Screening children's vision and hearing in schools: improving programme delivery in two London boroughs
PHE ePoster Library. Smith A. Sep 12, 2019; 274463; 26
Dr. Alexandra Smith
Dr. Alexandra Smith
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Abstract
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Abstract Introduction
The UK Healthy Child Programme and National Screening Committee recommend screening of children's vision and hearing at school entry. The screening programme in two London boroughs (A and B), delivered by school nursing teams, was reviewed to assess the value and impact of screening, identify quality issues and improve pathways.
Methods
A literature review was undertaken to identify national guidance and best practice. Local screening programme data were reviewed. Stakeholder engagement was conducted with: school nursing teams (n=5); commissioners (n=2); parents (n=2); teachers (n=2); and healthcare colleagues (2 audiologists, 2 orthoptists, 2 optometrists).
Results
Both boroughs had working screening programmes, using Pure Tone Screen for hearing. Screening coverage was adequate in Borough A (>90%) but low in Borough B (77%). In Borough B, the screening age required change from Year 1 to Reception, and vision screening method from Sonksen Silver to crowded LogMAR. No referral or diagnostic data were available.Stakeholders reported that screening is highly valued and detects health problems with significant educational impacts. Parents were rarely aware of problems beforehand. Stakeholders reported disadvantaged families were less likely to seek help without screening.
Conclusion
Screening should continue, due to evidence of benefit, lack of alternative routes to diagnosis, and inequity if screening were discontinued. Key challenges for both boroughs included screening coverage, training, and data collection. Data collection in Borough B has improved through the review. Next steps include audiology outcomes audit, data collection work, and developing links with orthoptists and audiologists for training, quality and programme sustainability. External funding details
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