Researchers: Parvaneh Rabiee, Sylvia Bernard, Kate Baxter and Gillian Parker
Funder: Thomas Pocklington Trust
Duration: October 2012 to September 2014
Demographic trends suggest that the number of older people in England is set to rise significantly. As age-related eye conditions are the most common causes of visual impairment, the number of people with visual impairment is also expected to rise considerably, implying potential increase in demands on health and social care provision and associated economic costs. With this and current moves towards personalisation, it is important that people with visual impairment are not excluded from receiving appropriate interventions that could improve their well-being and promote their independence. We did not know what services were doing to rehabilitate people with visual impairment, what specific service characteristics might maximise people's ability to live independently in the community and how variable access to services was.
The overall aim of this study was to provide an overview of the evidence base for specific models of rehabilitation interventions for people with visual impairment. More specifically it addressed the following research questions:
- what are rehabilitation services currently doing to support people with visual impairment?
- what are the possible outcomes that rehabilitation services might achieve?
- Undertake a review of existing literature on rehabilitation interventions for people with visual impairment
- undertake a national (England) survey to map out the prevalence, location, capacity, organisation and content of rehabilitation services for people with visual impairment that currently exist
- identify gaps in the evidence base about current service arrangements, their costs and their effectiveness
- scope the potential costs and effects of rehabilitation services for people with visual impairment
- assess how outcomes might be measured
- explore the feasibility of formal evaluation in the future to determine the cost effectiveness of rehabilitation services for people with visual impairment.
The study was carried out in England and focused on rehabilitation services funded by local authorities (but including those provided by local authorities, third sector and private providers). The study used a mixed methods approach, including: literature review, scoping workshops with people with visual impairment with the experience of using rehabilitation services and professionals working with people with visual impairment, a national survey of local authorities and voluntary organisations, focus group discussions with frontline staff, semi-structured interviews with people with visual impairment using rehabilitation services and feedback workshops.
Policy and practice implications
The research provides an initial evidence base for specific rehabilitation service models for people with visual impairment, opening up space for full evaluation in the future. It provides care providers, service planners and policy makers with:
- a description of the extent and models of vision rehabilitation provision currently available to people with visual impairment, highlighting gaps in rehabilitation interventions funded by social services for this group
- a summary of the key findings, from all stages of the project, identifying the priorities for future research and describing any issues to be considered in commissioning the research
- an indication of ingredients of a model of 'good practice' for rehabilitation services funded by social services for people with visual impairment which can be used by commissioners and service managers
- a list of key features that can be tested in future evaluation studies.
The project had an advisory board made up of people with relevant expertise in vision rehabilitation. They provided an excellent source of advice and knowledge on current issues and access to professional networks in order to have the maximum effect on services. Service users brought their unique experience and perspective to discussions about the research and the best way to reach people with vision impairments. Members of the board were:
Joan Beck, Director of Adults and Communities, Doncaster Council..
Martin Best, Disability Support Service Manager, Henshaws Society for Blind People.
Catherine Dennison, Head of Research: Health & Wellbeing, Thomas Pocklington Trust.
Jane Duddle, Rehabilitation Officer, Blind Veterans UK.
Caroline Glendinning, Professor of Social Policy, University of York.
Rachel Lintott, Manager, Rehabilitation & Specialist Visual Impairment Services, The Wilberforce Trust.
Simon Labbett, Chair of the Vision 2020 UK Rehabilitation Workers' Professional Network.
Jenny Pearce, Chair of the Rehabilitation and Low Vision Group of VISION 2020 (UK) Ltd.
Karen Osborn, Chief Executive, Kent Association for the Blind.
Anne Smith, Service User.
Andrea William, Service User.
Presentations and publications
Vision rehabilitation services: what is the evidence? Invited.
Rabiee, P., Association of Directors of Adult Social Services Physical Disabilities, Sensory Impairment and HIV/AIDS Network Meeting, London, 27 February 2015. Vision Rehabilitation Services: What is the evidence?, 2015
Rabiee, P., Parker, G., Bernard, S. and Baxter, K.. 2014
Vision rehabilitation services: increasing the evidence base. Invited.
Baxter, K. and Rabiee, P., Royal National Institute of Blind People Research Day 2014: Rehabilitation and Social Care, London, 20 October 2014.