• Brake joins forces with police to rid roads of defective driver vision

    Road safety charity Brake is teaming up with police forces in Thames Valley, Hampshire and West Midlands to run a month-long campaign on driver vision, revoking the licences of those who don't pass the 20m number plate check.

    Throughout September, anyone stopped by Road Policing Officers in these areas will be required to take the 20m number plate test, with those who fail having their licence immediately revoked. Data will be collected from each test and will be used to gain an improved understanding of the extent of poor driver eyesight on our roads, which is thought to be vastly under-reported in Government statistics.

    For further reading, click here

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  • Engagement on the 2019 tariff

    We have just received the following announcement regarding the NHS tariff consultation

    We are currently working with NHS England to develop our policies for the 2019 national tariff.

    Following the funding settlement announced in July, it is essential that we align the development of our tariff and pricing proposals with the development of the wider long-term plan for the NHS. Engagement with the sector will take place in that context, and the publication of proposals will be aligned with the long-term plan and the planning guidance for 2019/20 and beyond.

    Therefore, we will not be publishing a national tariff engagement document in the short term. We held a series of workshops to gather feedback on our developing policies in June and July. We will be undertaking further engagement on policies over the coming months.

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  • IGA comments on use of AI for eye disease detection

    Karen Osborn, Chief Executive “These are exciting results and there is no doubt that AI will play a role in the detection and monitoring of glaucoma. The use of technology to reduce the stress on hospital services and help optometrists with referral will ensure that people are correctly prioritised and appropriate treatment is commenced”.



    Ground-breaking research by Moorfields Eye Hospital, DeepMind Health and UCL uses artificial intelligence (AI) to help identify potentially blinding eye diseases.

