The certification of vision impairment: A regional 21st century perspective

Abstract

Certification and registration of those who are sight impaired (SI) provides commissioners, and the providers of health and social care support to those with vision loss, with quantifiable data on the extent of blindness and sight impairment within a community. In this article, we outline the results of a comprehensive review of certification/registration pathways and processes in Northern Ireland and highlight achievements to date. The Developing Eyecare Partnership (DEP) CVI Task Group established by the Health and Social Care Board (HSCB) reviewed all certification/registration processes, pathways and issues that may have contributed to regional under certification/registration. This was undertaken to ensure timely certification/registration of those who may benefit from being certified as either Severely Sight Impaired (SSI) or SI, and in so doing improving patient pathways and access to services. Activity included a review of all available epidemiological data collected in the 2-year periods before and after the introduction of the new pathway (January 1, 2018). This work has resulted in changes to the terminology used in relevant Northern Ireland legislation and other documentation concerning certification/registration. It has also resulted in the creation of more timely and efficient referral pathways and improvements in the quality of information available on certification and the process. Increased awareness of the certification process by health and social care professionals has resulted in a 22.5% increase in certifications over the 2-year period, before COVID-19. Certification rates are now comparable with those from other areas of the United Kingdom. The workings of the DEP CVI group, over a 5-year period, have increased awareness about SI and SSI Certification among patients and Health and Social Care Providers and have improved the quality of local epidemiological data on vision impairment. A patient-based evaluation of the new pathway is planned for 2020.

Certification of Visual Impairment due to Diabetic Eye Disease in Northern Ireland From 2014 to 2019

“…Previous annual certification reports showed that Northern Ireland has lower certification rates that the rest of the United Kingdom (Canavan et al, 1997). The Northern Ireland Developing Eyecare Partnership developed a plan in 2014 to improve certification rates in Northern Ireland (Jackson et al, 2020). In 2017, all certification processes and pathways were reviewed and improved (Jackson et al, 2020).…”

“…The Northern Ireland Developing Eyecare Partnership developed a plan in 2014 to improve certification rates in Northern Ireland (Jackson et al, 2020). In 2017, all certification processes and pathways were reviewed and improved (Jackson et al, 2020). Educational activities were undertaken in parallel to promote the new certification pathway to increase the understanding of, and compliance with, the process at both secondary care and community level.…”

“…The period of 2014-2019 was used due to improvements in the consistency of data collection and reporting by the certification team. Improved data collection and analysis were supported by the Developing Eyecare Partnership strategy, published in October 2012, allowing for more strategic and stringent data collection and compilation by a local certification team (Jackson et al, 2020). The Northern Ireland Statistics and Research Agency's population data report in June of each year was used to determine the overall population.…”

“…In Northern Ireland, the sight impairment register is composed of people who are certified as sight impaired or severely sight impairment as determined by their consultant ophthalmologist (Jackson et al, 2020). Once certified, people can access benefits and services to help them or their caregiver or both with daily activities.…”