Supporting people with sight loss – inclusive practice

“I am confident, I ask for help and use apps and tools. But I still miss out and feel left out when information which is just on paper and online information isn’t screen readable.” (person with sight loss who uses Edinburgh Health and Social Care Partnership services, 2024)

About this factsheet

This fact sheet helps Edinburgh Health and Social Care Partnership colleagues to deliver inclusive services to people with sight loss.

It was co-produced in 2024 by Communication Inclusion People. They worked with people with sight loss and used published evidence and advice from leading organisations as well as testimonial by a local resident with sight loss.

Factsheet development was funded by the Scottish Government See Hear Strategy.

What law and policy say services should do

The Equality Act 2010 (the Equality Act) says it is unlawful for public services to discriminate against people. They must make reasonable adjustments for disabled people to avoid disadvantage such as providing information in accessible formats.

The Patient Rights (Scotland) Act 2011 says people must:

  • be treated with dignity and respect
  • experience caring and compassionate healthcare
  • get the information and support they need to access and participate in their care. All communication must be clear, accessible and understood.

The Health and Social Care Standards state everyone should:

  • experience care and support that is right for them,
  • be fully involved in all decisions about their care and support.
  • enjoy high-quality service premises.

See Hear Strategic Framework for meeting the needs of people with sensory impairment in Scotland 2014 stresses people should be communicated with appropriately. They should be given the support they need when they need it.

Scottish Government inclusive communication guidance – Scottish Government announced in October 2024 that it intends to update national inclusive communication guidance. Public Sector Duty. Regulation will require public bodies to consider and use this guidance.

Challenges accessing services

Accessing one-to-one health and social care services typically involves a person going through these communication steps. People with sight loss experience challenges at every step.

  • finding out about the service
  • contacting the service
  • having a meeting at home, in the community, at an office or clinic
  • follow up or ongoing interaction with the service.

Here are some challenges people told us or reported in research. The diverse needs of people with sight loss are not always well understood. For example:

  • People with the same kind of sight loss can have different support needs.
  • A person’s needs can vary depending on the situation or issue. For example, depending on if it is a routine or first appointment, a vaccine or a sexual health need.
  • A person’s independence is affected by their confidence, the availability of inclusive environments, support from others, access to and their use of aids and technology.
  • People with dementia and sight loss experience multiple problems with spectacles including reluctance to wear glasses and missing or broken glasses. This was particularly common in care homes.
  • Services that use limited channels to communicate. For example only having information and booking systems on paper only, with no phone, text, online or email information options.
  • Receiving printed letters and information after asking for an alternative format such as audio.
  • Website pages and downloads that are not screen reader friendly.
  • Premises with:
    – poor signs
    – cluttered room layout
    – low lighting
    – low colour contrast between walls and furniture.
  • not enough information about how to get there and parking for disabled people.
  • Being given too much spoken information at once.
  • Needing more information about what is happening or about to happen during an appointment.

What you can do – inclusive communication good practice

Be aware of population needs and impacts

  • Edinburgh is home to between 11,274 and 17,500 people with significant sight loss. This population is expected to double by 2031 to between 22,500 and 35,000.
  • Sight loss is linked to dementia, diabetes, stroke, depression, high anxiety, learning disability and traumatic brain injury. It is two and half times more common among people living in care homes.
  • People with sight loss have poorer health outcomes than others. They do not have equal access to services.
  • Hidden and/or untreated sensory loss can be misinterpreted as symptoms of advancing dementia.
  • Sensory impairment is a major contributor to falls, admission to hospital, and onward admission to a care home.

Find out people’s communication and access needs and preferences

  • Ask people about their access and communication needs and preferences on referral forms, self-referral forms or on first contact. Record these in personal files and keep your record up to date.

Act on needs and preferences in the way you provide service

  • Access training, guidance and support listed below.
  • Act on the law. Be flexible. Provide adjustments if people ask for them.
  • Read and act on individuals’ recorded communication and access needs before, during and after appointments.
  • Always use communication-inclusive speaking. Break it up, say things in an easy-to-follow order, use simple sentences and everyday words. Speak clearly at a good pace.
  • Always use communication-inclusive writing. Break it up, write things in an easy-to-follow order, use simple sentences and everyday words.
  • Do not restrict communication to phone or online only. Provide the same information on different channels while adhering to your organisation’s digital security rules. Offer to communicate in person, in print using Braille, large print, by phone, text, online by email or webchat, or via Relay UK or a supporter. Let people use aids, apps such as Seeing AI
  • Provide accessible, up-to-date information on premises including the address, public transport, nearby landmarks, front door location, parking, and Guide Dog friendliness.
  • People may choose to have a supporter such as a family member, friend or paid carer. They can help to make appointments, with travel, sighted guiding and communication. Accommodate and recognise supporter roles.

When you are interacting with people with sight loss

  • Before you meet – read the person’s communication and access needs record.
  • Organise the space. Put things in the same place for every session including coats and bags. Use a ‘clock’ system (that is place things at “12 o’clock”, “3 o’clock” etc positions in front of the person) and bold colour contrast to lay objects out. Guide the person’s hand to items if they want you to.
  • Use communication-inclusive speaking and written materials.
  • Don’t shout or speak very slowly. It’s okay to use terms like “See what I mean”.
  • Speak directly to the person, not their supporter or dog.
  • Say the person’s name so they know you are talking to them.
  • Say hello and introduce yourself when entering a room. Make sure the person knows you are there. Never leave a room without telling the person you are going.
  • If you are moving about, offer the person “sighted guiding”. Not everyone will want this.
  • Ask the person what you can do to make communication easy for them. Avoid making assumptions.
  • People can’t see nonverbal cues. Say what you are doing. Let them know verbally that you are listening. Let them feel the equipment you use.

Information and support

Training videos

Guidance

Training, communication support providers

Services

Download as a pdf