VISION 2020 LINKS PROGRAMME TOOLKIT - International Centre for Eye Health London School of Hygiene and Tropical Medicine - Community Eye Health ...
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VISION 2020
LINKS PROGRAMME
TOOLKIT
International Centre for Eye Health
London School of Hygiene and Tropical
Medicine“Nobody
Table of Contents
Introduction 2
Steps in developing a VISION 2020 Link 3
Institutional structure of a Links Programme 4
Appendices:
1. Trust Links Steering Committee 5
2. Sample Job Description for Links Coordinator 6
3. Promoting the Links Concept 7
4. Sample Needs Assessment Document 8
5. Sample Memorandum of Understanding 12
6. Monitoring Links participants visits 15
7. Evaluation of Visits 19
London School of Hygiene and Tropical Medicine
International Centre for Eye Health
Revised June 2007
1INTRODUCTION
This toolkit is designed for medical institutions in the UK who wish to
establish a Link with a medical institution overseas, for the purpose of
human resource and skills development in the ophthalmic sector.
The VISION 2020 Links Programme
The VISION 2020 Links Programme originated as part of the ‘VISION 2020 –The
Right to Sight’ initiative. This is a global initiative established in 1999 by the World
Health Organization and the International Agency for Prevention of Blindness to
eliminate avoidable blindness worldwide. One of the key strategies of VISION
2020 is human resource development. The VISION 2020 Links Programme
provides training and support to develop the expertise of eye specialists overseas
and enable them to prevent more people going blind.
The Tropical Health and Education Trust (www.thet.org)
This toolkit is primarily a guide to developing a Link for the VISION 2020
Programme but could be adapted to suit other specialist departments such
as orthopaedics or obstetrics and gynaecology. The Tropical Health and
Education Trust (THET) has developed a Links Manual which provides
practical details for establishing multidisciplinary Links between health
institutions and for understanding the Links concept. This toolkit is a
supplement to the THET Links Manual. Both documents should be reviewed
together.
Tackling global health inequalities requires both institutional Link initiatives
as well as individual initiatives. Therefore, even with specialist Links, it is
particularly helpful to have the full support of senior management from both
the partnership institutions.
Benefits of Links
As well as being a positive contribution to global health, Links have a variety
of benefits. These include:
• Commitment to Global Eye Health
• Professional development
• Enhanced reputation of the NHS Trust
• Career break schemes to improve staff morale, this extends beyond
ophthalmology department in some cases. Fore example with children’s
eye care this would encompass the paediatric department as well
Links offer an excellent opportunity for the professional development of
NHS staff including:
• Accelerated clinical learning
• Cost-conscious approach to ophthalmic health care
• Problem solving in resource-poor settings
• Flexibility, self assurance, empathy
• Responsibility for developing quality of ophthalmic care
“The ultimate beneficiaries from UK professional health workers gaining
international experience are NHS patients in the UK” Sir Liam Donaldson,
Chief Medical Officer
2STEPS TO A VISION 2020 LINK
1. Acceptance, support and ownership by the UK NHS Trust of the Links
concept, including and in particular the development of an ophthalmic
Link
2. Establishment of a Trust Links Steering Committee (Appendix 1)
3. Identification of a person and space to facilitate and co-ordinate the
Links Programme. This could be the same person who helps to
coordinate other speciality Links such as VISION 2020 Link (see
Appendix 2)
4. Audit of existing overseas commitments within the institution
5. Promotion of the Links concept throughout the institution including the
specialty Link of VISION 2020 Links (see Appendix 3)
6. Liaise with Links agencies to identify potential partners. These include
THET (for multidisciplinary Links) and ICEH/VISION2020 (for
ophthalmic Links)
7. Complete Links needs assessment form of potential overseas partner in
order to begin the needs assessment process (Appendix 4)
8. Visits from, and the commitment of, key personnel of both hospitals to
each other to agree on the Link (purpose, content, time-frame). This
includes the Chief Executive and head of the specific department
interested in forming Links
9. Plan 3-5 year activities and budget based on priorities
10. Partner Institutions to sign a Memorandum of Understanding
(Appendices 5, 6 and 7)
11. Links Plan developed into a full funding proposal and funding
organisations identified
12. Links Steering committee developed in each institution which includes
identification of a coordinator for Links development
13. Monitoring of annual plan by Links Steering Committees in each
institution (Appendix 8)
14. Evaluation of visits (Appendix 9)
3INSTITUTIONAL STRUCTURE OF A LINKS
PROGRAMME
External Funding Trust Board Funding arm within
Bodies the Trust
.
