke to us on the day.

Lord Howe, Parliamentary Under Secretary of State for Quality (with responsibility for eye care) spoke at Vision UK 2011 about 'A vision of the 'Big Society' for eye care and sight loss provision.

“The development of the Vision Strategy and the work to take its aims forward provide an outstanding example of the Big Society in action," he said.


Did you know?

Michael Sobanja and Anita LightstoneNew eye care commissioning guidance was launched at Vision UK 2011 by NHS Alliance Chief Executive, Michael Sobanja.

The guidance will aid clinical commissioning groups to provide quality, cost-effective eye care services for their patients. The guidance is available as an easy-to-navigate online resource and it provides tools for assessing local need and links to sources of practical information.  Take a look: commissioningforeyecare

Don’t forget to tell your local PCT or community group about this guidance!




Plenary session highlights

The journey so far

Taking the podium for the first slot of the day, Bob Hughes, CEO Eye Health Alliance, set the tone high. Describing the current situation with sight loss set to double by 2050, he reminded the audience that half of this number is avoidable if we work together.

He addressed the delegates personally: "We're the people who can do something about that collectively and we need to do something about it urgently."

Bob's analogy of the journey since the launch of the UK Vision Strategy in 2008 was split into two.

First, he explained that the Strategy brought the sector together under joint agendas. And that the sector now argues in support of each other, which is much more powerful and receives more attention in the wider sphere.

"Such unity would have not been on the radar, in fact it would have been impossible about five or six years ago. This is a measure of just how far we have come," he said.

The second part of the journey he described as the Strategy's overall aim - to reduce the number of people who are unnecessarily losing their sight, as well as improving support and opportunity for those who do.

With the minister in mind, Bob raised some key problems, such as cataract treatments and the work taking place to address these. "Delayed cataract operations taking people beyond the point of effective sight is just not cost effective. Primary Care Trusts (PCTs) need to be brought to account on this."

He concluded by leaving the delegates with people at top of mind: "If we're not united and focussed in our arguments then who will argue for those we need to fight for?"


Government's commitment to eye care and sight loss

Lord Howe, Parliamentary Under Secretary of State, pledged the Government's commitment to playing its part in preventing sight loss and improving standards of care for those with visual impairment at Vision UK 2011 conference.

Responding to the demand on sight loss services, which is set to grow over the coming years he said:

"I believe that the changes we're proposing in the health and social care bill will enable the NHS, together with partners from across society, to better meet those challenges."

Lord HowePresenting his 'vision of the Big Society for eye care and sight loss provision', he stated that the UK Vision Strategy was an outstanding example of the big society in action.

"We believe that locally led, clinically led, patient focussed, collaborative working is the way forward. It’s the best way to improve services for patients and to provide support for people who've lost their sight," said Lord Howe.

The take home message from the whole day, which was also addressed by Lord Howe, was 'working with patients' and placing a genuine emphasis on the empowerment of the patient.

He said: "We want to improve the life chances of disabled people, including those with visual impairment, by promoting their inclusion and participation in community life, again enabling them to have more control over their own lives. This is central to our vision of the big society. It is about supporting community empowerment to enable people to take control over their own lives."

Acknowledging that there is variation in service provision across the country, he stated that "better integration across primary, secondary and social care, public health and the voluntary sector, is key to improving value."

Following Bob Hughes' comment about the consultation of the public health indicator, Lord Howe said: "Representatives of eye health organisations have proposed an additional indicator on eye health which we will of course take into consideration."

Lord Howe praised the UK Vision Strategy for building a local network to provide stimulus for improvement. Using the example of the joint working between UKVS and QIPP Right Care, Leicestershire and Rutland are to be the first eye care population lab on low vision. They will develop specific objectives and outcomes to allow others to be able to learn from their model, in the do once and share approach.

"That's the kind of local involvement and joint working that we'll be promoting across the country," he said.

Noting that guidance was to be launched at the conference, he said evidence based guidance for commissioners' is absolutely essential for delivering service improvements. "The guidance will be a very welcome resource for commissioners, I know."


Social care and the Big Society

David Behan, Director General of Social Care, Department of Health spoke about the changes taking place in the DH, and its implications.