    • AI system can recommend the correct referral decision for over 50 eye diseases with 94% accuracy – matching world-leading eye experts.
    • System could help doctors and other eye health professionals spot serious conditions earlier and prioritise patients who urgently need treatment.
    • An artificial intelligence (AI) system that can recommend the correct referral decision for over 50 eye diseases as accurately as world-leading experts has been developed by researchers at Moorfields Eye Hospital NHS Foundation Trust, DeepMind Health and University College London (UCL) Institute of Ophthalmology.The breakthrough research, published online by Nature Medicine, describes how machine learning technology has been successfully trained on thousands of historic de-personalised eye scans to identify features of eye disease and recommend how patients should be referred for care. It is hoped that the technology could one day transform the way professionals carry out eye tests, allowing them to spot conditions earlier and prioritise patients with the most serious eye diseases before irreversible damage sets in.More than 285 million people worldwide live with some form of sight loss, including more than two million people in the UK. Eye diseases remain one of the biggest causes of sight loss, and many can be prevented with early detection and treatment.
    • Dr Pearse Keane, consultant ophthalmologist at Moorfields Eye Hospital NHS Foundation Trust and NIHR Clinician Scientist at the UCL Institute of Ophthalmology said:            “We set up DeepMind Health because we believe artificial intelligence can help solve some of society’s biggest health challenges, like avoidable sight loss, which affects millions of people across the globe. These incredibly exciting results take us one step closer to that goal and could, in time, transform the diagnosis, treatment and management of patients with sight threatening eye conditions, not just at Moorfields, but around the world. “We’re immensely proud of this work, which once again demonstrates what is possible when world-leading clinicians and technologists collaborate to improve patient care”.
    • Matt Hancock, Health and Social Care Secretary, said: “This is hugely exciting and exactly the type of technology which will benefit the NHS in the long term and improve patient care - that’s why we fund over a billion pounds a year in health research as part of our long term plan for the NHS.”
    • Robert Dufton, chief executive at Moorfields Eye Charity, said: “The NHS has always nurtured medical breakthroughs and now artificial intelligence, although still in its infancy, has real potential to radically transform the way medicine is practiced. This exciting research provides important evidence about how AI can support doctors to provide more rapid diagnosis and treatment, freeing up clinicians’ time for direct patient care.”
    • Cathy Yelf, chief executive of the Macular Society, said:  “As optometrists are often the first port of call for people with the symptoms of eye disease, we are very excited about the potential that AI has to assist them in helping patients. Further support in prioritising the referral of the patients with the greatest need is in the interests of both practitioners and patients, and we look forward to the results of clinical trials of this technology.”Michele Acton, Chief Executive at Fight for Sight, said:  “This paper shows the power of utilizing artificial intelligence in ophthalmology. Innovative research such as this could help hospital eye services manage their clinics more effectively in the future.”
    • Professor Andrew Lotery, Chair Scientific Committee, The Royal College of Ophthalmologists, said:
    • “Artificial intelligence has the potential to help us address so many challenging health issues. We’re delighted that it is being used to help those patients most at need to receive timely access to ophthalmologists and appropriate treatments. This is a great step forward and we believe that the use of artificial intelligence will have an increasing role in addressing eye diseases in the future.”
    • Martin Cordiner, Head of Research at the College of Optometrists said:
    • “Macular disease is the biggest cause of sight loss in the UK, affecting 600,000 people. It is extremely debilitating and timely treatment for patients with wet AMD, such as Elaine, is vital. Pressure on eye clinics has resulted in delays for many patients, which has tragically led to unnecessary sight loss. We’re excited by this latest development and hope in time this technology will alleviate the pressure on clinics and mean patients will get the urgent treatment they need.”
    • Tony Young, NHS England’s National Clinical Director for Innovation, said:
    • “The need for treatment for eye diseases is forecast to grow, in part because people are living longer, far beyond our ability to meet the demand using current practice. Artificial intelligence is showing the potential to transform the speed at which diseases can be diagnosed and treatments suggested, making the best use of the limited time of clinicians. AI will also help our understanding of sight loss. Moorfields Eye Charity is proud to have funded equipment which underpins Dr Pearse Keane’s work as part of our programme of philanthropic support in pioneering researchers.”
    • “The UK leads the world in ground-breaking research and artificial intelligence has the potential to revolutionise the way we spot eye disease, and could be genuinely transformative for the NHS in the future.
    • Elaine Manna, 71, from north London and mother of three, went blind in her left eye from wet age-related macular degeneration (AMD). She is now being treated at Moorfields Eye Hospital to save the remaining sight in her right eye. She said:
    • “I lost the sight in my left eye in the year 2000 after noticing a sudden blurring of my vision. A few weeks went by and I was starting to get really worried. A doctor then told me I had a bleed at the back of my eye that needed to be treated urgently but it proved too late to save my sight. AMD has had a major impact on my life. I love going to the theatre but I find it difficult to see people’s faces and I struggle to find my way around dimly lit rooms. I really hope that technology can help people like me in the future.”
    • Professor Sir Peng Tee Khaw, director of the NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology said:
      “The results of this pioneering research with DeepMind are very exciting and demonstrate the potential sight-saving impact AI could have for patients. I am in no doubt that AI has a vital role to play in the future of healthcare, particularly when it comes to training and helping medical professionals so that patients benefit from vital treatment earlier than might previously have been possible. This shows the transformative research than can be carried out in the UK combining world leading industry and NIHR/NHS hospital/university partnerships.”
    • Mustafa Suleyman, Co-founder and Head of Applied AI at DeepMind Health, said:
    • Moorfields owns this database as a non-commercial public asset, which is already forming the basis of nine separate medical research studies. In addition, Moorfields can also use DeepMind’s trained AI model for future non-commercial research efforts, which could help advance medical research even further.
    • The work which has gone into this project will also help accelerate wider NHS research for many years to come. For example, DeepMind has invested significant resources to clean, curate and label Moorfields’ de-identified research dataset to create one of the most advanced eye research databases in the world.
    • If clinical trials are successful in demonstrating that the technology can be used safely and effectively, Moorfields will be able to use an eventual, regulatory-approved product for free across all 30 of their UK hospitals and community clinics, for an initial period of five years.
    • The next step is for the research to go through clinical trials to explore how this technology might improve patient care in practice, and regulatory approval before it can be used in hospitals and other clinical settings.
    • Secondly, the AI system can be easily applied to different types of eye scanner, not just the specific model on which it was trained. This could significantly increase the number of people who benefit from this technology and future-proof it, so it can still be used even as OCT scanners are upgraded or replaced over time.
    • The AI has been developed with two unique features which maximise its potential use in eye care. Firstly, the system can provide information that helps explain to eye care professionals how it arrives at its recommendations. This information includes visuals of the features of eye disease it has identified on the OCT scan and the level of confidence the system has in its recommendations, in the form of a percentage. This functionality is crucial in helping clinicians scrutinise the technology’s recommendations and check its accuracy before deciding the type of care and treatment a patient receives.
    • To establish whether the AI system was making correct referrals, clinicians also viewed the same OCT scans and made their own referral decisions. The study concluded that AI was able to make the right referral recommendation more than 94% of the time, matching the performance of expert clinicians.
    • Using two types of neural network – mathematical systems for identifying patterns in images or data – the AI system quickly learnt to identify ten features of eye disease from highly complex optical coherence tomography (OCT) scans. The system was then able to recommend a referral decision based on the most urgent conditions detected.
    • The study, which was launched in 2016, brought together leading NHS eye health professionals and scientists from the National Institute for Health Research (NIHR) and UCL with some of the UK’s top technologists at DeepMind to investigate whether AI technology could help improve the care of patients with sight-threatening diseases, such as age-related macular degeneration and diabetic eye disease.
    • “The AI technology we’re developing is designed to prioritise patients who need to be seen and treated urgently by a doctor or eye care professional. If we can diagnose and treat eye conditions early, it gives us the best chance of saving people’s sight. With further research it could lead to greater consistency and quality of care for patients with eye problems in the future.”
    • “The number of eye scans we’re performing is growing at a pace much faster than human experts are able to interpret them. There is a risk that this may cause delays in the diagnosis and treatment of sight-threatening diseases, which can be devastating for patients.

