Progress of See Hear strategic framework: FOI release

Information requested

In 2014, 'See Hear - A strategic framework for meeting the needs of people with a sensory impairment in Scotland' was published. A specific area of priority was older people's services including recommendations for:

• The introduction of basic sensory checks
• Scoping the range of formal and informal training opportunities for care staff and working with education providers to build content into core training regimes
• Auditing of the skills base of care staff with steps taken to address any identified deficits. 

I would be grateful if you could provide information on the following:
1. A breakdown of how the £2 million funding was allocated and spent.

2. To what extent the 7 recommendations were implemented and the areas outstanding with specific attention to Recommendations 1-3, care homes for older people and care staff training in sensory loss. 

3. In relation to 10.4 of the publication, what outcomes measures were agreed by the Scottish Government and partnership leads to allow measurement of improvement over years 2014/15 and 2015/16 and what remaining aps to be addressed thereafter were identified.  

Response

1. The table below how the funding was allocated to each local authority in each of the financial years 2013/14 and 2014/15. The distribution was based on the total population per Local Authority area and has been rounded to the nearest £1000.

Local Authority
Aberdeen City	0.041
Aberdeenshire	0.046
Angus	0.021
Argyle and Bute	0.016
Clackmannanshire	0.015
Dumfries and Galloway	0.028
Dundee City	0.028
East Ayrshire	0.022
East Dunbartonshire	0.019
East Lothian	0.018
East Renfrewshire	0.017
Edinburgh, City of	0.087
Eilean Siar	0.015
Falkirk	0.029
Fife	0.067
Glasgow City	0.107
Highland	0.042
Inverclyde	0.015
Midlothian	0.015
Moray	0.017
North Ayrshire	0.025
North Lanarkshire	0.061
Orkney	0.015
Perth and Kinross	0.027
Renfrewshire	0.030
Scottish Borders	0.020
Shetland	0.015
South Ayrshire	0.020
South Lanarkshire	0.057
Stirling	0.017
West Dunbartonshire	0.017
West Lothian	0.031
	1.000

The Strategy made it clear that after the initial 2 years funding of £1m/year, partnerships would still be required to continue to deliver the recommendations set out in the Strategy. The See Hear strategy has been, and continues to hold a direct influence and benefit for people living with sensory impairment across the country and the Scottish Government has committed the bulk of the annual budget for the strategy since 2016/17 (£320,000 each year) to support the continuing delivery of the recommendations locally. The See Hear budget since 2014 totals almost £4.5 million, as can be seen in the table below.

Financial Year	See Hear Funding
2013/2014	£1 million to local authorities
2014/2015	£1 million to local authorities
2016/2017	£478,000 of which £320,000 to local authorities
2017/2018	£478,000 of which £320,000 to local authorities
2018/2019	£478,000 of which £320,000 to local authorities
2019/2020	£478,000 of which £320,000 to local authorities
2020/2021	£478,000 of which £320,000 to local authorities *

From 2016/2017, £320k has been distributed annually to local authorities and used to achieve the recommendations set out in the strategy through localised sensory partnerships between statutory and third sector organisations who are responsible for identifying local priorities, developing work streams, timescales and implementation plans, based on local priorities and need. This ensures a responsive, flexible approach to deliver person centred outcomes, support and care. See Hear Leads have been nominated to help drive progress across priority areas within the local partnerships, insofar as local resources allow, and it is recognised that local partnerships will adopt different approaches and that the level and pace of progress towards the achievement of outcomes will accord with local circumstances.

It should be noted that this £320K is an additional investment and it is the responsibility of Local Authorities to determine local service needs and priorities for delivery. This approach was agreed with COSLA and their Settlement and Distribution Group. The Scottish Government has not been prescriptive in setting out detailed implementation activity, as we recognised that local Sensory Impairment Leads working together with partners, are best placed to decide how this money can be spent to support the Strategy and ensure that any activities fall cohesively within the Strategy’s priorities.

See Hear funding is provided as part of the General Revenue Grant paid to local authorities, and this being the case, a breakdown on how the amounts are spent within the allocation is not held.

The balance of the funds in the table above has been used over the years to support national priorities as well as the See Hear National coordinator’s post and more recently the development of the Sensory Hub based at the Health and Social Care Alliance where the National See Hear Coordinator is based. The Hub now brings together deafscotland and the Scottish Council on Visual Impairment (SCOVI), working together as sectoral networks and the Scottish Government provided additional funding in 2020/2021 * to support this development.

2. You asked about the outcome measures agreed by the Scottish Government and partnership leads, to allow measurement of improvement over years 2014/15 and 2015/6 and what remaining gaps to be addressed thereafter were identified. The role of the See Hear National Coordinator, based in the Health and Social Care ALLIANCE, and working in partnership with the Scottish Government’s Assisted Communications Policy Team, is to ensure a clear national direction and priority for the delivery of the ‘See Hear’ Strategy; lead, influence and drive the ‘See Hear’ Strategy delivery programme, to ensure continuity and retain the Strategy’s profile; support local Partnership Leads to plan, develop, implement, improve and evaluate the recommendations set out in the ‘See Hear’ Strategy and consistently embed its principles across Scotland.

The Scottish Government with the support of the See Hear National coordinator asked the Sensory Impairment Partnership Leads to take stock of progress in the first 18 months of the Strategy towards improving outcomes for Sensory Impaired people across Scotland; what had been achieved and what more needed to be done.

