1 Overcoming barriers to accessible eye care David Allen, Head of Sight Loss Prevention, RNIB Carol Hayden, Director, Shared Intelligence.

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Overcoming barriers to accessible eye careDavid Allen, Head of Sight Loss Prevention, RNIB

Carol Hayden, Director, Shared Intelligence

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Developing evidence of what works

• Evidence review• Eye health equity profiles• Qualitative research• Trial interventions (18 - 22 months)• Independent evaluation - London School of Hygiene &

Tropical Medicine (LSHTM)

Evidence review

De Montfort University conducted a review examining evidence of the effectiveness of intervention strategies to address inequalities in eye health care.

Johnson et al, 2011

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Eye health equity profiles

Local public health specialists conducted a systematic review of data in each of the five CEP sites to explore service provision, uptake and outcomes.

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Community engagement projects

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Qualitative research - our research aims

Through a community engagement approach:• Identify the barriers that prevent access to primary and

secondary eye care services among people most at risk of developing avoidable sight loss.

• Design and develop intervention strategies to increase the uptake of eye care services among these people.

• In Bradford, Glasgow (Pakistani population/diabetic retinopathy) Cwm Taf, West Belfast (White working class/glaucoma), Hackney (Caribbean/glaucoma)

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Qualitative research - what we did

Approach• Local collaboration• Community based participatory research• Co-production of change

Methods• Community focus groups• Interviews with service providers, professionals and

stakeholders• Focus groups and interviews with Diabetic Retinopathy

Screening Service target users• Interviews with secondary care service users

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Qualitative research - what we found (1)

Eye health• Understood in relation to sight and fear of blindness• Poorly compared to other health promotion information • Mixed understanding of risk factors

Primary care and eye examinations• Symptom – led demand from most people• Retail environment and perceived cost of glasses a

barrier• Positive experience with optometrist an enabler

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Qualitative research - what we found (2)

Secondary care - barriers• Complexity of eye care pathway• Lack of understanding or trust• Service response to inequalities• Specific barriers in some areas e.g. transport, costs

Secondary care – enablers• Appointment reminders• Constructive approach to managing non-attendance• Positive relationship with clinician• Role of ECLO's• Access to social and community support

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Qualitative research - what we learned

Important to:• Work closely with local/target communities • Work in partnership e.g. with Local Advisory Groups • Invest in staff skills and capacity - and service

monitoring

For:• Raising awareness of eye health• User-focused, pathway approach to service redesign

and development • Addressing health inequalities and preventing

avoidable sight loss

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Community engagement projects

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Independent evaluation

London School of Hygiene &Tropical Medicine•Outcome•Process•Economic

More information:

rnib.org.uk/healthprofessionals

Contact us:

[email protected]

[email protected]

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