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  • IGA receives lottery funding

    We are delighted to have received some funding from the National Lottery.  This contribution will help us work more efficiently in providing support to people within their local community. Thank you to the players for helping to prevent glaucoma sight loss.

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    The IGA is working with the Royal College of Ophthalmology, Macular Society and the RNIB to respond to this consultation.

    Following the delay, we have now been informed that the consultation will the published at the end of July. Please check back for more information on its publication and how to respond.

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  • National Tariff Consultation June 2018 – RCOphth, RNIB, IGA and Macular Society collaborate on response

    13 June 2018

    In preparation for the National Tariff Consultation due to be released 14 June 2018, The Royal College of Ophthalmologists and patient organisations; Royal National Institute for the Blind (RNIB), International Glaucoma Association (IGA) and the Macular Society, have collaborated on key messages that will be used in response to the consultation. This group have written to NHS Improvement to make them aware of:

    • The crisis in the hospital eye service is not news, it is overwhelmed due to the needs of an ageing population and the increase in chronic eye disease requiring long term treatment and follow up care
    • How the current national tariff system adversely affects follow up patients, who are the most vulnerable group with long-term chronic eye disease

    The key messages from The Royal College of Ophthalmologists and our partner patient organisations are outlined below and we encourage patients and medical and healthcare professionals working in the hospital eye services to respond to the upcoming National Tariff Consultation.  The Royal College of Ophthalmologists encourages our members to either respond to the consultation or provide comments and feedbackto Laura Coveney, Policy Researcher,

    National Tariff – Key messages

    Eye care services are under severe/unprecedented pressure

    There has been a 20%-30% increase in clinical activity over the last 10 years so that now there are 9 million patients per annum attending hospital eye services with ophthalmology accounting for 8% of all outpatient appointments. A 30-40% increase in outpatient activity is predicted over the next 20 years. Demographic changes and treatments for previously untreatable conditions, including for long term conditions, have increased demand for services. There are not enough medical training posts to match this increased need so there are many unfilled consultant and SAS posts.

    Despite every effort to innovate and improve efficiency services cannot cope with the number of patients

    Ophthalmology is making every effort to improve in efficiency and manpower eg:

    • Converting activity from in-patient theatre to outpatients, overnight stays to day cases, and general anaesthetic surgery to local anaesthetic surgery, with more productive theatre lists
    • Increased use of the multidisciplinary team with orthoptists, optometrists and nurses working in extended roles delivering “medical” tasks and use of technicians and virtual clinics in hospitals.
    • Increased use of community optometrists for reducing unnecessary referrals and managing low risk cases in the community

    But currently there is still great difficulty in seeing the number of patients who need care.

