SeeAbility is delighted to be supporting LOCSU with a refreshed pathway of eye care for people with learning disabilities, which has been launched in National Eye Health Week and aims to improve access to sight tests and eye care support for people with learning disabilities around the country.

Key in the new materials is a case study, written as a tribute to campaigner Sally Rose, who sadly passed away during the pandemic.

Sally had learning disabilities and, through her work with her mum Maureen, she helped pioneer an early eye care pathway in Barking and Dagenham. Her story and the impact of the project can be found here, as told by Maureen and local optometrist Jig Joshi. We hope this will inspire more commissioners to introduce eye care pathways in their area.

Over 1.2 million people in England have a learning disability and face significant health inequalities compared with the rest of the population, however despite experiencing greater ill-health, people with a learning disability often experience poorer access to healthcare. People with learning disabilities are known to be significantly more likely to have serious sight problems at a younger age than the general population, however this group is less likely to receive timely and appropriate eye care.

People with learning disabilities are a ‘hard to reach’ group and part of the reason they are known to suffer health inequalities is because health promotion information is not accessible to them. Therefore, communication is a key focus for the pathway, to ensure that people with learning disabilities, along with their families and carers, are aware of the service and how it can be accessed.

The COVID-19 pandemic has affected access to eye care for everyone, but has had a particular impact on people with learning disabilities, who rely on routine care to identify the emerging eye care issues that are more common amongst this group.

We have worked in partnership with LOCSU, as well as Mencap, ABDO and WOPEC to refresh the pathway and training resources to meet the needs of both patients and practitioners:

• Pre-appointment preparation – downloadable resources available for patients from the SeeAbility website describing what will happen at the appointment, with forms completed before the appointment so practitioners are aware of the patient’s situation in advance
• Tailored appointments – additional time at the appointment and adjustments to clinical procedures to meet patient needs
• Post appointment feedback – easily readable report provided after the appointment, so that patients and their carers understand the outcome, and what future action is needed
• Online resources – information explaining various eye conditions available on the SeeAbility website, in easily downloadable and readable formats
• Full management in primary care - support more people to be fully managed within an optical practice, avoiding unnecessary referrals to hospital eye services
• Local integration between primary and secondary care so that people who usually receive their care in hospital to be transferred to the primary care service and also enabling children in special schools to transition into the service for the continuation of their eye care, when the time is right. Patients can be referred into the service following their learning disability Annual Health Check with their GP, with information provided back to the GP following the appointment
• Communication – SeeAbility’s network of Eye Care champions can support the communication of new commissioned services to the target audience, as well as being able to support the NHS commissioning process if required

The pathway is intended to provide individualised care for people with moderate to severe learning disabilities; those with mild learning disabilities may access GOS sight tests in the usual way with minor reasonably adjusted support. It is important to note that the principles of the pathway can be applied to a broader population if need is identified, for example people who are autistic and who do not have a learning disability, and people with neurological and mental health conditions, such as dementia.

The COVID-19 pandemic has reduced access to eye care for people with learning disabilities, so this is a really vital time for us to step up to the challenge of making eye care more equitable for this group of patients. We are fully committed to supporting LOCSU and the LOCs with the commissioning process as well as helping to communicate new services to the target audience once they are commissioned. Lisa Donaldson, our Head of Eye Health

The Association of British Dispensing Opticians (ABDO) is extremely proud to have been involved in the work on this new pathway for people with learning difficulties. Dispensing opticians have always played an important role in the eye care of this group of patients and it is a great step forward to see a pathway of care introduced which will allow practitioners to work together to ensure the best possible visual outcomes. Max Halford, Clinical Lead for ABDO 

By improving access for this population to regular and routine eye care, there is the potential to prevent loss of sight, help people make the best use of the vision they have and for carers and supporters to understand what the person can see. This in turn should improve outcomes and independence for people with learning disabilities, with the benefits seen across the local health and social care system. Zoe Richmond, LOCSU Interim Clinical Director

Pathway documentation is available for Members to download from the LOCSU website.