RNIB’s Eye Clinic Liaison Officer (ECLO) service helps blind and partially sighted people maintain independence and reduces reliance on hospitals and GPs. Dr Gina Floyd and RNIB's Design and Evaluation team, talked to almost 700 patients to find out the true impact ECLOs make to people's lives.
As part of a team of specialists in research and evaluation at RNIB, I lead on, and support evaluations, of internal and externally funded projects. My main focus is carrying out the ongoing evaluation of the ECLO service, one of RNIB’s flagship initiatives.
The way this is completed is through a Patient Experience Questionnaire (PEQ), which helps us to better understand the difference ECLOs make to people’s lives in order to protect existing services from funding cuts and to expand provision across the UK.
ECLOs are situated in eye clinics to provide emotional and practical support at the point of need for all patients, family, friends and carers, acting as the bridge between social and medical provision.
Anecdotally, we know that ECLOs have a great impact on people’s lives, from information provision to emotional support, but how can we be sure if we don’t measure this?
As part of the PEQ, we surveyed 693 people (including families, friends and carers) who had received support from an ECLO within a six-month period. We asked people about their knowledge of support available to people with sight loss, emotional wellbeing, and their uptake of services.
By acting as the bridge between medical and social services, the ECLO provides people with a single point of contact and a clear pathway to further support. Quotes from patients responding to the PEQ have shown that this support can help some people maintain independent living, stay in their homes, and retain employment with the help of aids, adaptations and support services.
One patient responded to the survey, saying: “The ECLO made me feel more confident and made me feel as though I could go back to work.”
Another commented, "I can’t think of anything she didn't do. I live on my own, so she sent people who put things in my home a stair lift, wet room, and altered all the lighting.”
When asked where patients would have sought support if they had not had contact with the ECLO, 40 per cent said they would have contacted the hospital. The second most common answer was to turn to friends, family and carers. Over a quarter, would have gone to their GP, or the optician or optometrist.
This demonstrates how ECLO support helps to avoid unnecessary pressure on medical services, as well as potentially avoiding pressure on friends, family and carers. Shockingly, 15 per cent of respondents said they would not have contacted anyone, meaning some people who required support would not seek this out.
In 2016, there were over eight million people in the UK aged 70 years and over, which is projected to increase to 13.2 million over the next 20 years.
With roughly one in five people aged 75 and over expected to be living with sight loss, the potential cost to the NHS could be significant if nothing is done to improve the situation. With evidence from the PEQ, we can therefore clearly see the instrumental role ECLOs play in helping reduce the burden on medical and social services proving that the ECLO service is a vital bridge between the medical and the social services.
From carrying out the PEQ, we also found that, despite the continued promotion of the ECLO service in clinics, services still fell short of being seamlessly embedded in the clinical pathways.
When asked about improvements to the service and how they found out about it, many people noted frustration and surprise that they were not systematically made aware of the ECLO service by consultants and clinicians. This finding has led to the report’s recommendation that the referral pathway should be the focus of future improvements.
“I did not know anything about the service, I have been going to the hospital for six years and never heard of any support, you’re left in limbo. I saw a doctor I had never seen before who rang the ECLO service. I could not believe how fast things then moved and the fantastic support I have received. The simplest of things like stickers on my appliances […] have made an enormous impact on my life and independence. It is fantastic, I cannot stress enough how much of a difference it has made to my life, it’s like winning the lottery.”