    Ophthalmology is not all planned operations and minor disease and there are enormous numbers of patients with chronic sight threatening disease

    There is an assumption that ophthalmology is mainly cataracts and other planned operations or minor conditions. However, a significant proportion of ophthalmic patients have chronic diseases such as glaucoma, macular degeneration and diabetic retinopathy. These diseases cause loss of sight and blindness and, once the vision is lost, it cannot be regained.

    Loss of sight is devastating and costly

    Loss of sight, especially if avoidable, is devastating, reduces quality of life and independence, affects employment and the ability to drive, increases the risk or impact of numerous other health issues including falls, depression and dementia. This has a huge health and social care, and societal, cost.

    The highest risk of visual loss is in follow up patients not new patients

    The highest risk of permanent visual loss in ophthalmology is not in new patients – patients requiring follow up are 8-9 times more likely to have a chronic sight threatening condition.

    Lack of capacity is causing permanent harm in follow up patients due to delays

    There is strong evidence of the lack of capacity causing delays, particularly to follow up patients, with the highest risk of avoidable visual loss from delayed care being in chronic diseases (glaucoma, retinal conditions). Data from national incidents and research studies (British Ophthalmic Surveillance Unit) and from patient groups show about 200 patients per year with avoidable permanent vision loss since 2010. Many, many patients are becoming distressed and anxious about their delays.

    The system is biased towards protecting new patients which increases the risk for the follow up patients missing care

    Currently, the system is skewed towards favouring new patient activity over follow up, through: concentration on RTT18 targets for new patients and a lack of similar target for follow ups; no national data systems to collect outpatient delay data; commissioners efforts to drive down new to follow up ratios; and the front loading of the new patient tariff by 30% versus the follow up tariff. This is creating perverse incentives to see new patients in preference to follow ups and sends the message to providers and commissioners that follow ups are less important, which is worsening the situation already present due to inadequate capacity.

    The patient experience

    Research undertaken by the International Glaucoma Association (IGA) in 2017 shows that over 40% of their members have been adversely affected by cancellations or delays to follow up, with 22% of those experiencing delays saying that they were advised at the clinic they eventually attended that they had suffered further loss of their field of vision. This is leaving patients distressed, anxious and scared about the impact on their sight and their lives of the delays to their care.  Only the confident and persistent are able to navigate through a dysfunctional system.  Some people, who are able to afford it, refer themselves to private health care thus creating a two tier health system which is unacceptable and against the founding principles of the NHS.

    Eye patients are very clear about the value of sight and the impact on their mental health and well being through needless loss of sight.  A patient who works with The Royal College of Ophthalmologists, who has a potentially blinding eye condition and lung and breast cancer, says, ‘I would rather die from cancer with my sight intact than survive cancer blind.  What shocks me is that I have to fight for everything to do with my eyes including medication, research into my eye condition and follow up appointments in a timely fashion to avoid continued loss of sight.  However, with cancer, I am overloaded with appointments, information, support including acupuncture and counselling, medication and treatments and phone calls from various specialists, as well as approaches by researchers.  Why can’t some of this money and service be diverted into my eye care?’

    The All-Party Parliamentary Group (APPG) on Eye Health and Visual Impairment report, See the light: Improving capacity in NHS eye care in England, published in June 2018, confirms the scale of the issue and the harmful effect of delays on patients. For instance, of the 557 eye patients surveyed, just over half had at least one appointment or treatment delayed, 20% had at least one appointment or treatment cancelled and 15% reported both. For the majority of these patients this caused them anxiety, stress and had a negative impact on their day to day life. The report specifically concludes that the current national tariff for ophthalmology currently seriously disadvantages patients with glaucoma, wet age-related macular degeneration (AMD) and diabetic retinopathy who require follow up appointments and are particularly at risk of avoidable sight loss and calls for this to be urgently reviewed (recommendation 6). It also makes many other important recommendations including mandated measurement of and targets for follow up timing adherence, a higher national priority for eye care, better overall funding and staffing, and support for local and regional strategic service redesign and transformation.

