1. Improving lives for people with sight loss 1 Visual impairment rehabilitation in the context of personalisation and the core offer Jenny Pearce – CEO, Vista

2. Improving lives for people with sight loss 2 What the session will cover  Background – Local authority survey 2010  Reablement as an early intervention  Rehabilitation within personalisation framework & as part of core offer  Prioritising need in the context of Putting People First  The way forward for rehabilitation.

3. Improving lives for people with sight loss 3 Survey of local authorities  How was visual impairment rehabilitation viewed within personalisation framework?  Lack of clarity  Inconsistent interpretation  Lack of understanding of the specialist role of VI rehabilitation  Inflexible interpretation of reablement as a standard 6 week model.

4. Improving lives for people with sight loss 4 Findings  Rehabilitation often viewed as standard 6 week model, & personal budget if required. Results:  money not spent on early interventions  longer term needs not addressed adequately  more expensive over time  more disabling approach – does not enable inclusion and independence.

5. Improving lives for people with sight loss 5 Early intervention and prevention  Support to recover from the effects of illness  Help to manage a long term condition, including help to safely maintain home and garden  Training to get a job or return to work; support to start taking exercise.

6. Improving lives for people with sight loss 6 Transformation agenda - reminder  Universal services  Early intervention and prevention  Choice and control  Social capital

7. Improving lives for people with sight loss 7 Reablement  A specific form of early intervention  Active process of helping an individual to regain skills, confidence and independence, following a change in circumstances, or specific period of illness or injury  Usually provided as time-limited, intensive programmes of intervention and may involve use of specialist equipment or technology  Major preventative role.

8. Improving lives for people with sight loss 8 Rehabilitation… …within the personalisation framework  Is rehabilitation a kind of reablement or something completely different?  Does it matter? Why?

9. Improving lives for people with sight loss 9 Rehabilitation… …as part of the Core Offer  Rehabilitation is a long-term process borne out of a long-term condition:  emotional support  daily living skills  mobility training  communication.

10. Improving lives for people with sight loss 10 The difference…  Rehabilitation involves longer term intervention – and possibly recurrent intervention over time but …  Early intervention and prevention are fundamental characteristics – rehabilitation needs to be essential part of any primary response to sight loss.

11. Improving lives for people with sight loss 11 Does it matter? Of course it does!  Longer term intervention is needed to enable :  confidence building  mobility training  learning new communication techniques  etc  A time limited 6 week package is likely to fail to deliver and thus to fail the person with sight loss.

12. Improving lives for people with sight loss 12 Different perspective on reablement  Reablement should be viewed as an umbrella term for a range of interventions that meet the broad criteria – intensive, time limited but not time prescribed interventions that help an individual to regain skills, confidence and independence, following a change in circumstances, or specific period of illness or injury.

13. Improving lives for people with sight loss 13 Rehabilitation under a reablement umbrella  Flexibility around time frames  A form of early intervention and prevention  Essential and central part of the personalisation framework for people with sight loss  Its essential value as part of the core offer must be proactively defended.

14. Improving lives for people with sight loss 14 Policy context…  ‘Prioritising need in the context of Putting People First: A whole system approach to eligibility for social care’  Guidance on Eligibility Criteria for Adult Social Care, England 2010  Local authorities exhorted to focus on outcomes and invest in early intervention and prevention, rather than just ratcheting up the bar of eligibility criteria

15. Improving lives for people with sight loss 15 Policy context…  “councils should consider the needs of their wider population and put into place support strategies to reduce the number of people entering the social care system in the first place. Before proceeding to determine eligible needs, councils should consider whether an individual might benefit from a short period of re-ablement or intermediate care to increase what they are able to do for themselves before an assessment of longer-term need is undertaken ”.

16. Improving lives for people with sight loss 16 Policy context…  “The most effective community support systems will be ones in which all citizens can expect some level of support and those with the greatest needs can access additional help”.

17. Improving lives for people with sight loss 17 Eligibility needs in the context of the environment

18. Improving lives for people with sight loss 18 Levels of need identified  Presenting needs  Eligible needs.

19. Improving lives for people with sight loss 19 The ‘Putting People First’ approach

20. Improving lives for people with sight loss 20 The way forward for rehabilitation  Rehabilitation clarified as a distinct reablement intervention – stressing the difference but always remembering the umbrella! (time limited but not time prescribed)  Clear targets for measurable outcomes - evidence of the effectiveness of rehabilitative interventions  Rehabilitation recognised as an essential intervention – early intervention and prevention.

21. Improving lives for people with sight loss 21 Maximise the opportunity  Evidence based practice  Responses to specialist needs, eg dementia, dual sensory loss  Technological advances – computers, assistive technology  A valued qualification  Excellent standards of practice.

22. Improving lives for people with sight loss 22 And …  The UK Vision Strategy highlights the importance of rehabilitation as essential part of the eye care pathway  Rehabilitation clearly rooted within personalisation framework as part of the Core Offer.

23. Improving lives for people with sight loss 23 Visual impairment rehabilitation in the context of personalisation  A great opportunity for effective early intervention  Part of the range of reablement approaches but not…  Restricted by a ‘one size fits all’ approach.

24. Improving lives for people with sight loss 24 Contacts Jenny Pearce, Vista (Visionary representative) Jenny.pearce@vistablind.org.uk Simon Labbett, SCA Rehabilitation Workers Consultative Network simon.labbett@bradford.gov.uk simon.labbett@bradford.gov.uk Carl Freeman, Guide Dogs carl.freeman@guidedogs.org.uk carl.freeman@guidedogs.org.uk