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EPIOC Provision for People with Visual Impairments A National Review of Eligibility Criteria

This national review examines the eligibility criteria for EPIOC provision for people with visual impairments, highlighting discrepancies and potential discrimination. It suggests strategies to ensure fair assessment and compensation for users.

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EPIOC Provision for People with Visual Impairments A National Review of Eligibility Criteria

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  1. EPIOC Provision for People with Visual ImpairmentsA National Review of Eligibility Criteria

  2. IntroductionLisa Douglas – Senior OTJames Hollington – Senior RE Sussex Rehabilitation Centre, Brighton

  3. “the assessment may involve a very stringent interpretation of the Eligibility Criteria designed to minimise the outgoingsof the Wheelchair Service” and that “local interpretation” results in a “postcode lottery” Hard Pushed (2004), Fully Equipped (2002)

  4. Assessment Factors to Consider: Out and About (2006)

  5. Mr Hammond

  6. So what did we do?

  7. EPIC Risk Assessment Oh, did I mention he’s blind? ! ! ! ! ! EPIOC Special Issues Panel

  8. Requirements for powered wheelchair driving

  9. Snellen scoring 6/60 • Normal visual acuity is called 6/6 6/36 6/24 6/18 6m 6/12 6/9

  10. So what are the requirements?

  11. Requirements No legal eyesight requirement for users driving Class 2 or 3 vehicles • DVLA Guideline for Class 2 or 3 vehicles Read car number plate from 12.3m (40ft, 6/24?) and monitor • Driving Requirements for car Read car number plate from 20m and min field of vision 120o horizontal and 20o vertical plane

  12. Findings

  13. Do services assess service users with visual impairments for EPIOC provision to see if they can compensate either independently or with support?

  14. Variability of visual ability requirements which a service user would have to achieve in order to be considered eligible for EPIOC assessment

  15. Conclusion

  16. SUMMARY • No legal eyesight requirement for users driving Class 2 or 3 vehicles • This study highlights big discrepancies in eligibility criteria across the country • Could be argued that service users with visual impairments are sometimes being discriminated against CONCLUSION • Service users should be given the opportunity to show whether they can compensate • Question all areas of your local eligibility criteria • This study highlights the value of us all sharing our knowledge and how our services work

  17. Thank you

  18. References • Audit Commission (2002) Fully Epuipped • Currie, Z., Bhan, A., Pepper I. (2000) Reliability of Snellen charts for testing visual acuity for driving: prospective study and postal questionnaire. BMJ 321:990-992 • Department of Health (2006) Out and About • Department of Transport (downloaded 14/01/2008) Code of Practice for Class 3 Vehicles. www.dft.gov.uk/transportforyou/access/tipws/codeofpracticeforclass3vehic6165?page=1 • Directgov (2008) The Highway Code – 36-46: Rules for Users of Powered Wheelchair and Mobility Scooters. www.direct.gov.uk/en/TravelAndTransport/Highwaycode/DG_069852. • Drasdo, N., Haggerty, C. M. (2007) A Comparison of The British Number Plate and Snellen Vision Tests for Car Drivers Ophthalmic and Physiological Optics, Vol 1 Issue 1:39-54. • Drivers Medical Group, DVLA (2007) For Medical Practitioners – At a glance Guide to the current Medical Standards of Fitness to Drive. DVLA • Greenbaum et al (1998) Use of a Motorized Wheelchair in Conjunction With a Guide Dog for the legally Blind and Physically Disabled. • Muscular Dystrophy Campaign (2004) Hard Pushed: How the NHS Fails Powered Wheelchair Users • Think! Road Safety (downloaded 15/01/2008) THINK! Advice – Older drivers: drive on! www.thinkroadsafety.gov.uk/advice/olderdrivers01.htm. • Tim Carter (2006) Fitness to Drive: A Guide for Health Professionals. The Royal Society of Medicine Press Limited. • RNIB (downloaded 10/12/2008) How does the eye consultant measure your sight? www.rnib.org.uk/xpedio/groups/public/documents/publicwebsite/public_cert_vi.hcsp. • Statutory Instrument 1988 No. 2268 Road Traffic. The Use of Invalid Carriages on Highway Regulations 1988.

  19. Possible useful post talk discussion slides

  20. Compensation Strategies Feedback from services on strategies they used to reduce risk and ensure safe : • Ophthalmologist report can highlight specific areas an assessor needs to check to ensure adequate compensation. • Supervision / assistance conditions in the conditions of loan • Agree areas of use and restrictions outside these areas • Test a user’s ability to avoid obstacles on a pathway (more applicable than number plate testing • Grade the provision - EPIC first, then build up to an EPIOC • Dual control so assistance can be given in unfamiliar areas • Regular reviews for service users that have deteriorating vision • Offer a training package to give users time to learn how to compensate • Adjust EPIOC control programmes • Discuss provision amongst colleagues and minute so provision decision is made by the service rather than the individual assessing professional • Risk assess to check that service users are no a danger to themselves or others

  21. Snellen to number plate conversions a b z y y z a b

  22. Snellen scoring 6/60 • Severely Sight Impaired (Blind) • Acuity<3/60 full visual field • 3/60<acuity<6/60 reduced visual field • Acuity>6/60 very reduced visual field • Sight Impaired (Partially Sighted) • 3/60<acuity<6/60 full visual field • Acuity<6/24 moderate visual field • Acuity<6/18 severe reduced visual field 6/24 6/18

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