1. Bye bye BD8 Progress Report Carl Freeman & Richard Cox

2. Workshop overview Why change? Overview of the new system How it affects individuals How it affects organisations Current state of play Discussion.

3. What was the BD8 for? The BD8 was intended to: Identify those with little or no sight and a starting point for services Validate serious visual impairment Act as a passport to services and benefits Collect statistics to aid with planning.

4. What were the problems? Long identification process Optician - GP - Eye Clinic - BD8 - Social Services - Support Help often needed before registration Terminology not always helpful - particularly label of “blind” Majority remained unregistered limited value in planning terms Emotional Impact often unrecognised.

5. A snake with few ladders © Richard Cox

6. Dept of Health review Review October 2001 - August 2002. Examined how people with failing sight are identified & access help & support Review group made up of voluntary, professional & statutory bodies Articles in journals, open consultation via government website.

7. Review participants Association of Blind Asians Service user representatives

8. 3 documents for timely referral LVI - issued by high street opticians RVI - issued by eye clinic staff CVI - issued by ophthalmologists 3 ways to access social care.

9. LVI Self-referral letter issued by optometrists to people with uncorrectable sight loss Developed locally based on national template containing: information and details of how to obtain social care assessment and/or support onus on individual to send in the form.

10. RVI Referral for social care assessment from the eye clinic – not dependent on eligibility or “willingness” to register Includes comment on “urgency” of required response Can be completed by anyone working in the eye clinic (with patient’s consent) Copy to GP and user.

11. CVI Certificate of eligibility to be registered – akin to current BD8 and must be signed by consultant ophthalmologist Also acts as “backstop” referral form for if LVI or CVI not previously issued Copy to Patient, GP, Hospital notes informs central statistics collection with tick boxes for common eye conditions.

12. Snake with 3 ladders © Richard Cox RVI LVI CVI

13. New terminology “Sight Impaired / Partially Sighted” “Severely Sight Impaired / Blind” More “inclusive” and less misleading No opportunity to change the underlying legislation So 2 basic categories remain

14. Implementation update Slow start Transition phase Some opposition Some enthusiasm How is your area doing?

15. Main implications for users Potential for: improved “patient pathway” more timely support availability of help prior to registration But may lead to: Unmet expectations of social care less incentive to register?

16. What should local societies do? Promote & monitor the change over Become “experts” in the new system Share their expertise with all local stakeholders Provide relevant support to newly visually impaired people at each stage.

17. What should SSDs do? Become fully briefed on the system Talk to the other stakeholders Local societies re including their details on all 3 documents Eye clinics re “localising” RVI & CVI LOCs (Optometrists) re arrangements for distributing the letter Print the LVI – a specific SSD responsibility Train their staff (& eye clinic staff?).

18. Where to find out more www.sightlossmatters.com Gateway to (very long) Dept of health website address Source of more information & FAQS http://www.dh.gov.uk/PolicyAndGuidance/ HealthAndSocialCareTopics/Optical/Optica lDocumentsArticle/fs/en?CONTENT_ID=40 74843&chk=q%2B1fLr)

19. Discussion Happy to take questions and clarify issues covered Do you think the new system represents a step forward in timely support? Discussion on what ACTION we can take to make it work well.