Trust Links Steering Links Specialist Support
Committee Support Link Organisation
Organisation e.g. ICEH/VISION
Links Co-0rdinator e.g. THET 2020 Links
Programme
Departmental Steering Committees
e.g. Ophthalmology, Surgery, Orthopaedics
4APPENDIX 1
TRUST LINKS STEERING COMMITTEE
The Steering committee is the driving force behind a successful Link. It is
important that the senior management of the trust are represented as well
as medical, nursing, academic and administrative staff. As the Link
progresses, other talented and enthusiastic individuals can be recruited to
supervise particular activities such as fundraising or publicity.
Suggested Members:
1. Links Co-ordinator
2. Trust Board member
3. Clinician(s) involved in Links of specific department
4. Nursing representative
5. Fund raising lead
6. Post-graduate Dean or academic representative
7. Member of the Public
5APPENDIX 2
SAMPLE JOB DESCRIPTION FOR LINKS COORDINATOR
Key Roles (it may be appropriate for some of these tasks to be shared)
Steering Committee
- Identification of new people in the hospital with specific skills/needs
expressed by partner
- Delegation of work (e.g. promotional work, fundraising activities) to other
members
Planning for overseas visits
- to assist people in the writing of objectives
- to ensure objectives are in line with need identified in the partner hospital
- to advise visitors how their work might assist in the long term plan for the
Link
Planning for visits to the UK
- to arrange schedule for visitors from overseas, to arrange visit logistics and
accommodation
- to provide information about the possible methods of evaluating specific
objectives and activities
Follow up on visits
- to follow-up plans made during visits
- to chase up visit reports /actions not carried out
Communication
- to ensure appropriate people are kept informed of any developments in the
Link
- to ensure minutes are circulated soon after meetings
- to ensure actions identified in meetings are followed up
Fundraising
- to help organise and manage fundraising events
Travel
- Ideally the post holder will be able to make a visit to the partner hospital at
least once a year
To provide part time support (approximately 4 hours per week) to develop the
Link between the hospital and partner overseas
To have an overall vision of the various aspects of the Link and its developments,
to help drive the Links work and coordinate the running of the Link group
6APPENDIX 3
PROMOTING THE LINKS CONCEPT THROUGHOUT THE UK
INSTITUTION
This could be done firstly through a letter sent to trust staff and then
followed by a questionnaire for all those who have expressed interest.
Sample letter
To all Trust Personnel,
Re: Establishing Links with hospital departments overseas
We would be very interested to know whether anyone would be keen to participate in
an exchange link with another hospital overseas.
Some of you may already be involved in some way with hospitals around the world, in
which case it might be possible to build on an existing link.
The aim is to provide effective needs-based and long term support by encouraging
local health workers to develop their skills to improve their service and build morale.
There are benefits on both sides, not least staff development, whilst at the same time
providing valuable skills for under-resourced hospitals.
The skills required could be managerial, technical or administrative as well as
medical, so we welcome responses from any member of staff.
We would like to form a core group to take this forward, certainly within
ophthalmology, but also involving other departments, particularly if the hospital can
link with a University Hospital. Issues such as funding and leave can be overcome
where there is a will!
Please contact…………if you would like to be involved in this new initiative.
Yours etc,
Sample questionnaire
Thank you for your expressed interest in the …….. initiative. We would be grateful if
you could complete this questionnaire so that we can take this programme forward.
1. Are you interested in working overseas as part of the Links initiative?
2. What is your job title in your department?
3. Do you want to include ‘Links’ as part of your job plan or description?
4. Have you worked overseas before –when, where, how long, what capacity?
5. What can you offer to a ‘Link’ initiative? and what could your department offer?
6. Any other comments
Thank you and we will keep you in touch with developments
7APPENDIX 4
SAMPLE NEEDS ASSESSMENT DOCUMENT
University Hospital Link Programme
LINKS PROGRAMME NEEDS ASSESSMENT
……Ophthalmology…... (Specialty)
Questionnaire
This questionnaire is designed to measure the main priorities of your
Institution, Department or Centre with a view to establishing the most
appropriate form of Link with the Norfolk and Norwich Hospital.
Name of
Institution……………………………………………………………………………
Head of Institution /
Department………………………………………………………......
Total number of Hospital beds ________
Total number of Department/Specialty beds ________
Population of your district or coverage area ________
Staff – 2006
How many doctors work in your department/centre? Total _______
How many nurses work in your department/centre? Total _______
How many technicians work in your department/centre? Total _______
8Other personnel?
Titles _________________________________ Total_______
_________________________________ Total _______
_________________________________ Total _______
_________________________________ Total _______
Surgical Statistics 2006
Number of operations in your department? ` Total _______
Specific procedures:
Procedure ____________________________ Total _______
Procedure ____________________________ Total _______
Procedure ____________________________ Total _______
Training Courses 2006
Please provide information about courses offered in your
centre/department. If more than five courses are offered please continue
on the back of the sheet.
