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NB magazine is the leading magazine for professionals who work with people with sight loss.
Containing the latest news and opinions on national and local campaigns, research, Government policy, professional practice, healthcare and social work sectors, jobs, career advice and products for blind and partially sighted people.
NB is the must read publication for people working in the eye health and sight loss sectors.
Media rate card 2014
NB
Informing, supporting and inspiring people in the eye health and sight loss sectors since 1917
The VisionNB is a free bimonthly magazine available in print, audio, braille and accessible email. You can also read it online at rnib.org.uk/nbmagazine
Onlinel News and features updated weekly
l NB archive
l Job advertisements
l Social media marketing
Printl Published six times a year
l Increased reach to professionals
l Includes professional practice content
l Has products for patients and clients
E-alertsl Frequent news and features to
readers’ inboxes
Eventsl NB is a media sponsor at events and
conferences
l NB hosts round table events with high profile delegates
Advertising and sponsorship opportunitiesl Print and, braille, audio and accessible
email formats We offer display adverts, recruitment
adverts, sponsored pages and advertorials.
l Web advertising You can advertise your products, services
or jobs on RNIB’s landing pages and NB’s web pages. Please contact us to discuss placement and specs.
l E-alert banner advertising NB’s popular e-alert is published twice a
month and more frequently when we have breaking news. We will link your advert directly to your website.
l Event sponsorship NB offers you opportunities to showcase
your services or products at our events and roundtables.
l Tailor made campaigns To ensure your advert reaches all the key
decision makers in the eye health and sight loss sectors.
rnib.org.uk/nbmagazine 39
Jobs
For all the latest and best jobs in the sight loss sector, click on to rnib.org,uk/nbmagazine and see page 14 in NB.
To advertise your jobs in NB call 020 7520 9474
ServicesExperienced braillist/proofreader offers transcription service. For further information please contact: Judith Furse, 23 Masefield Avenue, Swindon, SN2 7HT. Telephone 01793 644346. E-mail: [email protected]
TelephonesAlto 2 talking mobile phoneThe Alto 2 reads out all on-screen information as well as each and every key press. Text messages are clearly spelt out as they are written. Received messages can also be read out. Designed as a ‘slide’ phone, the Alto 2 has a well spaced number keypad, along with colour coded buttons for easy navigation. Available in three colours: dark grey (HM43K), orange (HM43OR) or blue (HM43BL). The phone costs £119.49 to £143.39.
Doro landline phones and mobilesThe price of some Doro phones has not been cut, plus there is further 10 per cent off any mobile or landline phone until the end of the year. All mobile phones are unlocked. Prices range from £37.50 to £120.00 ex VAT. Landline phones have cordless options as well as the standard plug in the wall. Prices range from £20.00 to £100.00 ex VAT.
Talking Freeview+ recorderMissing your favourite show will be a thing of the past with the TVonics talking Freeview+ digital recorder (TV06). The recorder is easy to set up from the moment it is plugged in. Synthetic speech reads all the on-screen information including programme guides, menus and a recorded programme library. There is a 15 per cent price reduction on the product until the end of the year. The special offer price is £152.96 Inc VAT plus £7.50 postage.
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To order, or for more information call our Helpline on 0303 123 9999 or visit our online shop at rnib.org.uk/shop.
Prices correct at time of publishing and where two prices are listed, registered blind or partially sighted customers pay the lower price.
All of the special offers end on December 31 2012.
Products
WelcomeIt may be the season to be jolly, but for anyone involved with the Social Care Association (SCA), it is anything but. Formed in 1949, the independent voice of social care workforce has now closed.
With falling membership and no Government funding, the SCA had to rely on external training and consultancy work to keep it going. However, the emergence of more and more cash-strapped organisations in a recession hit Britain, resulted in this work drying up and the body could not carry on. See our news story on page 5.
Meanwhile, the SCA’s Rehabilitation Workers Professional Network (RWPN) will become a specialist interest group within VISION 2020 UK. It aims to be the voice of rehabs and if the aspirations of its chair ring true, the body could be taking its first steps into becoming a full professional body. See our article on page 18.