He explained that following the listening period, there would be a stronger accountability for GP consortia, now called 'Clinical Commissioning Groups,' Health and Wellbeing Boards are to be given a stronger role locally. There will be clearer duties across these services in respect of people who use services and carers.

“There will be new safeguards against price competition, cherry picking and privatisation, which were many of the concerns that the Future Forum reflected back to government in their work,” he said.

“Interestingly, I think for your work, there will be support for a much more integrated approach to health and social care, with stronger duties being placed on commissioners and on monitors to support this; that care is integrated around the needs of individuals who are using services through mechanisms such as the extension of personal health budgets, and through joint health and social care budgets.”

Responding to the aging population and rising demand on eye care services, David called attention to the development of Joint Strategic Needs Assessments (JSNAs) and joint Health and Wellbeing Strategies as very important levers to drive integration at a local level.

“Local clinicians will be best-placed to decide how that money is spent, which is where the JSNAs become absolutely critical for you.”


Stepping forward

With tough times afoot due to the uncertainty of NHS funding and the cuts to welfare benefits, Lesley-Anne Alexander, Chair of UKVS Strategic Advisory Group and CEO of RNIB, encouraged delegates not to accept the current conditions.

She explained that whilst the cuts would have an effect on charities, government and local authorities, the burden of cuts would be born by the service user.

"I think now, more than ever, is the time for us as individuals to step up and lead and to improve services for those we seek to serve. But we of course mustn't abandon working together - there is strength in numbers," she said.

"Taking personal responsibility within a team of like-minded people has to be the winning combination."


Plenary stream highlights

Stream one: Ethnicity and sight loss, joining the dots

Mark Johnson, De Montfort University

There is little research about visual impairment in terms of ethnicity. But what is known, is that there are raised levels of glaucoma in African Caribbean populations and black populations have a greater risk of developing AMD compared to the white population.

Mark pointed out that there is an association between poverty and socio-economic deprivation, as well as an expectation that sight loss is associated with age.

He suggested that transferable lessons from other conditions could include enlisting the support of Link workers from minority ethnic communities.

He also said that findings from his research suggested that communities are saying: "Sight loss support services need to recruit staff from within minority communities and translate information into minority languages."

Messages to these groups should be delivered through minority media channels, for example, Asian radio stations, satellite TV channels and local newsletters.

For more information, Mark Johnson's report 'People from Black and Minority Ethnic (BME) communities and vision services: a good practice guide is available at: www.pocklington-trust.org.uk


Stream two: Commissioning for the service user

Paul Zollinger-Read and Douglas Smallwood, East of England SHA

The Health and Wellbeing boards are the most important component of the future of commissioning, according to Douglas Smallwood.

Health and Wellbeing boards are going to be the mechanism whereby all the key partners are required to come together in order to provide a high quality service for all. The boards will plan services and do their best to make sure quality is achieved by taking any complaints back to the NHS commissioning board.

"What better time is there to give these emerging boards something of real substance that's going to make a real difference to people's lives in the local community than the task of coming together jointly, creating a local strategy for vision services, and overseeing and making sure it's implemented by the consortia and other partners," Douglas said.
 
Approximately 85 per cent of GPs in the area have taken on the position of 'Pathfinder' to lead on the commissioning of services. Due to this, the East of England recently undertook a survey of joint commissioning and the results were quite positive in terms of GPs and local authorities talking together. Paul Zollinger-Read explained that integrated care has been one of the key points to come out of the reforms; integration to get rid of the primary-secondary care divides.

"We need to unlock the power of the voluntary sector, like we haven't done before. The voluntary sector has a massive role to play in the provision, but it also has a big role to play in commissioning," Paul said.

"If there's one word that I sum up with it's the "with" bit; it's commissioning with the patient."


Stream two: Commissioning for the service user

Michael Sobanja, Chief Executive NHS Alliance

Commissioning and the Dilnot report are hot topics across health and social care media platforms right now. So what does commissioning actually mean? And what will the new eye care commissioning guidance do?

Michael Sobanja explained that eye care services cost in the region of £3.72 million for every 100,000 people.

