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Blind patients’ need

23 October 2015

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Partially sighted and the blind population can sometimes be ignored. It’s important that general practice is aware of where it can make arrangements to suit these patients

Almost two million people in the UK are living with sight loss and this number is predicted to rise to four million by 2050.
By making reasonable adjustments for blind and partially sighted people, GP practices will provide equal access to all their patients, avoid the risk of falling foul of equality legislation, and most importantly meet the new NHS accessible information standard from the Standardisation Committee for Care information (SCCI) – SCCI 1605 (see Resources).
Findings from the Royal National Istitute of Blind People’s (RNIB) Attitudes to eye health among GPs and optometrists report 2010 showed that GPs understand the importance of eye health. However, only a third believe they are well informed about the needs of people with visual impairments. Above all else, GPs felt that they need training and guidance to overcome these barriers. Information and guidance from organisations such as RNIB, UK Vision Strategy and Thomas Pocklington Trust can help.

Communication
Inaccessible correspondence can lead to errors in reading appointment times; meaning that access to treatment is delayed and vital time is wasted on missed appointments. There can also be patient safety consequences where a patient is unable to read the GP’s written instructions on their medication.
Blind and partially sighted patients should be given all healthcare information in the format they need, such as large print, by email, in audio format or braille. Patient confidentiality is crucial, they should not be expected to accept ordinary print and then ask a family member or friend to read out their private health information.
For GP practices, accessible information isn’t an optional extra and NHS England recently announced a new mandatory accessible information standard (SCCI 1605). This comes into force on 1 April 2016, reinforcing the need for blind and partially sighted people to be given all health information including letters, test results and appointment reminders in their required accessible format.
As well as information, inaccessible buildings may deter blind or partially sighted patients from visiting their GP. Steep stairs with no ramp up to the surgery and obstacles in the practice such as chairs and leaflet stands are not just an inconvenience for people with sight loss, they can be a real danger. Poor signage or lack of colour contrast within the surgery can disorient partially sighted people, and inaccessible booking systems can also prevent patients from attending.

Advice
Start your implementation of the new NHS Accessible Information Standard (SCCI 1605).
Run sight-loss awareness training with staff (see Resources).
Make sure there are accessible and easy-to-use alternatives to self-check-in systems and electronic display boards.
Ask patients what their preferred format is and record that preference.
Provide information, such as RNIB leaflets and publications, on local and national support services.
Place signage at eye level in well-lit areas, follow ‘clear signage’ design principles and ensure there are strong colour contrasts.
Ensure clear walkways free of obstacles and consider enhancing the visibility of glass by adding stickers or signs.

Guiding
It is essential to provide guiding assistance to some blind or partially sighted patients when walking to the consulting room or to other clinics. A clear and friendly verbal greeting when the patient first walks into the surgery is also helpful.
Always ask the person if they want assistance and ‘offer’ them your arm.
Ask the person on which side they prefer you to walk.
Stand side by side so that the person can locate your upper arm.
Start moving and walk slightly ahead so they can follow your direction.
Point out any hazard such as slopes, steps or closed doors.
Guide the person so they can put their hand on the arm of the chair.

Extra informtion
RNIB has worked with Doctors.net.uk to develop a set of educational resources for GPs. The four accredited modules have been designed to help GPs increase their knowledge of sight loss conditions, support patients better and help them gain continuing medical education (CME) points. Doctors.net.uk is open to all General Medical Council (GMC) registered doctors.

Hugh Huddy, policy manager at the Royal National Institute of Blind People (RNIB).

Resources
1 SCCI 1605. Health and Social Care Information Centre. hscic.gov.uk/isce/publication/SCCI1605 (accessed 9 October).
2 Sight-loss awareness training. rnib-business.org.uk for more information (accessed 9 October).