I was stunned to hear that 65 per cent of glaucoma patients stop taking their eye drops within 12 months. One of the main reasons for this is that people need support in applying eye drops. Therefore, we have provided some advice on how eye nurses can support glaucoma patients who may need further assistance in this area, see page 32
The importance of team-working in a healthcare sector is also highlighted in our feature on page 34. It would be easy to pay lip service to better team-working, but the research is clear – effective teams equal great cooperation, fewer mistakes and better patient care.
41 Politics A reflection on a year in Westminster
42 What’s on and services Forthcoming events not to be missed
44 That’s all folks A round up of all the biggest stories
rnib.org.uk/nbmagazine 3
Olufunmi MajekodunmiNB EditorContents
News and analysis4 News
10 Analysis Swift action is needed to ensure councils
carry out assessments on deafblind children
12 Debate Do we need GPs to refer patients to eye
clinics?
Features15 Special report on rehabilitation Nick Johnson on the demise of the Social
Care Association
18 Opinion The next move for rehabilitation workers
19 What lies ahead? Jenny Pierce on the future challenges
facing rehabs
20 Star of India LV Prasad Eye Institute shows the world
how to deliver eyecare services
22 The year ahead Health and social care professionals tell NB
about the challenges facing the sector for 2013
Professional26 Eye health Focus on sight loss and Parkinson’s disease
30 Patient’s journey A patient describes the effects of having
birdshot uveitis
32 Shared practice Tips for healthcare professionals to ensure
glaucoma patients take their eye drops
34 The A Team How to build effective healthcare teams
36 Hardest hit in numbers What the Government’s welfare cuts mean
for disabled people
Extras38 Technology Our IT guru takes a look at Windows 8
40 Telephones Festive offers on a variety of telephones
“The hard copy is excellent. I carry it with me and can read it on the train, during lunchtime.”
Ophthalmic nurse
ReadershipPrintNB is read by health and social services professionals working with people with sight problems including rehabilitation workers, ophthalmic nurses, ophthalmologists, optometrists, orthoptists and occupational therapists. It also goes to local blind societies and to blind people themselves.
In 2013 NB became a free magazine and doubled its print run. NB aims to reach every single eye clinic and rehabilitation service in the UK. NB is also available in braille, audio CD, audio DAISY, and accessible email. All advertising is converted into these formats as standard.
We also publish NB online at rnib.org.uk/nbmagazine to ensure that thousands more readers can access the magazine easily. RNIB’s website receives more than 1.8 million unique visitors every year.
Our readers help partially sighted or blind people with specialist assessment, counselling, mobility training and advice on useful gadgets and aids, as well as encouraging and empowering them to lead independent lives.
rnib.org.uk/nbmagazine 5
Social Care Association closes its doorsThe Social Care Association (SCA) has announced that it is to close after 60 years despite living “hand-to-mouth” for many years.
The body, which provided a voice for rehabilitation workers and those working in social care, is credited with producing codes of practice for members and taking the issues of the workforce to the Government.
Following its announcement, it criticised the Government for failing to recognise and support staff in the social care sector. It said that although professional registration was being introduced into other parts of the country, there was no “prospect” of it occurring in England despite legislation being passed in the year 2000. In a press statement it added: “We think that the general public will be shocked to understand that such staff are not required to be properly professionally registered”.
The SCA said that membership fees had been modest and to keep the organisation going, it had relied on training and consultancy work to external bodies. However, cuts in spending had meant the body had no choice, but to close.
The SCA was able to attract just a fifth of all rehabs as members from an estimated workforce of 500. Its total membership has been in decline for many years. At its peak it boasted 5,000, but this had fallen to 1,000, this year. It’s final chief executive, Nick Johnson, wanted the SCA to be remembered for all its good work.
The Directors of Adult Social Services (ADASS) paid tribute to the SCA. Its president, Sarah Pickup, said it had played a significant role in the past 60 years in promoting, defending, and applying all that is best about social work and social
Social Care Associationsigns of avoidable diabetic complications. Yet fewer than half of people with diabetes receive all these tests.
Hodge added that the variation in the level of progress across the NHS also means that there is an unacceptable “postcode lottery” of care, whereby the quality of diabetes care varies dramatically across the NHS.