There was clear evidence of significant positive progress being made across all of the recommendations and, as expected, the level and pace of change/progress varied across authorities to meet local priorities and within available resources. Much of the first 18 months was spent capacity building, including identifying, engaging and establishing local partnerships and assessment of local priorities and actions required. At a national level a network of the Partnership Leads was established and met quarterly to share progress, ideas and best practice. No ‘one size fits all’ approach would have been appropriate, and local partnerships adopted different approached, although many invested funds in specialists/engagement officers to take forward the work.

Best practice examples identified in the first 18 months included the following -

• That a partnership approach to the delivery of See Hear actions worked very well
• That establishing Hearing aid battery service pick up points in local libraries and some health centres, resulted in the following tangible results
• 45% decrease in the number of battery packs issued per week through audiology
• 32% reduction in number of personal visits to audiology for battery collection
• 74% decrease in postal service users
• The trial of smoke detectors for deaf people
• Providing an iPhone for a blind user meant there was no requirement for the longer term care at home support, which resulted in resources being used more effectively
• The development and production of Accessible training resources for professionals and agencies in the form of ELearning modules
• Established screening project in Care homes.

As to the extent to which the 7 recommendations were implemented and the areas outstanding, with specific attention to Recommendations 1-3, care homes for older people and care staff training in sensory loss, the following gives more detail of some of the achievements made during the first two years:

Set up and capacity building

• Local areas were invited to nominate See Hear Leads to implement the Strategy locally
• Sensory Impairment strategic planning groups and partnerships were established across Scotland, which generated capacity building, assessed local priorities and took forward actions to respond to these priorities
• Partnerships invested Scottish Government funds in specialists/engagement officers to take forward the mapping and planning of the Strategy in some local areas
• A Partnership Leads Network was established, facilitated by the National Coordinator for See Hear, to meet quarterly to share progress, ideas and best practice
• See Hear National Co-ordinator provided support by working in close collaboration with local and national partners including local See Hear Partnership leads. The post is funded by the Scottish Government and is based in the Health and Social Care Alliance Scotland in Glasgow.

Training and development

• A training and development working group was established to introduce accessible training resources for professionals and agencies in the form of e-learning modules on deaf awareness and sight awareness recognised by NHS Education Scotland (NES)
• Work was undertaken with Glasgow Caledonian University and partners to develop an accredited Scottish based training course for low vision rehabilitation workers, and seeking to embed the key elements of this in the mainstream training programmes of other crosscutting professions.

Actions on the ground

• Mapped care pathways for vision, hearing and children in most areas. Some areas extended this work to consider the impact of stroke and learning disability on care pathways
• Introduced screening projects in care homes in some local areas
• The Scottish Government successfully commissioned and funded a digital solution for British Sign Language (BSL) Users - contactScotland-BSL. This is the UK’s first publicly funded online BSL video relay service, which uses digital technology to enable BSL users to self-manage their own calls by providing access to public, voluntary and private sector numbers on a 24/7 basis, and facilitating these services to contact them
• Some local areas, such as Lothian, established hearing aid battery service pick up points in local libraries and some health centres, which brought efficiency savings and other benefits
• Introduced smoke detectors for people who are hard of hearing (e.g. Dumfries and Galloway)
• NHS Forth Valley in partnership with the Forth Valley Sensory Centre introduced an interpretation and translation service to provide communication support for people who are Deaf, Deafblind and hard of hearing 24 hours a day, 365 days a year enabling them to communicate with services when they needed them
• Took forward the Government’s manifesto commitment to enhance community audiology services and testing
• Continued to work with local and national partners to take forward the Scottish Government’s commitment to implement nationally the learning from the two pilots of the Local Record of Deaf Children. Considered how best to extract information from current patient management systems on the number of children in contact with NHS Audiology Services and how best this information could be used to support deaf children and their families
• Continued to work with the Visual Impairment Network for Children and Young People (VINCYP) to support children and young people with a visual impairment, and to improve the care available to them and their families.

With regard to your question about other information on sensory loss training for care home staff, staff in care homes need to have an accredited qualification e.g. a SVQ in social care with the level of qualification dependent on the role they undertake. It is an employer’s responsibility to ensure that staff have the skills and knowledge to carry out their role and support their staff to attain these. If specialist training is required e.g. sensory training for the role, that is a matter for the employer.

As mentioned above, the Scottish Government provided funding to develop accessible training resources in the form of 3 e-learning modules on deaf awareness, sight loss awareness and dual sensory impairment, recognised by NHS Education Scotland (NES). These training modules are available to anyone on the NHS Education for Scotland website: https://learn.nes.nhs.scot/. In Greater Glasgow and Clyde, this training is mandatory for all Health and Social Care Staff, including council elderly care staff. These modules have been shared with the See Hear partnerships nationally, and can be accessed by anyone by registering and creating a username and password.

3. In addition, the Scottish Government provided funding for more than 100 health and social care professionals to access Sensory Champions Training over the years 2018 and 2019. This training was designed to increase awareness of sensory loss and to provide practical advice on adapting the care provided to be more affective and supportive for those with a hidden or undiagnosed sensory loss, which may be present in people with learning disabilities or conditions such as dementia or stroke and was rolled out in Edinburgh and Lothian and Argyll and Bute.

The Third Sector also worked together to produce guidance for health and social care workers during the pandemic which offered advice on communication with people with sensory loss, including those who have a learning disability, autism or both, and can be found at this link. A number of the organisations involved and listed in this can provide further information on additional resources they have produced for care settings. Please note Royal Blind are now known as Sight Scotland and Action on Hearing Loss are now known as RNID and the links in the guidance will take you to their current websites.

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