He expressed his delight in launching the commissioning guidance. He said that commissioning must be about the design and re-design of services, as well as making decisions about how to invest the available money to get a return for those we are working for.

"If I suffer from sight loss, can I work? Can I retain and remain in employment? Can I get back into employment?" Those are the sort of outcomes that we've got to focus our commissioners on. We've certainly got to support patient choice about treatment and provider,” he said.

The new commissioning guidance seeks to improve current health inequalities to produce integrated patient-centred care, ensuring patients don’t get lost between services, all whilst achieving a financial balance.

The guidance is saying “if you've got a finite amount of resource, this is what you should focus on, it’s not a vehicle for give me more.” It sign posts commissioners, who are usually generalists in their nature, to specialist advice.

The online guidance features good practice examples, pointing out that good care for vision and sight loss can reduce demand in other areas. For example, falls, mental health, and other support services. What is done in the health service is of critical importance for social services and vice versa.

Michael also mentioned the benefits around QIPP and aligning service models with financial reality; and where it makes sense, spending more money now to invest in the future.

“We hope that this guidance will improve the awareness of eye care and sight loss services amongst commissioners, educate people like me, who were uneducated when I was commissioning services.”
 

Stream three: Techshare

Greg Fields, Senior Accessibility Product Manager, Research in Motion

Greg Fields from Research In Motion (RIM), maker of BlackBerry smartphones, told us about how they embed some accessibility features into their smartphones such as a grid layout, font size adjustments, reverse colour contrast options and different visual themes.

One recent innovation, the Clarity theme for BlackBerry, offers low vision users, with reading difficulties, the option of downloading a customised user interface which makes a BlackBerry device much easier to operate. The Clarity theme is free of charge and runs on 10 current BlackBerry devices. Clarity will also soon be offered on the impending BlackBerry operating system.

Greg also mentioned RIM has recently acquired a company called QNX. "It's possible that we may see a move towards the QNX platform for future RIM devices," he said.

To date, rather than building in accessibility features for blind users, RIM has instead provided ways for third party developers to create custom solutions such as the Oratio for BlackBerry screen reader product.

Petteri Alinikula

Director Sustainability, Nokia

Petteri explained that Nokia are currently going through a very substantial period of change and, as a result, their future software strategy will have two distinct elements. All future Nokia smartphones will operate on the Windows Phone 7 operating system, while simpler phones will continue to run the Symbian operating system for the foreseeable future.

He commented that they will be working with Microsoft and other partners to bring about an accessibility solution for Windows Phone 7.


Masterclass highlights         

masterclassA selection of seven masterclasses took place on a variety of noteworthy issues during the afternoon. Delegates had the opportunity to debate their views and share examples of good practice and ideas with others from across the UK. Stephen Remington, Chief Executive, Action for Blind People presented a summary on the day.

The overriding theme of the masterclasses, and the whole conference in fact, was "putting people first" - no great surprise there. Ensuring people have the necessary information to make realistic choices, recognising that many people will, in reality, have very little idea of what is available, and yet, avoiding making the choices for them, it's quite a balancing act.

The children and young people's masterclass four said that "we must move away from adults leading, to adults enabling children and young people to make their own choices." To achieve this they suggested we need to change our language and our attitudes.

Masterclass five - What is a patient/user centred journey - on the same theme, said that people need to be considered as a whole person. They suggested we need to think outside the box to ensure that we acknowledge and understand everything that is happening in their lives.

Masterclass seven - Improving eye care through maximising value - discussed the importance of engaging with patients, and public, in prioritising how we use resources, and they also stressed the crucial importance of sustainability, relating this to environmental, economic and equality factors.

Masterclass three discussed campaigning, and it highlighted the need to be absolutely clear on the key issues of a campaign, and what success would look like. Know who your advocates and adversaries are, and achieve maximum impact by focusing your resources.

Another reoccurring theme from the conference was innovative partnership working. Masterclass two, Improving Provision - why we need local plans, stressed how we must explore more effectively and better share successful partnership models - keep testing new models and share relevant data. They also raised the importance of embedding sight loss in Joint Strategic Needs Assessments throughout the country.

Masterclass one, Technological Innovation - looked at the huge value of technology enabling people with sight-loss to access unprecedented numbers of books and information.