The report says that although there is consensus about what needs to be done for people with diabetes, progress in delivering the recommended standards of care and in achieving treatment targets has been “depressingly poor.” There is no strong national leadership, no effective accountability arrangements for commissioners, and no appropriate performance incentives for providers, it says.
Barbara Young, chief executive of Diabetes UK, pictured, said: “This report sets out how a postcode lottery of care has been
“ Around 24,000 people die prematurely every year because their diabetes has not been managed effectively”
Too many people with diabetes are developing sight loss because they are not receiving the care and support they need, according to a new report.
The warning by the Public Accounts Committee (PAC), the Government’s value for money watchdog, comes after it published its findings into the management of adult diabetes services in the NHS. The report by the cross-party group comes after the National Audit Office and Diabetes UK both published
critical studies on diabetes care this year. Diabetic retinopathy is one of the most common complications of diabetes. People with diabetes are also at risk of getting cataracts.
Margaret Hodge, chair of PAC, said: “Around 24,000 people die prematurely every year because their diabetes has not been managed effectively, and many more develop avoidable complications such as blindness and kidney disease.”
She added that the NHS spends just under £4billion a year on diabetes services and 80 per cent of that figure is spent on treating avoidable complications.
In 2001, the Government set out minimum standards for diabetes care, including nine basic checks for the early
The Social Care Association (SCA) has announced that it is to close after 60 years despite living “hand-to-mouth” for many years.
The body, which provided a voice for rehabilitation workers and those working in social care, is credited with producing codes of practice for members and taking the issues of the workforce to the Government.
Following its announcement, it criticised the Government for failing to recognise and support staff in the social care sector. It said that although professional registration was being introduced into other parts of the country, there was no “prospect” of it occurring in England despite legislation being passed in the year 2000. In a press statement it added: “We think that the general public will be shocked to understand that such staff are
Watchdog criticises diabetes care on sight loss
News
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Social Care Association closes its doors
NursesMary Shaw, chair of the RCN Ophthalmic Nursing Forum“There is going to be a challenge to show the GPs and local authorities who will be holding the purse strings, that the services we offer are not just value for money, but that we can also make cost savings too. But, there are also going to be opportunities arising from the Royal College of General Practitioners’ decision to make eye health one of its priorities over the next four years and the UK Vision Strategy’s work.”
WalesCeri Jackson, director, RNIB Cymru “In Wales we have much to look forward to in 2013. The Welsh Government will be publishing their first ever Eye Care Plan and eye health will become a public health priority.
The biggest challenge facing so many blind and partially sighted people is cuts to welfare benefits and how we can most effectively respond to that, when benefits are non-devolved.
Another will be in protecting the funding and quality of local authorities and hospital services. We know cost cutting exercises are already having an impact on these vital services, with many local authorities moving to generic service provision and people with sight loss being denied services.”
Rehabilitation Simmone Miller, senior rehabilitation worker“It is very important to safeguard professional training, so I would say that the closing down of courses for rehab workers is the biggest threat. Yes, funding is a problem, but the big problem is the role is being absorbed by other roles, and work like mobility training, needs to be protected.”
Eye Clinic Liaison Officers Cathie Burke, Eye Clinic Liaison Officer (ECLO)“In 2013, it is likely that there will be a large demand for re-assessments of vision by eyecare staff from a number of patients facing disability living allowance reviews. There is a lot of insecurity and uncertainty among visually impaired patients about how the change to personal independence payments will affect them financially. As with previous benefit changes, the process cause a lot of distress and anxiety for visually impaired people.
rnib.org.uk/nbmagazine 25
2013 challenges
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Treatment
I later transferred to Moorfields Eye Hospital in London. On 24 September, 2009, I stood holding 80mg of the steroid prednisolone and was ready to start my treatment. That was a real lump in the throat moment. You only have to read the label for possible side-effects – weight gain, depression, black stools – to know why.
The improvement was remarkable – please don’t think I am sad – but I have kept notes of the condition, changes in my eyes and how I felt from the start.
Within two weeks, the problems I had with glaring light had significantly reduced, as had the visibility of the dots in my eyes. The downside was the steroids made my skin very dry, my tongue felt swollen, my face was hot and my lips were sore. For me it was a pretty a good trade off, eyesight for a bit of discomfort.