Course title Length Who attends? How
many
attend
1
2
3
4
5
9Current Equipment
Please complete the table stating what equipment you have with any
comments.
Equipment Yes No Comment
Perimeter
Slit Lamps
Cataract surgical sets
Operating Microscope
Laser
Phaco machine
Others…
Services
Do you have other services? If yes please describe.
____________________________________________________________
____________________________________________________________
Please describe your access to educational resources?
____________________________________________________________
____________________________________________________________
Please describe your access to internet?
____________________________________________________________
____________________________________________________________
With whom do you have Links formal/informal (other institutions)?
____________________________________________________________
____________________________________________________________
Are these Links
international/national?______________________________________
Future Priorities
What are your TWO main priorities for development of your
department/centre? If you wish use the checklist below to help you decide.
10Speciality checklist Comment
Cornea
Cataract
Glaucoma
Refraction
Low Vision
Strabismus
Paediatric Ophthalmology
Medical Retina
Surgical retina
Oculo-plastic
Public Health / Epidemiology /
Community
Nursing
Theatre Practice
Histo-pathology
Information Technology for eye care
Priority One
Priority Two
How could the Links Programme assist the development of your
programme with reference to your two main priorities?
Priority One
____________________________________________________________
____________________________________________________________
Priority Two
____________________________________________________________
____________________________________________________________
Other Comments
11APPENDIX 5
MEMORANDUM OF UNDERSTANDING
Between
Institution in Africa (K)
and
University Teaching Hospital, UK (B)
12[The two named institutions] hereby enter into this Memorandum of
Understanding to foster international cooperation in education, research
and clinical practice, to their mutual benefit. The Agreement has the
support of the Ministry of Health in [African country] and the Department
of Health in the United Kingdom.
[Description of two institutions]
K and B agree to develop a Link and to incorporate within that Link the
relevant activities of the hospitals and other institutions associated with K
and B. It is anticipated that the link will be assisted by the [academic
institution associated with the hospital(s)]
In the United Kingdom, the Link will be registered under the auspices of the
VISION 2020 Links Programme run by the International Centre for Eye
Health at the London School of Hygiene & Tropical Medicine and with the
National NHS Health Links coordinated through the Tropical Health and
Education Trust.
The Link will encompass:
• Multi-professional education and training
• Exchange of faculty members, research scholars and students
• Joint research activities
• Systems and service improvement
Before specific activities begin, all parties will identify and agree the priority
needs and prepare a detailed year-by-year Activities Plan in each specified
area.
A joint Advisory Panel will be established to review the Memorandum of
Understanding and Action Plans and amend as necessary. Each partner will
also establish a Steering Group to oversee and support the Link. For
Ophthalmology the Link co-ordinator will be:
[name of co-ordinator]
Specific activities and visits will be evaluated and each partner will provide
feedback to the other. A joint annual progress report will be produced.
This Agreement shall become effective at the date of signature by the
heads of the institutions. The Agreement will be reviewed every five years
to evaluate progress and improve the Link. The amendment or termination
of this Agreement will only take place through the mutual agreement of
both parties.
13OBJECTIVES
A. Within the Department of Ophthalmology
To develop and improve ophthalmology services in the region by
addressing the issues identified by K in the following way
• The development of subspecialty services at K and surrounding
hospitals.
• Support for research activities at K
B. To develop and improve laboratory services at K
C. The exploration of further opportunities to widen the link to other areas
RESPONSIBILITIES OF BOTH PARTIES
• Logistical support for visits
• Professional registration of visiting staff
• Assistance with finding accommodation
• A commitment to make available staff to participate in the Link as
per the defined Activities Plan
• Monitoring and evaluation through the steering committees
ACTIVITIES PLAN
An initial three to five-year Activities Plan is drawn up and the areas on this
list are prioritised in terms of resources, staff time, outputs etc. and as a
separate document but with the main categories mentioned here.
Examples of some key Activities proposed within the link include the
following broad areas:
• Develop medical retina sub-specialist training:
o Specialist to B for four weeks
o Local follow up by B trainers in Africa context
o Develop medical photography including FFA at K
• MMed teaching support and assistance
o Dissertation and research support at K
• Ophthalmic Nurse Training
o Skill development of Nurse Manager designate
o Visit to B nursing and nursing school while in the UK
o Skill development of School of Advanced Ophthalmic nursing
tutors
• Medical Technology
o Equipment maintenance support
o Medical photography
o Visual Fields
Signatures by the Director/CEO of each Institution
14APPENDIX 6
MONITORING OF VISION 2020 LINKS PARTICIPANTS VISITS
Examples from a specific exchange programme :
Medical feedback
1. What were the objectives of your visit?
2. What activities did you carry out during your visit?
3. How did you find the facilities at the partner institution? Give details.
4. How did you find the medical skills of the member of staff that you were
assigned to work with?
