Eye Health Aotearoa Strategic Plan 2021-2024 HTML

EYE HEALTH AOTEAROA STRATEGIC PLAN 2021 - 2024

About Eye Health Aotearoa

Eye Health Aotearoa Trust (Charities Register registration number CC41236), is the unified voice for the New Zealand eye health sector. We’ve banded together to ensure that all New Zealanders can access equitable, quality eye health services and prevent avoidable vision loss, in line with the WHO World Report on Vision 2019 and the 2030 Insight Strategy). Our plan is affordable and achievable. It will significantly improve New Zealanders’ eye health and reduce costs elsewhere in the health system. It targets high-risk communities who are unable to access eye health services.

We advocate for all New Zealanders to have access to equitable, quality eye care on behalf of all New Zealanders.
We use research to gain insights and provide evidence for change. We campaign for the change that’s needed.
We strive to give effect to Te Tiriti o Waitangi.

All organisations working within, in partnership with, or with an interest in the sector are welcome to join. We are a member of the International Agency for the Prevention of Blindness (IAPB).

Trustees on the Board represent the following organisations:

Blind Low Vision NZ
Glaucoma NZ
Kāpō Māori Aotearoa
Macular Degeneration New Zealand
New Zealand Association of Optometrists
Sight Support Trust
The University of Auckland School of Optometry and Vision Science
The Royal Australian New Zealand College of Ophthalmologists
Visual Impairment Charitable Trust Aotearoa (NZ) (VICTA)

For a list of our supporters, please visit our website: www.eyehealthaotearoa.org.nz

Vision, Mission, Goals

Vision - Accessible, comprehensive eye health services for all New Zealanders.

Mission - Partner with Government to reform the New Zealand eye health system.

Goals

Government commits to measure the prevalence of eye health, and access to eye health services.
Government is convinced that the system is broken and needs to be reformed based on evidence.
Government provides fully funded eye health examinations for disadvantaged children and young people under 18 years of age, low income groups including Work and Income beneficiaries, and Community Service Card holders.

The Impact of Vision Loss

The eyes are the windows to our world. Almost 80% of sensory information our brain receives comes from our eyes. Globally, 1.1 billion people are living with avoidable vision loss^[1].

Latest estimates suggest that one in every 24^[2] New Zealanders is living with vision loss. The total cost of vision loss in 2017 was estimated to be over half a billion dollars^[3].

Vision loss can have a devastating impact on thousands of people's lives. Not only those experiencing vision loss, but those who love and care about them.

People with vision loss are:

far less likely to be employed^[4];
three times as likely to experience clinical depression^[5];
twice as likely to fall and four times as likely to suffer hip fractures^[6].

Eye Health Aotearoa recognises that the eye health system is facing complex challenges. While recognising these, we recommend eight effective interventions based on the latest evidence to increase equitable access to quality eye health for all New Zealanders. These interventions are in-line with the key pillars of the IAPB 2030 Insight Strategy: Activate, Elevate, Integrate; and with the Global eye health targets 2030.

Our Strategy

Sustainability - Ensure strong governance with effective and sustainable structures and systems.

Ensure the Trust can cover its operational running costs (e.g. salary for a part-time administrator/fundraiser)
Confirm Eye Health Aotearoa's mandate as the umbrella advocacy organisation on eye health policy in New Zealand.
Seek letters of support from member organisations to affirm Eye Health Aotearoa's mandate.
Identify funding for specific Eye Health Aotearoa projects that add value to member organisations' priorities like World Sight Day, the WHO Eye Care Situational Analysis Tool (ECSAT) and the National Policy Dialogues.
Grow our supporter base.

Advocacy - As the umbrella advocacy organisation on eye health, facilitate policy change to improve eye health and vision care outcomes.

Advance policy changes to address eye health and vision care inequity for Māori, Pasifika, older New Zealanders, and people in rural and remote communities.
Address eye health and vision care inequity and inequality on the basis of ethnicity, gender, age and location.
Back eye health and vision care services that are culturally safe, age inclusive, timely, coordinated and on an equal basis throughout New Zealand.
Celebrate World Sight Day annually to raise public awareness of and educate on the importance of looking after your eyes.
Encourage policy changes that empower people who are blind, deafblind or have low vision to remain independent and participate fully in the community.
Influence through the Parliamentary Friends of Eye Health and Health Select Committee.

Evidence - Strive for evidence-based eye health and vision care policy.

Commission the WHO Eye Care Situational Analysis Tool (ECSAT).
Obtain a commitment from Government officials to acknowledge the need to measure the prevalence of eye health, and access to eye health services, in this term of office and justify this with a high-level proposal, including cost benefit analysis for the National Eye Health Survey.
Continue to offer our collective advice to Government, and other decision makers, to improve evidence-based decision making on eye health and vision care.
Provide a detailed proposal to Government on what should be included in funded eye health examinations.

