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When you consider that over two million people in the UK suffer from sight loss, and in over half of those cases the sight loss is due to preventable or treatable causes, it is clear that there is a need for commissioners to focus on early diagnosis and intervention. It is also important that the contributory effects of sight loss on independence and social isolation are recognised not only in terms of a person's overall 'well-being' and 'quality of life' but also in the economic benefits linked to these issues which addressing avoidable sight loss could bring.
As Anita Lightstone, Director of the UK Vision Strategy said (Optician 03.02.12), 'It is the first time since the inauguration of the NHS, over 60 years ago, that the importance of eye health and sight loss have been recognised by the government.'
Speaking on behalf of the Optical Confederation, David Hewlett commented recently 'This public health indicator provides the impetus for NHS commissioners and joint Health and Wellbeing Boards to work with eye health professionals in primary and secondary care, the voluntary sector and patient groups, in improving access to good quality eye care services.'
This announcement is the latest in a flurry of news around the changing map of public health - strategies, indicators and plans - but what does it all actually mean for eye care professionals working in the community and their patients?
There is a real opportunity for eye care professionals to use the announcement of the Ophthalmic Public Health indicator to influence the Joint Strategic Needs Assessment (JSNA) at a local level.
From April 2013 all local authorities in England will be required by law to have a Health and Wellbeing Board. Each board will be responsible for producing a JSNA and will have a strong role in driving a collaborative approach to commissioning across health and social care. In most areas the Health and Wellbeing Boards have now been established in shadow form. Clinical Commissioning Groups and Local Professional Networks will need to work closely with their Health and Wellbeing Board so that the commissioning strategy ultimately supports delivery of the JSNA and improvement in the health of the population.
What this actually means for eye care professionals and Local Optical Committees (LOCs) is that the JSNA is the tangible mechanism to raise the profile of eye health and introduce specific plans to address inequalities over the provision of eye care services in the area. Eye health is not currently mentioned in the vast majority of JSNA in England or their equivalents across the UK. In fact in 2010 only 20 out of 151 JSNAs in England contained sections on eye health. The announcement of the Ophthalmic Public Health indicator is an important driver not only to get eye health included in the local JSNA, but also to ensure a detailed Eye Health Needs Assessment is carried out by every Health and Wellbeing Board.
LOCs, along with charities and other organisations, should be a significant voice in raising awareness of eye health issues in the local population. Some LOCs, including Lincolnshire, have already demonstrated that they are up for this challenge as Jason Rickaby, Secretary of East Midlands LOC and LOCSU Optical Lead explains.
So what can LOCs do to improve ophthalmic public health and highlight the scope for expanding community eye care services with Health and Wellbeing Boards?
? Get on the agenda make contact with influential members of the Health and Well Being Board. Getting to know key people such as the Director of Adult Social Services, Director of Public Health, local councillors and representatives of the local Health Watch can be time consuming. LOCs should start by using existing networks and links they have made through their work with CCGs.
? Collaborate with local stakeholders - get together with local vision strategy groups, patient organisations, voluntary sector, ophthalmologists, orthoptists to agree an approach.
? Be clear about your routes for influencing - make sure that you raise awareness of the impact of eye health on wider public health issues such as falls in older people.
? Gather the evidence - data and evidence are crucial to establishing local eye health needs and ways in which services can be redesigned to meet those needs. The Ophthalmic Public Health Network as detailed below will be a vital resource for LOCs.
At a Roundtable on Public Health hosted by the College of Optometrists last year, leaders in optics came together with public health experts to explore what they could do to promote ophthalmic public health. In order to join up the work of the optical sector with others in the eye care community and public health, it was agreed that LOCSU would lead on setting up the virtual Ophthalmic Public Health Network. This Network will be free to join and open to anyone interested in ophthalmic public health. It will support those who want to improve ophthalmic public health and be a platform to share knowledge, expertise and innovation. The Optical Confederation and College are working at a national level with UK Vision Strategy partners to ensure the same key messages go to all clinicians and all parts of the ophthalmic and sight loss sector.
Another important issue that has been highlighted in recent discussions is that there are currently too few specialists in ophthalmic public health. Supporting places on ophthalmic public health courses is one way of boosting the capacity of the ophthalmic public health workforce. RNIB recently offered bursaries for 14 places on an Ophthalmic Public Health Short Course at Leeds University.
In summary, whilst the recent announcement is excellent news and welcome recognition at last of the significance eye health plays in the people's health and wellbeing, it is just the beginning. The challenge now is for all optometrists and opticians to get behind their LOC. They need to make sure that LOCs have the resources and expertise to seize this opportunity to put eye health and eye care services at the heart of their local Commissioners' plans to improve the health and wellbeing of the population.
More information
Anyone who wants to 'keep in the loop' on the progress of the Ophthalmic Health Network or the development of local enhanced services can sign up to LOCSU's website at www.locsu.co.uk to get the latest news as it is published.
Bespoke training for LOCs to develop the skills of the committee to prepare them for networking in the public health and commissioning arenas is available from LOCSU. Contact info@locsu.co.uk
Guidance on JSNA 2007 Department of Health
http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_081267.pdf