We all react differently to drugs – there is a long list of stuff I take and I’ll spare you the details – but, I seem to do okay on steroids. The specialists are managing the condition and balancing my eyesight against the long term effects of taking the drugs.
I’ve had three flare ups since I started on the steroids on 10 Dec, 12 April and 12 June. The first one was very distressing, because you think the condition is cracked and literally within a few seconds, it’s back with vengeance. I now know the routine – back to Moorfields, an increase in steroids and on we go. The symptoms subside and I hope for the best.
I know I can’t see as well as I did. Detailed images are difficult to interpret and certain lighting conditions are definitely better than others. But on the other hand, birdshot is pain
free, so that’s something to be thankful for. At present the condition is under control again, but I know it’s only a matter of time before the next flare up.
I don’t usually tell people about the condition, not because of any embarrassment or shame, but hearing about others’ ailments can be pretty dull. But, this is where the Birdshot Uveitis Society (B.U.S.) was good for me.
When I attended the inaugural B.U.S. meeting, I met lots of other people with the same condition.
It was clear it affected us all similarly, but also differently. I know I don’t have it as bad as others and I put that down to luck.
All I can conclude is that I have visual field defects that include bits of retina where I can’t see anything, bags of floaters and thousands of black dots. Thankfully, my brain has learned to ignore all these things. Despite having birdshot, there’s not a lot I can’t do now that I could do before. And, for me, that’s a pretty good result.
Birdshot chorioretinopathy, also known as birdshot or birdshot uveitis is a rare, auto-immune, potentially blinding and chronic form of posterior uveitis. Uveitis means inflammation of the uvea, part of the eye that is made up of the iris, choroid of the eye and ciliary body.
Common symptoms include floaters blurred vision, night blindness, sensitivity to lights and shimmering vision, this is difficult to describe but some people say imagine looking through a glass or water.
A doctor will be able to see oval shaped spots coloured cream or orange at the back of your eyes, if you have had it for some time. The disease is called birdshot because the spots resemble the pattern seen when you fire birdshot pellets from a shotgun.
Source: BUS
rnib.org.uk/nbmagazine 31
“For me it was a pretty a good trade off, eyesight for a bit of discomfort”
What is birdshot?
Living with birdshotSix years ago, Steve Page was diagnosed with birdshot uveitis, he explains how he coped with the eye disease.
Flashing lights
Typical for the condition, it took three years for the diagnosis. I was 52 at the time.
I was on a boat bobbing on Lake Michigan, close to Chicago, when I thought I was surrounded by thousands of small midges. Within a few minutes I worked out that these were actually dots within my eyes.
A couple of days later, flashing lights in my eyes became visible and resembled what I can only describe as shells, other people refer to this as “shimmering,” see box.
Diagnosis
After the usual checks and tests I was referred to the Birmingham and Midland Eye Centre. More tests wrongly concluded that I had a problem in the optic nerve.
Two years later, after thousands of more dots flared up in my eyes. I rang my GP who referred me to a specialist in Birmingham. I was seen by a duty eye specialist in the casualty department. He knew what was wrong and after a second opinion he suggested I had birdshot uveitis, see box and that it could be treated with steroids.
Patient’s journey
22 rnib.org.uk/nbmagazine
What do rehabs need in the wake of the closure of the Social Care Association?For me, it is a sense of collective identity – both to ourselves and to the visual impairment sector.
It is interesting that in the last month a new regional group for rehabilitation officers for the visually impaired (ROVI) has started in Anglia, the north-east group has been resurrected and Northern Ireland has also taken steps to create a forum, so clearly the need to share experience and learning is strong.
Simon Labbett, chair of the RWPN
Access to allSteps are already underway to establish the Rehabilitation Workers Professional Network (RWPN) as a special interest group within Vision 2020 UK. RWPN will be open to all people who hold the normally-accepted qualifications to practise but also include student ROVIs.
Information and relevant guidance can be specifically targeted to those working in England, Wales, Scotland and Northern Ireland. The aim is to have resources available for ROVIs that can provide assistance in day-to-day work, such as guidance from the Association of Directors of Adult Social Services on rehabilitation, eyecare pathway information and monitoring/evidence.
