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Corporate slide master With guidelines for corp -the work of the orate presentations

Corporate slide master With guidelines for corp -the work of the orate presentations. Vision for Children -the work of the Children’s Eye Health subgroup. Eye Health Conference 17 th September 2014. Heather Payne, Paediatrican , Subgroup Chair

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Corporate slide master With guidelines for corp -the work of the orate presentations

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  1. Corporate slide master With guidelines for corp -the work of the orate presentations Vision for Children -the work of the Children’s Eye Health subgroup Eye Health Conference 17th September 2014 Heather Payne, Paediatrican, Subgroup Chair Rebecca John, Clinical Lead, Low Vision Service heather.payne@wales.gsi.gov.uk

  2. Children’s Rights to vision • Play • Learn • Be resilient • Have good health • Make friends • Feel safe • Not be disadvantaged Corporate slide master With guidelines for corp -the work of the orate presentations

  3. Children’s Subgroup Aims: • Prevention • Early intervention • Effective, accessible services Corporate slide master With guidelines for corp -the work of the orate presentations

  4. School Pupil Eye Care Subgroup (SPECS) • Chaired by Minister • Includes all delivery partners • Newborn eye screening • School entry screening • Special Schools Project Corporate slide master With guidelines for corp -the work of the orate presentations

  5. Special Schools Eye Care Pilot 2013-2014 Rebecca John

  6. What is a Special School? ‘An educational establishment specifically resourced to meet the needs of the most complex and challenging young people in communities. Typically they will provide an environment for the delivery of education as ell as social and health needs’ (Welsh Assembly Government 2005:The National Service Framework for Children, Young People and Maternity Service in Wales. )

  7. Background • Vision screening should be carried out on all children aged 4-5 years. • A full eye examination should be performed on children of any age with suspected visual defects, a significant family history or any neurological or disabling condition. Reword (Hall and Elliman, 2008)- Hall report • Children in special schools are at greater risk of refractive error and / or visual impairment (A Clear Vision June 2012) However; • Special schools are not necessarily included in the funding for school vision screening (Pilling 2011)

  8. ‘A Clear Vision’ June 2012 • In 2012 a research project took place to look at the provision of Eye care in the Special School environment within Wales to determine whether eye tests should be made available in special schools. • Should eye care be provided for children within the special school environment?

  9. Barriers to High Street Care • Access- wheel chairs, travel, parents, carers • Unfamiliar settings • Time constraints of routine appointments • Multiple health appointments • Poor communication • Challenging behaviour

  10. Advantages of a school based service • A familiar environment for students. • No long, uncomfortable journey involved. • Parents do not have to be present. • Support and knowledge of teachers, nurses and care givers. • Ability to raise awareness of the educating and care staff regarding the importance of spectacle wear, effect of vision impairments and provisions which may need to be made. • A similar dental service does exist for special schools

  11. Key findings • One in five pupils have a visual impairment which is likely to impact on their education. However, only 6% of pupils a visual impairment recorded in their statement of Special Educational Needs. • Over 50% of the children needed spectacles while only 30% had previously had them prescribed. Only 15% were still wearing them. • At least one fifth of the pupils with low vision could have normal vision with spectacles.

  12. Recommendations • An optometric service should be provided to pupils in special schools. • A transitional service should be established to support pupils in special schools become familiar with having sight tests in community practice

  13. A Pilot is born • Special schools Eye Care Pilot project • December 2013- July 2014 • Pilot Members: • Maggie Woodhouse- Advisor • Rebecca John- Clinical Lead • AideenMcAvinchey- Optometrist • SPECS group.

  14. School Pupil Eye Care Services (SPECS) • A sub group of the ‘Children’s Vision Service Advisory Group • Members representation • Welsh Government- • Chief Optometric Advisor Welsh Government • Head of Eye Care policy Welsh Government • Children’s vision advisory group • Optometry Wales • RNIB • LVSW • PHW • Education • Health board • Chaired by Mark Drakeford- Minister for Health, Welsh Government • Role: To advise the Children’s Group on Pupil Eye Care Services.

  15. Considerations • How the service would work • Staff needed and job roles • Responsibilities of the service • Responsibilities of the school • Equipment needed. • Resources at school needed. • Education. Staff, children, parents/carers • Inclusion of LVSW

  16. The Role of the pilot • Continued care to patients seen in the research project. • New care to other children in the research project schools • Identification of whether it is practical to provide an optometric service within special schools. • How that service would work. • The difficulties that would be encountered. • Patient eye care pathways. • Staff, facilities, equipment and training that would be required. • How the service would function financially and any barriers which may exist such as current legislation.

  17. Pilot vs Research project • Consent levels increased by 11%-68% • In 2 of the schools there was 100% consent • Encouraged by teachers who had seen a positive outcome following the research project • Of those dispensed in the research project, the rates of children still wearing spectacles ranged from 20%-67% compared to 15% previously. • Spare pairs • Awareness of teachers of need

  18. Other Factors • Not all those who consented for a sight test were able to be tested • Refusing to leave the classroom • Running away and hiding when moving from classroom to test room. • Violence during the test • Verbal threats during the test • Not all those identified as needing glasses were dispensed. • Physical aggression (teachers needing to hold children down) • Self harming (glasses seen as another tool for self harm) • At request of parents/school

  19. Difficulties Encountered • Time spent phoning parents and guardians for history and symptoms • Chaperone not always being available so unable to perform the test • Room allocation- • Time consuming administration. • Teacher and support team advice • Finding the children. • The majority of these difficulties will be solved by the proposed model for the Special Schools Vision Service for Wales.

  20. What a All Wales Special School Vision Service looks like. • Optometrists, dispensing opticians and orthoptists. • Central administration team • Suitable rooms • Equipment • Training • Run along side LVSW • Transition

  21. Voucher GOS 3 issued for patient (P) ** Voucher GOS 3 issued at school (O) ** Frame selection, fit and dispense at optometric practice. (P/Comm O) Frame selection, fit and dispense at school (O/DO) Obtain positive Consent (S+A) Special Schools Vision Service Draft Patient Pathway. Appointment made through central administration team. (S+A) Practitioner returns to school for final frame fitting. (DO) History and symptoms (O/DO/S) Reception age/transition pupils. Special school team attend and perform eye examination on school premises, GOS 1/6* (O+DO) BV problem identified Refractive correction required No pathology or refractive error found Pathology identified Need of Low vision appointment identified. Full orthoptic assessment (OR) Referral to relevant professional. (O) Low Vision Assessment performed within school setting. (O/DO) Management within school (OR) Recall period set and report written for parent and school. (O)

  22. What happens next • Full pilot year report. • Health boards and education on board • Funding • Change in legislation • Eye health care delivery plan has set ‘more children having sight tests in special schools’ as one of its outcomes.

  23. School Feedback I am pleased to give you feedback from a schools point of view regarding the Low Vision Service Wales initiative. Testing eye sight in school has made a remarkable difference within our school. I must admit at the start of the process I thought the time taken within school would limit the learning opportunities and cause disruption for the children.   However the opposite has happened.  The service has been delivered  in an extremely professional manner with little or no disruption in school. Parents, carers and the teaching staff are delighted with the service.  Of course the teachers are delighted that pupils needing glasses are able to have them when in fact parents at home may not of even bothered. This service has been exceptional our recent Estyn Inspection highlighted our school as Excellent with the view that our collaboration with services was outstanding.  The Low Vision Service was one of the services that they were impressed with during their visit. I hope now this service is able to continue.

  24. Conclusions: Corporate slide master With guidelines for corp -the work of the orate presentations

  25. References

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