A preventative approach to ensuring Access to a Sustainable, whole System pathway for older people with vISion impairmenT (ASSIST)

End of project summary

Main Messages

Sight loss affects over 2.2 billion people globally and is a significant public health issue, particularly for older people. It can seriously affect physical and mental health and a person’s independence, making people more likely to have a fall or become socially isolated. In the UK, the cost of sight loss was £28 billion in 2018. Unfortunately, many older people with sight loss don’t get the help they need and don’t know about available services. In this study, we looked at the care and services that help older people with vision impairment, to find where support works well and also how it can be improved.

We surveyed and interviewed older people with sight loss across Wales and spoke to staff who help them and found that:

• Only 36% reported receiving an assessment of their needs.
• Many indicated a need for more help with mobility and daily living.
• 47% cited anxiety or lack of confidence as barriers to accessing services.
• People felt it was very important to have a good understanding of their condition.
• Family support, transportation, and service coordination were also felt to be important for improving independence and wellbeing.
• However, many describe challenges such as digital exclusion, stigma, and inconsistent service availability.
• Our economic assessment identified that improving access to services could reduce falls, potentially saving NHS Wales of the order £2.3m resources per year in injurious falls averted. Similarly, development of depression and dementia could be averted with modest investment.

The key recommendations are that all older people with sight loss should expect: 

1. health and care systems and policy to identify and consider their needs;
2. to receive a low vision assessment, vision rehabilitation and information about their eye condition and support needs;
3. access to a central information hub which is up-to-date;
4. the opportunity to develop a good knowledge of their eye condition knowledge with regular professional monitoring;
5. awareness training for community services;
6. that the professionals supporting them are trained together and work together;
7. dedicated financial support for transportation.