    Many ophthalmology disorders like glaucoma and age-related macular degeneration are lifelong serious conditions and patients should be treated equitably and feel supported and cared for throughout life and not just at the point of diagnosis.

    The Royal College of Ophthalmologists, the RNIB, IGA and the Macular Society are calling for:

    1. A reversal of the tariff front loading structure back to 10%
    2. Tariffs for non face to face and non consultant care
    3. Avoidance of block contracts
    4. The recommendations of the APPG report addressed at all relevant levels from the Department of Health to achieve adequately funded, staffed, organised and monitored services for ophthalmic conditions for current and future demand to protect patients

    References and further reading

    APPG report on eye health capacity & demand ‘See the Light’

    RNIB. Sight loss: A public health priority. (2013). at

    IGA Eye Health Services Failing People with Glaucoma

    Macular Society

    Surveillance of sight loss due to delay in ophthalmic treatment or review: frequency, cause and outcome. Foot B, MacEwen CJ. Eye (2017) 31, 771–775

    NSPA patient safety alert:  rapid response alert on glaucoma 2009

    Davies A, Baldwin A, Hingorani M, Dwyer A, Flanagan D. A review of 145234 ophthalmic patient episodes lost to follow-up. Eye 2017; 31: 422–429.

    The economic impact of sight loss and blindness in the UK adult population. Lynne Pezzullo, Jared Streatfeild, Philippa Simkiss, Darren ShickleBMC Health Serv Res. 2018; 18: 63.

    Pezzullo L, Streatfield J, Simkiss P, Shickle D. The economic impact of sight loss and blindness in the UK adult population. RNIB and Deloitte Access Economics 2016

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  • Eye health services failing people with glaucoma

    The International Glaucoma Association response to the

    All Party Parliamentary Group on Eye Health and Visual Impairment Report

    See the light: Improving capacity in NHS eye care in England

    The International Glaucoma Association (IGA) welcomes the APPG Eye Health and Visual Impairment review. Patients with glaucoma have been badly let down by lack of financial investment, poor policy decisions and chaotic communication and administration systems.

    The report highlights the need for the forthcoming NHS Tariff review to redress the financial imbalance between first and follow up appointments. Glaucoma is a lifelong condition and we want to see a system where people with glaucoma are fairly treated and feel supported and cared for throughout life and not just at the point of diagnosis.

    Our research shows that over 40 per cent of members have been adversely affected by cancellations or delays to follow up. Members call us distressed, anxious and scared about the impact that the delay will have on their sight. Only the confident and persistent are able to navigate through a dysfunctional system.

    We have had members who have paid for private healthcare in order to avoid delays. The creation of a two tier health system is unacceptable and against the founding principles of the NHS.

    The report is clear and confident in the recommendations for financial investment, revised pricing structure, increased recruitment and the need for joined up electronic patient records. We look forward to the Government response.

    The IGA is the charity for people with glaucoma. Established over 40 years ago, it raises awareness, promotes research related to early diagnosis and treatment, and provides support to patients and all those who care for them. In addition it also part funds the IGA Professor Ophthalmology for Glaucoma and Allied Studies, Professor David Garway-Heath, at UCL and Moorfields Eye Hospital, London. Other services include a helpline, patient information, patient support groups, events for professionals and patients, as well as providing grants for research funding. It is run by a board of trustees which represents ophthalmologists, optometrists, ophthalmic nurses and people with glaucoma.

    To read the report, click here.

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  • Joint IGA and Fight for Sight Research grant

    A new small grant is available, jointly funded by the International Glaucoma Association and Fight for Sight. For further details please see

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  • A focus on dry eye and glaucoma for National Glaucoma Awareness Week


    The impact of dry eye on people with glaucoma


    The International Glaucoma Association is focusing on the impact of dry eye syndrome for people with glaucoma during IGA National Glaucoma Week - 4 to 10 June 2018. Dry eye can have a debilitating effect on a person’s quality of life yet is little understood.

    Dry eye syndrome affects 50 to 60 per cent of people with glaucoma and one in three people over the age of 65. It is a disorder where the eyes don’t make enough tears, or the tears evaporate too quickly. This can make eyes feel dry, scratchy and irritated or watery, and feel heavy and tired by the end of the day. In severe cases people report pain, discomfort and depression, and its impact has been compared with that of angina, dialysis and disabling hip fractures.

