“Listen to each other, understand each other and appreciate each other”
Anita Lightstone, UK Vision Strategy Programme Director and interim Chief Operations Officer of VISION 2020 UK is stepping down this summer. Hannah Flynn asks her about the lessons learned over a career in the eye health and sight loss sector.
The UK Vision Strategy has come a long way since its inception in 2008, and soon-to-retire programme director, Anita Lightstone has seen it develop from its beginnings through to it playing a key role in raising awareness of eye health and sight loss issues across the UK, for example defining the Public Health Indicator for Eye Health, launched last year.
Starting out in the eye health sector as an optometrist, Lightstone has worked in many roles, from the high street, to the lecture theatre (she was a senior lecturer at the Institute of Optometry in London focusing on children and adults with learning disabilities) and then on to the voluntary sector where she has worked for RNIB and VISION 2020 UK.
In these roles Lightstone has worked with people and professionals from across the sector. She is passionate about ensuring that the sector as a whole “speaks with one voice” and keen to point out that united and consistent messages are hard to argue with.
She recalls: “When on secondment from RNIB to the Department of Health, I was in a meeting with the minister who said that when patients and professionals spoke with the same voice it was a very powerful voice that could not be ignored, and that’s when I thought ‘that is what I want to achieve’.”
Lightstone claims that the role of directing the UK Vision Strategy has enabled her to make significant inroads into achieving these ambitions.
She was appointed to the role of programme director of the UK Vision Strategy in 2008, first project managing the development of the Strategy in 2007 through to its launch the following year. In 2012 she took on the role of interim Chief Operations Officer of VISION 2020 UK.
A changing sector
Since Lightstone started working in the eye health sector as an optometrist the biggest change she has seen over the years in the sector has been a “greater appreciation” for the different professional roles.
“The silos between the different professionals have really reduced,” she explained.
“Traditionally, there were a lot of professional divides in the eye health sector, particularly between secondary and primary care, as they worked in different ways and in different areas.
“They often didn’t work together and therefore the patient pathway wasn’t as joined up as it should be,” she said.
There has also been a significant change with regards to the way the needs of patients with sight loss are recognised. One clear example of this has been the development of the Eye Clinic Liaison Officer (ECLO) role, she said.
“The importance of getting the right information to people when they are diagnosed with sight loss is now much more appreciated on the eye health side and organisations such as RNIB are really helping to get the information about that out there, and it is really interesting to see the change that has taken place with regards to increased awareness of the need to support patients.”
There was also the opportunity for more information sharing within the sector due to the increase in working between different professions.
“I can remember back to the very first seminar to get the UK Vision Strategy in development and it was a seminar and workshop to get ideas about how we could work to improve the sector.
“Interestingly, some of the best ideas about improving eye health services came from the people in the voluntary sector and people with sight loss, and some of the best ideas for improving sight loss services came from the eye health sector,” she remembers.
This reflects another big change she has seen since starting work in the sector, which is the increased value professionals place on other professional group’s input.
“If people are organising a new programme or a new project they now think cross sector, they think ‘who else should we include?’, ‘who else do we need to talk to?’, rather than just doing it in their own silo, which was all too often common practice.”
This has led to more consistent messages coming from the sector, she felt.
These consistent messages may have lead to what Lightstone considers possibly be the greatest achievement: the Public Health Indicator for Eye Health. The indicator means that the Government is making preventable sight loss a top public health priority, alongside issues like dementia and obesity. The indicator, launched last year, is a clear signal that eye health and reducing avoidable sight loss are high on the Government’s agenda.
She was “delighted to get the public health indicator for eye health”.
“Though it wasn’t just me and that needs to be said loud and clear. It was the sector working together, it was so good to really work with others from across the sector and see it coming together,” she added.
However, the eye health and sight loss sectors need to remain vigilant about the challenges that it is facing now and will be in the future. The financial pressures on local government and the NHS could mean that eye health and sight loss services will have to be increasingly fought for.
“The sector needs to make sure that local authorities and commissioning bodies understand cutting eye health and sight loss services will not reduce costs and the longer term effect is that it will impact many other areas of service delivery and will increase costs,” she argues. The sector also needs to make sure it has strong, good evidence based arguments to support them.
“Complaining and campaigning” was the correct thing for charities to do, but she argued that “we need to make sure we have a cost effective solution that we can offer commissioners. One that is evidence-based and we will help them put it into place. That is not to say we will do it free of charge but we will work with them and not against them”.
One area she wished she had seen develop further were rehabilitation services, and believed that this aspect of the sector would change greatly over the next couple of years.
“The VISION 2020 UK rehabilitation and low vision group is working hard to bring constructive change to the world of habilitation and rehabilitation and it would have been lovely to have seen good services established throughout the United Kingdom,” she says.
Enabling equal and timely access to eye health and sight loss services is another aspect of patient care that she wished she had seen more of, but acknowledged “that is a very big aim”.
Not goodbye but au revoir
Lightstone took the decision to retire last year, and is looking forward to her retirement and has a lot planned.
She is looking forward to taking up playing the church organ again, having previously been a church organist and music director at her local church. She gave up this role when she started working with RNIB, but is interested in getting behind the keyboard again.
“I loved working with young people. As part of my role as the music director at the church I ran a young peoples’ choir.
“It was a very formal Church of England church; the young people had to be robed and lined up to do the service, and wait for the vicar to take them up the aisle.
“I really enjoyed seeing these people develop the responsibility at that young age of making sure everything was just right: they had the right hymns ready and the music was at the right place. That was really great,” she recalled.
Lightstone is also planning on travelling, saying that her ambition is to travel to Victoria Falls in southern Africa. She is also planning on moving closer to the Thames in order to take up sailing again, having sailed dinghies in the past.
Having spent so long working in the sector, Lightstone is keen to note that she expects to keep up to speed with the sector after she steps down from her role and enters retirement, following the recent Vision UK 2014 conference.
“I hope I don’t disappear out of the sector altogether, I am too keen to see it go forward,” she said, adding, “I may consider a trustee role or engaging in project work; I do hope to keep in touch with the sector in that sort of way.”
Though she promises to stay involved, she offers one final piece of advice to the sector when facing the challenges that lie ahead: "People should listen to each other, understand each other and appreciate each other.”