On eye health research, masterclass six exhorts the government to produce more funding, particularly given the exciting progress being made on stem cell treatment, and the benefits that should flow from that in a few years' time.

More in-depth notes about each session are available here


Questiontime

QuestiontimeA lively debate took place in the afternoon with key opinion leaders discussing the wider social and economic issues surrounding eye health and sight loss services.

Chair: Gary O'Donoghue – BBC Political Correspondent

Panel members:
•    Roy Lilley – Writer, broadcaster and publisher of nhsmanagers.net e-letter

•    Richard Humphries – Senior Fellow Social Care, The King's Fund

•    Samantha Peters – Chief Executive and Registrar, General Optical Council

•    Lord Colin Low – Vice President, RNIB Trustee, Action for Blind People

Watch some of the discussion on the day

Jenny Pearce, CEO of Vista told us her thoughts about rehabilitation following one of the questions in the session.



Interview with the UKVS Programme Director

Anita Lightstone spoke to us at the end of the day, hear her perspective of the day's events and watch the clip!



Posters

To showcase the astounding amount of work taking place across the country, a poster exhibition was held throughout the day.

There was a high standard of poster submissions, making judging particularly difficult, and it was great to see such a range of activity taking place. After much deliberation, awards were given for the following posters:

Outcome 1
Creating an Eye Health Network in NHS Grampian
Justin B McKee et al, NHS Grampian

A review of the changes and impact within NHS Grampian following the creation of an eye health network to reduce non-emergency walk ins at emergency eye clinics.  

PostersOutcome 2
Assessing the impact of eye care liaison officers (ECLO) in Northern Ireland
David Galloway - RNIB Northern Ireland

The aim of this project was to assess the effectiveness of the Northern Ireland ECLO service in improving the patients’ sight care journey and also to consider their impact and integration within hospital eye services.

Outcome 3
Improving the environment for people with dementia and sight loss: good practice points for design
Sarah Buchanan - Thomas Pocklington Trust

A study presenting a series of good practice points that may inform supportive environments for people with dementia and sight loss; including features that may be detrimental to people with both dementia and sight loss.

Honourable mention
RNIB Scotland Learning and Development Centre
Kate Storrow, RNIB Scotland

A novel approach to integrate a social firm, learning access technology and workplace experience to improve employability skills for blind and partially sighted people.  

Technology
Crowding and tracking: reading with para-central vision
David Mansfield - Inverclyde Royal Hospital, Greenock

Defining the optimal strategy for software applications for the enlargement of text on screen; used with devices such as e-books

Congratulations to all our winners and our thanks go to all those who submitted posters. We would particularly like to thank our judges; Richard Leaman, Chief Executive, Guide Dogs and Yvonne Needham, Chair, RCN Ophthalmic Nurses Forum.

For more information about the posters featured on the day email the UKVS team: ukvisionstrategy@rnib.org.uk


Volunteers

Approximately 35 volunteers from a mix of organisations kindly gave their time to assist us during the day. Find out what they thought about the day.

Nicola Gibbon

Guiding a delegate was the highlight of my day as a volunteer.  As a new volunteer I was slightly nervous. However far from being awkward or difficult, I completely enjoyed the new experience, and was fascinated to hear about his life. The events of the day have taught me that experiencing new things and assisting others is very rewarding.

Keziah Jade Bines

Volunteering for Vision UK 2011 is something I would love to do again. It felt great knowing that I was helping people, enjoying myself, and learning about eye care all at the same time.

Kav Singh

Helping to direct people around the Queen Elizabeth II conference centre in Westminster, I met many people from all walks of life and heard their anecdotes about the day. I learnt lots about the importance of eye care, I met new people and, most of all, my input was valued and appreciated.


Tell us your news:

Do you have a story or contribution for the September edition of the UK Vision Strategy newsletter?  Please contact Janelle Heath, Communications Manager UK Vision Strategy.  Email:  Janelle.heath@rnib.org.uk.  

UK Vision Strategy Implementation Team:
For general enquiries, feedback and suggestions please contact
ukvisionstrategy@rnib.org.uk or Tel: 0207 391 2157