UK lacks pathways through social and clinical care for eye patients

UK study results reveal that emotional and family support is lacking for individuals with visual impairment.

The survey of clinical and rehabilitation staff working at eye clinics and in the community showed discrepancies in opinions over what constitutes essential services for visually impaired patients, and which type of personnel provides such services.

For example, a greater proportion of clinical staff reported the availability of particular services at their institution, while rehabilitation staff were more likely to consider emotional support and referring to social services as being essential, explain Ahalya Subramanian (City University London, UK) and colleagues in Eye.

"Referral pathways need to be developed for the patient journey through clinical and social care to ensure that both patients and health practitioners know what services exist, to make it clear who provides individual services, and to encourage clinicians to make appropriate referrals," they suggest.

A total of 67 clinical and 42 rehabilitation staff made up of ophthalmologists, optometrists, dispensing opticians, nurses, and rehabilitation and support workers completed the survey, which differed slightly between these groups to account for role differences.

Responses from clinical staff indicated good overall provision of services for visually impaired patients in the UK, with 89‑96% reporting the availability of services including explanation of the cause of vision loss and prognosis, explanation and training about the use of low-vision aids, and signposting to other services.

By contrast, fewer (59‑81%) rehabilitation staff felt that such services were available, and only a third (35%) reported that family support was widely available to patients, compared with 50% of clinical respondents.

Significant differences were noted between clinicians' and rehabilitation staff responses on which services were essential, with a respective 100% and 98% of the latter reporting that referral to social services and emotional support are essential, compared with 88% and 86% of clinical staff.

When asked who provides services to visually impaired patients, responses from clinicians indicated gaps in care, particularly in family and emotional support, which were reported as being provided by "no-one" by 48.3% and 34.5% of clinicians.

Conversely, rehabilitation staff reported that all services were covered, and in the majority of cases, by multiple personnel as opposed to one individual.

"Many conditions resulting in visual impairment cannot be cured or alleviated, resulting in rehabilitation services being the main source of care," concludes the research team.

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