People with impaired vision may ‘miss out’ on vital support entitlement

A quarter of local authorities restrict access to vision rehabilitation on the basis of social care assessment, says York research

New research from the University of York’s Social Policy Research Unit (SPRU) provides evidence that securing specialist vision rehabilitation support gives people with sight loss confidence, makes them feel safer and helps maintain independence. However the research, commissioned by sight loss charity, Thomas Pocklington Trust, shows that some people are not receiving this essential support. In a national survey of English vision rehabilitation services, a quarter of services inappropriately required people to have a Fair Access to Care Services (FACS) assessment to determine if they were eligible, meaning that people have to develop a substantial care need before they get support. In addition, funding cuts put services under pressure, creating long waiting lists, staff reductions and fewer opportunities for staff training.

Dr Parvaneh Rabiee of SPRU, who led the research, says: “Our study shows that vision rehabilitation support can have a real impact on people’s quality of life. Yet too often, vision rehabilitation services are not reaching those who need them.  Local authorities need to acknowledge the vital role of specialist rehabilitation, make it available as early as possible, and not require people to have full social care assessments.”

There are around two million people in the UK living with sight loss. Estimates suggest this number will more than double by 2050, as the proportion of older people in the population increases. Sight loss affects all aspects of a person’s life. Under the Care Act 2014 local authorities are now required by law to actively promote wellbeing and independence. The Government urges them to invest in early intervention and specifies the importance of rehabilitation for people with visual impairment. Yet SPRU’s report ‘Vision Rehabilitation Services: What is the evidence?‘ reveals barriers that prevented people receiving adequate rehabilitation.

Eighty seven vision rehabilitation services (representing more than half of English local authorities) responded to SPRU’s survey:

  • A quarter required people to have a FACS assessment – linking vision rehabilitation to a person’s eligibility to receive other social care
  • Two thirds of the services had waiting lists with the average being 10 weeks
  • Staff were concerned about staff shortages and lack of opportunities for training
  • Managers and workers were concerned that the importance of specialist vision rehabilitation skills was not always recognised by colleagues in social care
  • In 40 per cent of services the initial screening of referrals was sometimes carried out by staff without specialist skills in vision rehabilitation
  • Financial cuts were seen to affect numbers and types of staff, waiting times and the kind of support provided, with voluntary organisations feeling the biggest pressure on budgets

People with sight loss told the researchers that vision rehabilitation had:

  • Made them feel safer
  • Had positive impacts on their confidence
  • Increased independence
  • Motivated them to learn new skills

“People with sight loss told us how vital vision rehabilitation services were to their lives and independence,” says Dr Rabiee. “Without this support, care needs may just escalate. Drawing on all the evidence we have collected, we have set out what good services should look like.”

Their recommendations include: having staff with specialist knowledge; offering personalised support that addresses social and emotional, as well as daily living, needs; and supporting group activities.

Jenny Pearce, BEM, Chair VISION 2020 UK Rehabilitation Group welcomed the findings. “This research tells us that vision rehabilitation services are under threat, facing funding cuts and staff shortages. Far too often people with sight loss are unable to access the rehabilitation services they need to maintain their independence. This is a statutory responsibility and local authorities should be stepping up to the mark.”

Dr Catherine Dennison, Head of  Health & Wellbeing Research, at Thomas Pocklington Trust, says: “This new research from SPRU provides important evidence that can help local authorities and others to provide people with sight loss with the best rehabilitation support.”