PHI Info JSNA

PHI Info JSNA

Don’t Lose Sight……of prevention

RNIB is calling upon public health professionals, Health and Wellbeing Boards and Clinical Commissioning Groups to work together to ensure that people do not lose their sight unnecessarily.

Overview

Sight loss prevention has been clearly positioned as a public health concern. The sight loss sector successfully secured a Sight Prevention Indicator as part of the Public Health Outcomes Framework (PHOF).

The PHOF is a desired set of outcomes for public health and are set by the Secretary of State.

The sight loss indicator measures the number of Certificates of Visual Impairment (CVI); and these are completed by eye departments across England and sent to MoorfieldsEyeHospital to be collated.

The data measures the number of people certified as either sight impaired (partially sighted) or severely sight impaired (blind) with Diabetic Retinopathy, Age-related Macular Degeneration and Glaucoma.

Tackling these three conditions is the primary public health challenge in eye care. They are the biggest causes of certifiable blindness in England but with the right care, at the right time, in the right place, people can be treated effectively and, in many cases, their sight saved.

The importance of the eye health indicator

Over 50 per cent of sight loss in the UK can be avoided (1).

Losing your sight can have a huge emotional and financial impact. It can prevent some people from undertaking paid employment, driving and preparing meals safely. People with sight loss are also at an increased risk of experiencing depression. Older people are twice as likely to experience depression then people with good vision (2).

As the population ages and new treatments are approved for use, demand for ophthalmology services is set to increase. In fact, the associated costs and demands on NHS outpatient services are high with ophthalmology having the third highest attendances in 2011-2012 (3).

In 2008, the direct and indirect costs of sight loss were £6.5 billion and this isestimated to have risen to £7.9 billion in 2013 (1).

Recommendations

RNIBis calling onpublic health professionals, Health and Wellbeing Boards and Clinical Commissioning Groups to work together to ensure that people do not lose their sight unnecessarily.

Step One: Monitor

Prioritise the monitoring of sight loss data that is published annually on the Public Health England website:

Step Two: Interpret

It is important to further investigate the reason behind CVI data levels as the makeup of the local population and availability of local services may affect CVI data.

For example:

High levels of CVI data may indicate;

  • too many people are losing their sight unnecessarily due to late diagnosis and treatment and that a clear prevention plan needs to be developed
  • that there is a good and strong recording process in place in which CVIs are completed and returned to Moorfields
  • that there is a higher population of at risk groups such as older people, people diabetes etc.

Low Levels of CVI data may indicate that;

  • there is a step missing in the process of completing CVIs, for example, they are not being completed or not being sent to Moorfields
  • there are low numbers of people at risk of developing sight loss within the local authority
  • patients are being diagnosed and receiving treatment in a timely manner

Step Three: Liaise

To interpret the data effectively it is important that public health professionals liaise and build relationships with the CCG and hospital clinicians to review the data together and produce an eye health pathway which looks at the patient’s journey and identifies strengths and weaknesses in provision.

Step Four: Report

Sight loss prevention data should be reported in the JSNA (Joint Strategic Needs Assessment) annually.

For further information

For further information and support in identifying key issues in your area please contact:

Tara Melton, Campaigns Officer, Eye Health

01179 341 707

References

  1. Access Economics 2009. Future Sight Loss UK 1: Economic Impact of Partial Sight and Blindness in the UK adult population. RNIB
  2. Evans, Fletcher and Wormald, 2007. Depression and anxiety in visually impaired older people. Ophthalmology. Volume 114 (2), 283–288.
  3. Hospital Episode Statistics: Outpatient, treatment speciality by attendance type: England 2011/2012, Health & Social Care Information Centre

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