    Commenting on the campaign, Karen Osborn says: “Dry eye has an adverse impact on quality of life, with people saying that they cannot read, find the sunlight painful, feel unhappy and can’t even open their eyes long enough to do certain daily tasks.”

    “We want to encourage anyone who has aggravating dry eye symptoms to seek the advice of their optometrist, pharmacist or GP and it is important that people with glaucoma raise any dry eye symptoms with their ophthalmologist as a change of glaucoma treatment to a preservative free eye drop often helps to reduce the symptoms of dry eye syndrome”.

    Glaucoma affects around 700,000 people in the UK and the majority of people will initially be treated with medical eye drops. Managing both dry eye and glaucoma effectively is important, but challenging. Both conditions are long-term but manageable.

    What are the most common symptoms of dry eye?

    Heavy tired feeling of the eyes

    Difficulty reading or working on the computer

    Blurriness of vision

    Excessive watering of the eyes

    Discomfort when wearing contact lenses

    Stinging or burning of the eyes

    A sandy or gritty feeling in the eyes

    Pain and redness of the eyes


    Tips to help

    Drink lots of water which helps tear production

    Get enough sleep

    Avoid alcohol and spicy foods

    Avoid smoking and smoky areas

    Wear glasses or sunglasses on windy days

    Avoid air-conditioned environments and draughts

    Consider using a humidifier

    Blink more frequently when using a computer screen or reading

    Look away from computer screens every 30 minutes



    Our leaflet contains lots more information:

    Free Dry Eye Syndrome leaflet


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  • URGENT: Invite your MP to important eye care event 6 June

    Act now to stop people losing sight due to delayed and cancelled hospital appointments

    Make sure the Government prioritises eye care by asking your MP to attend a Parliamentary reception to learn how they can help to stop people losing sight.

    You can write to your MP by using the template letter below or by taking RNIB’s simple online action that will send the letter to your MP for you visit

    Alternatively contact by email, Facebook or Twitter.

    1. Sending the message in an email

    Email subject line: Act now to stop people losing sight

    The NHS eye care system is currently failing patients, service provision is not keeping pace with demand, meaning that hospitals are delaying and cancelling appointments, resulting in people losing sight.

    The All Party Parliamentary Group on Eye Health and Visual Impairment (APPG) held an inquiry in to this problem and on June 6 will release its findings at a report launch event.

    Ask your MP to attend the event and help to stop people losing sight due to delayed and cancelled appointments. You can either use the template letter attached and send it to your MP or take RNIB’s simple online action which will send the letter to your MP for you. Visit

    2. Tweeting

    Ask your MP to attend the @EyeHealthAPPG report launch and help stop people losing sight due to cancelled or delayed appointments

    3. Facebook

    Ask your MP to attend the All Party Parliamentary Group on Eye Health and Visual Impairment report launch and help stop people losing sight due to cancelled or delayed appointments in eye clinics across England


    4. Contacting by Letter

    Insert name

    Insert address

    Insert date

    Dear XXX

    Re: Capacity crisis in NHS Eye Care: APPG report launch, 6 June

    I am one of your constituents and a patient at XXXX using eye care services((insert name of hospital or delete if more appropriate). I am aware that the increase in demand for eye care services in recent years means patients are experiencing delays in accessing sight saving care and treatment. Research shows that as a result of these delays and hospital cancellations some patients are permanently losing sight, despite the availability of sight saving treatments.

    The All Party Parliamentary Group for Eye Health and Visual Impairment has conducted an inquiry to identify solutions to the capacity crisis in England, to ensure that services meet demand.  The inquiry report will be launched at a reception in Parliament on 6 June 2018 from 4pm to 6pmin the Churchill Room.

    You will have received an invitation from the Royal National Institute of Blind People (RNIB)and the Optical Confederation; I hope that you are able to attend the reception to learn about the situation in your Sustainability and Transformation Partnership area, and about what you can do to tackle the crisis.Please RSVP to Jessica Ford at RNIB ( 0207 391 2184)

    I would very much appreciate hearing what action you will take after the event to promote implementation of the recommendations from the inquiry.

    Yours sincerely,



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