Corporate slide master With guidelines for corp -the work of
the orate presentations Eye Health Conference 17 th September 2014
Heather Payne, Paediatrican, Subgroup Chair Rebecca John, Clinical
Lead, Low Vision Service [email protected] Vision for
Children -the work of the Childrens Eye Health subgroup
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Corporate slide master With guidelines for corp -the work of
the orate presentations Childrens Rights to vision Play Learn Be
resilient Have good health Make friends Feel safe Not be
disadvantaged
Slide 3
Corporate slide master With guidelines for corp -the work of
the orate presentations Childrens Subgroup Aims: Prevention Early
intervention Effective, accessible services
Slide 4
Corporate slide master With guidelines for corp -the work of
the orate presentations School Pupil Eye Care Subgroup (SPECS)
Chaired by Minister Includes all delivery partners Newborn eye
screening School entry screening Special Schools Project
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Special Schools Eye Care Pilot 2013-2014 Rebecca John
Slide 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. )
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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)
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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?
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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
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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
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School nameLocation Age (years) Number of pupils on roll
Maesgwyn School Aberdare11-19102 Ysgol Heulfan Y Canol
Wrexham3-1628 Crownbridge School Pontypool2-1980 St.Christopher's
School Wrexham6-19240 Portfield School Haverfordwest3-19108 TOTAL
558
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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.
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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
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A Pilot is born Special schools Eye Care Pilot project December
2013- July 2014 Pilot Members: Maggie Woodhouse- Advisor Rebecca
John- Clinical Lead Aideen McAvinchey- Optometrist SPECS
group.
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School Pupil Eye Care Services (SPECS) A sub group of the
Childrens Vision Service Advisory Group Members representation
Welsh Government- Chief Optometric Advisor Welsh Government Head of
Eye Care policy Welsh Government Childrens vision advisory group
Optometry Wales RNIB LVSW PHW Education Health board Chaired by
Mark Drakeford- Minister for Health, Welsh Government Role: To
advise the Childrens Group on Pupil Eye Care Services.
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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
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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.
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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
Slide 19
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
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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.
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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
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Obtain positive Consent (S+A ) Appointment made through central
administration team. (S+A) History and symptoms (O/DO/S) Special
school team attend and perform eye examination on school premises,
GOS 1/6* (O+DO) No pathology or refractive error found Refractive
correction required Pathology identified Need of Low vision
appointment identified. Referral to relevant professional. (O)
Voucher GOS 3 issued at school (O) ** Frame selection, fit and
dispense at school (O/DO) Voucher GOS 3 issued for patient (P) **
Practitioner returns to school for final frame fitting. (DO) Frame
selection, fit and dispense at optometric practice. (P/Comm O) BV
problem identified Reception age/transition pupils. Full orthoptic
assessment (OR) Recall period set and report written for parent and
school. (O) Low Vision Assessment performed within school setting.
(O/DO ) Management within school (OR) Special Schools Vision
Service Draft Patient Pathway.
Slide 23
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.
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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.
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Corporate slide master With guidelines for corp -the work of
the orate presentations Conclusions: