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People with sight loss confused by 'disjointed' system

Published: 24 May 2023 at 15:33

Woman having an eye test

Research finds lack of clarity around access to benefits, support and rehabilitation

People with sight loss in the UK are confused by a “disjointed” certification and registration system that “creates a barrier” for people trying to access support, benefits and rehabilitation, a new academic study has reported.
The research, led by Anglia Ruskin University (ARU) and published in the journal Eye, examined experiences of people with sight loss around receiving a Certificate of Vision Impairment (CVI), and their subsequent access to welfare, support or further healthcare assistance through a Referral of Vision Impairment (RVI).
In the UK, the CVI certifies a person as sight impaired (partially sighted) or severely sight impaired (blind). The registration is completed by ophthalmologists and passed with the patient’s consent to their GP, their local authority, and The Royal College of Ophthalmologists Certifications Office. Once a person has been certified with a CVI, they have a voluntary option of registering with their local authority for access to advice and different types of support through an RVI.
Around 2 million people across the UK live with sight loss, but RVI registration varies wildly across the country – in 2016/17 the percentage of people with sight loss in Hampshire who had registered for RVI was 87.9%, compared to 26% in Rutland.
Researchers carried out interviews with 17 individuals in the UK with eye disease, as well as optometrists and Eye Clinic Liaison Officers (ECLOs). Participants were asked open-ended questions about their own experiences of care, certification and registration.
Patients reported confusion regarding decisions and processes of certification and registration. Some reported inconsistency amongst people who certified them, with some more inclined to certify than others. Participants also reported long waiting lists for accessing support, and issues with capacity for social services support from local authorities.
Participants also were unsure exactly what certification and registration entitled them to, and where services could be accessed. Interviews also suggested that optometrists do not tend to engage much with the certification process.
Lead author Professor Shahina Pardhan, Director of the Vision and Eye Research Institute at Anglia Ruskin University (ARU), said: 

“Vision loss can be a devastating experience for a patient and there is currently confusion around the process of certification for CVI, which is done through the NHS, and for registering for further support from local authorities through RVI.
“It is clear from our research that many feel the process of registration and certification is disjointed, creating a barrier for people with sight loss. It needs to be made simpler and more consistent if people are to receive the support they need.
“More timely, efficient, and effective provision of information, advice, and signposting to relevant support services in local social care and third sector organisations, along with more informed decisions around certification and registration by eye health professionals, will benefit patients and improve their wellbeing and quality of life.”

The study was supported by the Royal National Institute of Blind people (RNIB). The full, open-access paper can be viewed at https://www.nature.com/articles/s41433-023-02520-0