At present the RWPN aims to be both an information site and as comprehensive a list of workers as is possible in the UK. For me, professional registration is of real importance so that we can offer safeguards to the people we work with. RWPN is not a professional register.
The RWPN is not a professional body, but maybe
it is a start towards one. I know there is interest within the sector in renegotiating links with the Association for Education and Rehabilitation of the Blind and Visually Impaired in America.For me, it is a sense of collective identity – both to ourselves and to the visual impairment sector. We also need a sense of confidence in the value of what we are doing.
My own view is that any such body should ultimately include habilitation workers and qualified teachers of the visually impaired. The move seems a fair way off right now, but the RWPN feels like a good start.
Simon Labbett, chair of the RWPN
Letters
Are we allowing core values to slip away?
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Write to us
“NB is very useful to me in my work. I really do think it is essential for an ECLO and I would strongly recommend it to colleagues.”
ECLO
We need to make this step-change to our eyecare services, urgently. RNIB Scotland has warned that the number of Scots with sight loss could double between now and 2030.
We are on the verge of having a truly world class eyecare system in Scotland. Since 2006, we introduced free eye health checks ensuring that an extra 300,000 Scots are assessed each year. This new investment will pay further dividends in relation to preventing avoidable sight loss currently estimated in excess of £17,000 per year.
We mustn’t step back from this now. Making this investment now will pay dividends later – t is estimated that more than 50 per cent of sight loss in the UK is avoidable. Targeting these issues in the ageing population will lead to reductions in sight loss, and measurable gains in other health indicators such as mobility, frailty,
and reduced levels of depression.
Ultimately, it is likely that by preventing avoidable sight loss, patients will be less reliant on families, carers and other support and social services. Reducing the risk of sight loss will enable patients to live healthier and more productive lives while diminishing the burden of care placed on others.
This is why, working with the UK Vision Strategy, the Royal College of General Practitioners (RCGP) has just announced that eye health, with a focus on ageing and sight loss, will be one of its clinical priorities from 2013-2016, see news story page 8.
We welcome the use of electronic images, and this is a significant advance in communication between eyecare clinicians. These images will lead to prompt diagnosis, and there is a potential for preventing avoidable sight loss, especially in conditions like wet age-related macular degeneration. This will be associated with a reduced risk of falls and depression, and a reduced lack of
rnib.org.uk/nbmagazine 21
Should GPs remain the gateway to eyecare or should they make way?
We feel it is therefore essential that the closely in this referral process
More onlinernib.org.uk/nb/eyehealth
A revolution in eyecare treatment is taking place in Scotland. The Scottish Government has allocated £6.6million to roll out a high tech initiative – currently being piloted in Fife – across all 14 health boards in the country.
The new electronic referral with digital images system has drastically reduced referral times by taking an electronic photograph of people’s eyes at high street opticians, then instantly emailing them to hospital ophthalmology departments.
It will replace the current archaic system where hard-copy images are posted by “snail-mail” between opticians, GPs and eye clinics.
Eye specialists say the new technique has revolutionised the way people are referred on to eye clinics and saved the sight of patients who require immediate treatment, by drastically reducing the time between initial
examinations and specialist follow-up. Already, we have had urgent cases, where the need for immediate treatment was identified.
It’s a truly win-win solution. The system not only allows us to speedily identify patients that require sight-saving treatment, it also ensures that patients are sent to the most appropriate specialist clinic at first visit, thus giving a one-stop service at hospital. This re-design of electronic communication optimises the use of hospital resources for patients, ophthalmologists and optometrists.
Eye specialists in Fife say the system has significantly improved eyecare services through reduced paperwork, more accurate appointment allocations, and allowing for e-diagnosis. A highly significant outcome has been the high proportion of patients identified as not needing a hospital appointment, saving both time and money. Another advantage is that it also frees up GP appointment Times by getting people to go to their optician.
Should GPs remain the gateway to eyecare or should they make way for a new electronic referral system?
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Debate
We feel it is therefore essential that the closely in this referral process
OnlineRNIB’s website is very popular with over 52,410 page views over the last year (August 2012 to August 2013). Page hits have risen by over 400 per cent compared to the previous period.
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