Launching the Easy Eye Care Pathway in South East London
OT heard from the SeeAbility team involved in championing the pathway for patients with learning disabilities and autistic people in London
26 September 2023
Commissioned by the South East London Integrated Care Board (ICB), the service is operated in accredited practices which have undertaken WOPEC training and has been operational since 31 July 2023.
people, approximately, in South East London have a learning disability, and some 21,000 are autistic
The pathway supports practices to provide a number of adaptations for patients, including providing more time than would typically be given for a General Ophthalmic Services (GOS) sight test, or providing multiple appointments, such as a pre-appointment visit to see the practice and meet the clinicians, and easily understandable patient information in an ‘easy read’ format.
The Easy Eye Care service will be available across the London boroughs of Bexley, Bromley, Greenwich, Lambeth, Lewisham, and Southwark, reaching 20% of the capital.
Referring into Easy Eye CareTrevor Hunter, SeeAbility’s London Eye Care Pathway for People with Learning Disabilities coordinator, explained: “The pathway is for people with learning disabilities and autism, of all ages.”
Patients can self-refer, or can be referred through advocacy groups, hospitals, and GPs.
Hunter added that the pathway means people with learning disabilities and their carers know where to go for support.
Grace McGill, SeeAbility expert by experience and eye care champion, highlighted that not all patients need to be in the hospital for routine tests, adding that the sight test can be carried out in a less stressful way in the community.
Hunter added; “As Grace alluded to, hospitals are often not the best environment. It is busy, noisy, and you often have long waits.”
“Financially, it’s much more cost effective to be seen in the community than in a hospital environment for what we’d say was a standard sight test,” Hunter added.
Those on the learning disability register with their GP are entitled to an annual health check, and it is this route that the coordinators believe will be most important to encourage referrals.
“Some of the questions on the health check are about sensory issues, audiology and eye care, and we are trying to educate GPs into asking those questions and then referring or recommending the pathway for the patients,” Hunter said.
Adults with learning disabilities are 10 times more likely to experience eye problems, and children are 28 times more likely, he highlighted.
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“As Grace said, everyone can have an eye test,” Hunter emphasised. “You don’t have to know how to read, you don’t need to be verbal. Adjustments can be made in practice.”
Recognising practicesAll accredited clinicians will have completed the WOPEC training via Cardiff University on learning disability and autism.
Practices will receive the standard sight test fee, along with an enhanced fee paid by the local ICB for providing the longer appointments or multiple sessions required to suit the patient’s needs.
Services in South East London are audited on an annual basis, so the pathway will be reviewed in June 2024.
“We have a lot of data that will be collected to review the pathway, and give some really good evidence for hopefully continuing it,” Hunter said.
Describing the variation seen in current approaches, he explained: “It’s all very hit and miss at the moment. If you are passionate about seeing patients who have learning disabilities, you’ll give that extra time in the practice, but that’s not always possible, and clinicians do run a business as well.
“This will start to recognise the practitioners who do give that extra time, and reward them financially.”
Progress made and still to come
The service is currently running in the North West of England, Durham, and the London borough of Sutton.
“But it’s mine and Grace’s aim to get it running across all of London,” Hunter said. “We’ve gone a long way towards that.”
A warm welcome
Reflecting on what the pathway could mean for patients, Hunter highlighted: “There’s a great unmet need, not only in the UK but across the world, to identify sight tests for adults and young people with learning disabilities. If they have those sight tests and get glasses, it can change their whole lives.”
Asked how practices could support this work, the duo recommended engaging with local optical committees as a starting point.
“I think they need to encourage their LOC to lobby the local commissioner,” Hunter said.
He highlighted that this topic straddles two disciplines: community eye care, and learning disability, which can make “getting all those ducks in a row” a challenge.
The team at SeeAbility remains resolute, however, and eager to discuss the pathway with everyone involved in eye care across the UK.
“There is such a need, and the pathway will complement the rollout of the special schools services across England in giving seamless eye care for this group of patients,” Hunter emphasised.
Asked how it feels to celebrate the launch of the pathway in South East London, McGill reflected: “It makes me want to cry.”
Hunter agreed: “It is emotional. We have really worked very hard on this, and it will be extremely rewarding to see the difference this makes to peoples’ lives.”