Leadership - As an umbrella advocacy organisation, our aim is to partner with Government to find solutions that improve the eye health and vision care system.

Ensure the Māori Health Authority is aware of the importance of improving eye health and vision care outcomes for Māori.
Confirm and implement Eye Health Aotearoa’s Māori and Pacific Action Plan to give effect to Te Tiriti o Waitangi.
Ensure Health New Zealand prioritises eye health policy and improving eye health and vision care outcomes for New Zealanders in its mandate.
Be a think tank for innovation to improve eye health and vision care services for New Zealanders to reduce avoidable blindness.
Seek consensus, while respecting that member organisations may have differing opinions from time to time.

Eight Point Plan summary

Campaign for a National Eye Health Survey. As a first step, commission the first New Zealand survey using the WHO Eye Care Situation Analysis Tool (ECSAT).
Convene a series of National Policy Dialogues using the ECSAT data as a starting point.
Raise public awareness of and educate about the importance of taking care of your eyes. Celebrate World Sight Day annually to highlight the importance of eye health and vision care.
Advocate for funded eye examinations as a first step to increase equitable access to eye health services for at risk and hard to-reach populations.
Promote the “New Zealand Vision Bus” programme which will deliver funded comprehensive eye examinations to key groups.
Advocate for timely access to quality treatment services to prevent or slow down vision loss.
Raise public awareness of the importance of early support for people diagnosed with eye conditions or vision loss.
Campaign for Government to ensure rapid access to comprehensive vision rehabilitation, habilitation, and low vision services.

Eight Point Plan detail

Establish a benchmark against which to plan for and measure progress in eye health and vision care.

New Zealand’s eye health policy, planning and programmes should be supported by high-quality research and data collection systems. But New Zealand has no formal data on the prevalence or causation of vision loss. Other countries like Australia have strategies, policies and frameworks that give them up-to-date representative data on eye health conditions. As a result, New Zealand has no comprehensive eye health strategies, policies or frameworks to plan for and measure progress in eye health and vision care. The first step in correcting this is to get truly representative and current New Zealand population-based data on the prevalence and causes of vision impairment.

Intervention 1

Conduct the first ever National Eye Health Survey in New Zealand, to inform future planning and funding decisions. New Zealand can learn from the Australian experience of running their first National Eye Health Survey. As a first step, commission the first New Zealand survey using the WHO Eye care situation analysis tool (ECSAT). As a first step, commission the first New Zealand survey using the WHO Eye Care Situation Analysis Tool (ECSAT). This will be the first ECSAT for New Zealand and the only pilot in a High-Income Country.

Educate the public about the importance of taking care of their eyes.

Every New Zealander needs to recognise the importance of protecting themselves against eye injury and disease, and then to know how to take care of their eyes at all stages of life. The New Zealand Association of Optometrists recommends a comprehensive eye examination every two to three years or sooner if you suspect something is wrong. But currently, not all New Zealanders regularly have eye examinations, mainly because they are unaware of the important role they play in maintaining eye health. Some of the major eye conditions that cause, vision loss do not display any symptoms in their early stages. If more New Zealanders were aware of the need for regular eye examinations, we would be able to catch eye conditions earlier and help people get the treatment they need.

Intervention 2

Convene a series of National Policy Dialogues to:

Develop a national strategic eye health integration plan
Agree a timeline and process for developing a national eye health strategy
Use a stakeholder map to identify roles, resources and responsibilities Report on the Eye Care Situation Analysis Tool (ECSAT) findings

Intervention 3

Raise public awareness about the importance of taking care of your eyes. Celebrate World Sight Day annually so people know how to take care of their eyes at every stage of life.

Advocate for Government to increase funding for Eye Health Awareness, Education, Treatment and Rehabilitation.

Our vision changes throughout our lifetime. Many New Zealanders currently don’t have regular eye examinations as they will only see an optometrist if their ability to see is being affected, and many aren’t aware that an eye examination every two years can detect early chronic diseases and save sight. Some New Zealanders, like those who have a Community Services Card, don’t have regular eye examinations.

These hard-to-reach New Zealanders (by geography and socioeconomic outcomes) are less likely to go to an optometrist. These populations may have never had an eye examination before, which is the first step in accessing treatments, supports, and rehabilitation. The 2016 Australian National Eye Health Survey showed that almost two thirds of vision impairment can be fixed with a pair of glasses. We can assume that the situation would be similar in New Zealand.

Intervention 4

Advocate for funded eye examinations as a first step to increase equitable access to eye health services for at risk and hard to-reach populations. For example, Māori and Pacific Island communities are known to have a disproportionately high risk of eye disease, and vision loss.

