Abstract
Purpose: :
To critically evaluate the organisation of rehabilitation services for visually impaired people in the UK by comparing them to rehabilitation services in developed countries worldwide.
Methods: :
A questionnaire was sent to key contacts in 15 developed countries asking thefollowing questions:1. Is there a process to register people who are visually impaired, and what are the outcomes of registration?2. Are there regional variations in the services provided to people with visual impairment?3. Is there a standardised/official referral pathway?4. Is there a position that co-ordinates or bridges the gap between the delivery of clinical and social services?
Results: :
1. Almost all countries had a process of registering people who were visually impaired based on clinical criteria. Sweden however did not have a registration process.2. Few countries had consistent service provisions across all regions. Those countries that did tended to have one main provider of low vision services. For example, the National Council for the Blind of Ireland (NCBI), the Spanish National Organisation for the Blind (ONCE) and government funded low vision services in Sweden.3. Very few counties had an official or standardised referral pathway.4. In the UK, some clinics have a staff member that provides access to a range of rehabilitation services, bridging the gap between clinical and social services. Other countries have a member of staff who co-ordinates the delivery of different types of services (for example, Low Vision Advisers in Australia, Needs Assessors in New Zealand, Case Managers in the USA). However, these positions are not consistently available throughout each country.
Conclusions: :
A registration process for people with visual impairment is almost always provided. It is however based on clinical criteria, rather than an assessment of need as tends to be the case in the UK. The countries that have inconsistent service provision across it's regions, and a lack of standardised referral pathways tend to have a member of staff who co-ordinates services or bridges the gap between clinical and social services (for example, the UK, USA, Australia and New Zealand). Whether a co-ordinator would be advantageous if there was consistent service provision and clear referral pathways is a matter for further research.
Keywords: clinical (human) or epidemiologic studies: health care delivery/economics/manpower