Low vision service provision in Scotland: review

Method

A retrospective survey was used to gather data from low vision services across Scotland.

2.0 The Advisory Group

An advisory group were selected to review the methods and survey content. The group consisted of research leaders in the field of low vision service development and provision.

• Dr Tom Margrain, Reader, Optometry & Vision Sciences, Cardiff University
• Dr Barbara Ryan, Chief Optometric Advisor to the Welsh Assembly
• Dr Ann Sinclair, Ophthalmologist, NHS Fife

2.1 Assumptions

The basic assumptions based on current professional knowledge of services, were that:

• there is no set pattern of provision;
• services are being provided in many types of location;
• services are using a variety of professional and voluntary practitioners who in turn were providing a variety of service models and
• there is a need for comprehensive data about service availability.

2.2 Design

A 15 item questionnaire was developed by Helen Court and Gillian Mitchell (see Appendix), based on knowledge from previous studies which sought to evaluate the provision of low vision services (Culham et al., 2002). The questionnaire was reviewed by a group of 5 optometrists ( NHS Education for Scotland senior postgraduate tutors) and the advisory group to check content and face validity. The questions included detail about the type of service, sources of funding, services included, staff/agencies involved and referral routes.

The questionnaire was initially administered by telephone. This method of data collection was selected based on the experience and advice of Dr Barbara Ryan. One week prior to the telephone call, a covering letter was sent to all potential providers. Upon first telephone contact, the provider was offered the opportunity to respond to the survey over the phone. However, if they were unable to respond at that time, they were given the option of arranging a further call, being posted a paper copy (with pre-paid return envelope) or being sent an internet link to an online version of the questionnaire. After 2-4 weeks, if the paper or online questionnaire had not been completed, another questionnaire was sent. Failing this, a final telephone call was attempted.

2.2.1 Identification of potential service providers

The following groups were identified as potentially delivering a low vision service:

• Hospitals with eye departments
• Optometry practices
• Local authority social services
• Local societies/charities for people with VI
• Specialist teachers
• Glasgow Caledonian University Optometry department

Gillian Mitchell, Client Services Manager at Sight Action, compiled a database containing all the contacts for each of the groups. Service providers were identified using various existing published directories. Optometry Scotland, Dr Janet Pooley (Scottish Government Optometric Advisor) and the Optometric Advisors for each NHS Health Board also were contacted to help compile the database. These lists were then cross validated by contacting the Sensory Impairment Partnership leads (SeeHear team leads) - representatives from all Scottish local authorities responsible for overseeing sensory impairment provision. They were further validated by using lists provided from a mainstream low vision aid provider, who provides aids to services across Scotland.

Optometry practices were by far the largest potential group of providers (n=959 ^[1] ). Rather than phone all of these practices, practices were contacted who had been identified by the process above. Optometric Advisors will have the best knowledge of services in their area, and as such we are confident that we have contacted the majority of optometry providers. The database identified that there were four community-based services, and a number of practices providing private services.

2.3 Data analysis

All the survey data was entered into SPSS (ver 20) by Gillian Mitchell. For purposes of validation, data entry was checked by Helen Court. Analysis of the type and extent of services were performed using SPSS software.

Mapping the location of services across Scotland was achieved by using Instant Atlas (an interactive mapping programme), including data about Health Board boundaries and percentage of the pensionable aged people within each Board ^[2] .