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Blog: seeing the bigger picture

Blog: seeing the bigger picture

Andrew Rowlands, commissioning manager with the North of England Commissioning Support Unit (CSU), explains how a community low-vision service reduces accidents

Andrew Rowlands, commissioning manager with the North of England Commissioning Support Unit (CSU), explains how a community low-vision service reduces accidents. Patients who use the service explain how it transformed their day-to-day life.

As commissioners it’s important we understand the link between eye health and quality of life, particularly for our increasing elderly population.

Low vision, or sight loss that can’t be corrected, is very common in older people and at the root of many costly and serious conditions. Falls are the major cause in the hospitalisation of the over 65s and the biggest cause of accidental deaths in those over 75. Fractures from falls cost the NHS £2.2 billion per year. Meanwhile, a recent Age UK report, Promising approaches to reducing loneliness and isolation in later life, says that social isolation threatens to become a major public health challenge. The case for accessible, joined-up, low vision services to support people with sight loss is crystal clear.

In April 2014 South Tees Clinical Commissioning Group (CCG) and Hartlepool and Stockton-on-Tees (CCG) commissioned a service for three years from local optical practices to provide a community low vision service, which is highly valued by the patients who have used it. Patients receive a comprehensive assessment to identify what specialist aids or support will help them make the best of their remaining vision. This service improves the patient’s quality of life and reduces their risk of accidents.

Here are just some of the patients’ personal testimonies about the low vision service provided by the CCGs:

Frank, 92, suffers from cataracts and had problems reading, watching TV and relied on his wife for help. Frank, a former PE instructor, is a keen armchair sports fan and was missing out watching it on his new 42inch flat screen. “Before, it was like watching a black and white telly; all the colours were missing. But the opticians gave me a frame that helps me see a lot better. And they gave me a magnifying glass, so I can read a newspaper now. It’s definitely made a big difference. The opticians have certainly improved my quality of life. I’ll certainly bang the drum for them. It’s a great service.”

Dora, 84, has no sight in her left eye and very little sight in the other. She relies on her husband to drive her to all hospital appointments. “I can’t read labels or make out people’s faces,” says Dora. Now, Dora visits a local practice to see the optometrist. “It’s closer, it’s easier to park and the appointment times are more convenient. There is no waiting about. It was always choc-a-block at the hospital.” The optometrist has given Dora a magnifier and the washing machine has stick-on dots to identify regularly-used programmes.

Whether it is identifying low vision or support to lead a more socially inclusive life; optometrists can certainly help commissioners get upstream of the problems when it comes to prevention and proactive models of primary care. As commissioners it’s important that we see the bigger picture, not just the bottom line.

A series of pathways that cover a number of common eye problems has been developed by the Local Optical Committee Support Unit (LOCSU), an organisation that promotes the role optometrists and opticians to work together with local commissioners to design and add value to local eye health pathways, making services accessible for patients and cost-effective for the NHS.

For more information about community-based eye health schemes, contact Katrina Venerus, managing director of LOCSU, visit


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