Intervention 5

Promote the University of Auckland School of Optometry and Vision Science “New Zealand Vision Bus” programme. This programme will deliver funded comprehensive eye examinations to key groups like geographically isolated communities, those in lower socio-economic communities, children, and those in high-risk groups.

Timely access to eye health treatments prevents or slows down vision loss.

If people access the right treatment at the right time, they can either have more time to adapt to vision loss, or carry on with their lives. But each year, more people are going blind and losing their vision due to lags in accessing treatments. Eye health professionals care about providing the best eye health for New Zealanders, yet system level issues mean there is an overwhelming demand for these services. This could be resolved by working with eye health professionals to decide where to target extra funding, where it can improve systems and support the professionals to deliver timely eye health services.

Rapid access to support at the time of vision loss is essential if people are to maintain their confidence and independence.

People with newly diagnosed eye conditions should be told what support and services are available.

For example – Glasses loan scheme. Someone on a low income or benefit may not know about Work and Income’s glasses loan that helps with the cost of eye examinations and glasses. We know that currently people are falling through the gaps, and managing a deteriorating quality of life, before they access the right support and services. Systems for providing all people diagnosed with a vision threatening condition should be put in place to enable a rapid assessment of the needs of the individual, immediate advice and onward referral to appropriate health, social care, and consumer group support services.

When people experience vision loss, they should have timely and rapid access to rehabilitation and low vision services to help them learn to live with vision loss. Trained professionals deliver essential support services. Counselling supports people to come to terms with vision loss. Services like adaptive daily living training enable people to continue living independently. Habilitation teaches children to live with vision impairment at each stage of life. We know that currently many people experience a deteriorating quality of life because they do not access comprehensive vision rehabilitation services. Currently there are not enough trained professionals to deliver these services. Investing in rapid access to comprehensive vision rehabilitation could provide social returns on investment as high as $3 for every $1 invested.

Intervention 6

Advocate for timely access to quality treatment services to prevent or slow down vision loss. Working with eye health professionals to inject funding and resources into the right treatments will remove existing backlogs, ensure timely access to treatments, and decrease avoidable vision loss in New Zealand.

Intervention 7

Raise public awareness of the importance of early support for people diagnosed with eye conditions or vision loss. Early support services should be available at every eye clinic and optometry practice, allowing people to start to rebuild their lives following the devastating news that they are losing their sight.

Intervention 8

Campaign for Government to ensure rapid access to comprehensive vision rehabilitation, habilitation, and low vision services. You cannot learn the new skills to live an independent life with vision loss in a few weeks. An additional injection of about $10 million is needed to deliver core vision rehabilitation to those who currently qualify but do not access core vision rehabilitation services. This funding needs to be complemented by strategies to grow the specialist workforce required to deliver these services.

Make Eye Health Count in 2023

Implementing these eight effective interventions will improve New Zealanders access to equitable, quality eye health services and prevent avoidable vision loss. We believe this is a good start for our first national eye health plan. This is how we will close the eye health and vision loss gap.

We call on all the Parliamentary Parties to make eye health count in their 2023 pre-election health policies by committing to our eight point action plan.

Are you with us?

[1] World Health Organisation (WHO). World Report on Vision. 2019. https://www.who.int/publications/i/item/9789241516570

[2] Worked out by dividing the New Zealand population estimate as at 31 March 2019 (4,957,400) divided by approximate number of New Zealanders with vision loss (200,000) - https://www.stats.govt.nz/topics/population.

[3] The Economic Cost of Vision Loss in New Zealand 2017. A Report prepared for the New Zealand Blind Foundation by Keith Gordon Ph.D. Blind Foundation Research Director. Available on request. Note this is an update of the Clear Focus: The economic impact of vision loss in New Zealand in 2009 report

[4] Disability, education and the labour market: A longitudinal portrait for New Zealand – AUT January 2016 - https://bf- website-uploadsproduction.s3.amazonaws.com/uploads/2016/04/Disability-education-and-the-labour-market-A- longitudinal-portrait-for-New-Zealand.pdf

[5] Rovner B, Ganguli M. Depression and disability associated with impaired vision: the MoVies Project. Journal of the American Geriatrics Society 1998;46:617-9.

[6] Klein BEK, Moss SE, Klein R et al. Associations of visual function with physical outcomes and limitations 5 years later in an older population. The Beaver Dam Eye Study. Ophthalmol 2003;110:644-650 Klein BEK, Klein R, Lee KE et al. Performance-based and self-assessed measures of visual function as related to history of falls, hip fractures and measured gait time. The Beaver Dam Eye Study. Ophthalmol 1998; 105:160-164.