5. Do you feel you were able to develop a good relationship with the member/s of
staff that you were assigned to work with? Why or why not?
6. What were your overall impressions of the hospital and hospital staff?
7. Do you feel that a good relationship has been developed with the partner
institution? Why or why not?
8. Do you feel that the objectives of your visit were fulfilled? How or how not were
these objectives fulfilled?
9. Generally what do you feel you have learnt through the Links programme?
10. How do you feel the Links programme will be of benefit to your institution? Are
there any specific inputs that you will put into place in your institution following
the exchange?
15Personal feedback
1. How was your accommodation?
Excellent Good Average Below average
Please circle one and add your comments below including any problems that
you may have had.
2. How well organized was the exchange?
Excellent Good Average Below average
Please circle one and add your comments below including any problems that
you may have had.
3. How do you think the organisation of the exchange could be improved?
4. Do you feel that the exchange helped your personal development e.g.
increased your self-confidence? If so, please detail below.
Comments
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
Future Exchanges
1. What could be improved upon in future visits?
2. Do you have suggestions or recommendations for future developments?
Overall
Feedback impressions and2020
from VISION general comments:
steering group at UK institution
_________________________________________________________________________
1. What were the objectives of the participant’s visit?
_________________________________________________________________________
2. What activities did the participant carry out during the visit?
_________________________________________________________________________
_________________________________________________________________________
3. How motivated and enthusiastic did you find the participant?
_________________________________________________________________________
Very Quite Neutral Unmotivated
_________________________________________________________________________
4. How did you find the medical skills of the participant?
5. Do you feel you were able to develop a good relationship with the participant
and that s/he was willing to learn? Why or why not?
6. Do you feel that a good relationship has been developed with the partner
institution? Why or why not?
7. Do you feel that the objectives of the participant’s visit were fulfilled? How or
how not were these objectives fulfilled?
8. How do you feel the Links programme will be of benefit to the partner
institution? Are there any specific inputs that you would like to see put into
place at the partner institution following their visit?
9. What could be improved upon in future visits?
10. Do you have suggestions or recommendations for future Links?
General comments and overall observations:
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________16
_________________________________________________________________________MONITORING OF VISION 2020 LINKS PARTICIPANTS VISITS
Example from a specific exchange programme :
Feedback from the steering group at partner institution
(Completed by the Links co-ordinator / departmental facilitator)
1. How well organized was the link?
Excellent Good Average Below average
Please circle one and add your comments below including any problems that
you may have had.
2. How do you think the organisation of the link could be improved?
3. What were the objectives of the participant’s visit?
4. Do you feel that the objectives of the visit were fulfilled? How or how not were
these objectives fulfilled?
5. How do you feel the Links programme will be of benefit to your institution? Are
there any specific inputs that you will put into place at your institution following
the visit?
6. Do you feel that the link helped in the participant’s personal growth? If so
please state what changes you have noticed and how you feel they will help the
institution.
7. What could be improved upon in future visits?
8. Do you have suggestions or recommendations for future developments?
General comments:
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
17APPENDIX 7
EVALUATION OF VISITS - SAMPLE EVALUATION DOCUMENT
FOR LINKS PARTICIPANT
(Completed 6 months after the visit by participant)
1. What benefits do you feel you have gained from the link, six months on,
both on a professional and personal level?
2. Have you found that you have been able to put these benefits to use
within the hospital and if so, how?
3. Have there been any changes at the hospital as a result of your visit?
4. Are there any inputs that you would like to put into place in the future as
a result of your visit?
5. What kind of link do you think it would be most beneficial to organise for
the institution next?
SAMPLE EVALUATION DOCUMENT FOR PARTNER INSTITUTION
(Completed 6 months after the visit by the Links co-ordinator / departmental
facilitator)
1. What benefits do you feel the participant has gained from the link, six
months on, both on a professional and personal level?
2. Have you found that you and the participant have been able to put these
benefits to use within the hospital and if so, how?
3. Have there been any changes at the hospital as a result of the
participant’s visit?
4. Are there any inputs that you would like to put into place in the future as
a result of the participant’s visit?
5. What kind of link do you think it would be most beneficial to organise
next for the institution?
Creating true global health partnerships will both help to improve health and, by
bringing people together, contribute towards improved
relationships across the world
Nigel Crisp, February 2007
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