Free eye examinations will be rolled out to all children in special schools in England from 2025, NHS England has confirmed.
The move comes after a successful pilot, which has seen children in 83 special schools in England benefit from eye examinations conducted by specially trained optometrists and dispensing opticians since 2021.
The move means 165,000 children are likely to benefit from eye examinations in their familiar school settings from next year.
Children who need spectacles will be provided with two pairs of their choice under the plans, NHS England said.
This includes specialist frames, which will be included free of charge.
After the eye examinations, reports will be provided for parents, carers and teachers, which will explain the results and offer insight to improve the child’s engagement both at school and at home.
Guidance on good eye care and managing eye conditions will also be provided.
Children in residential special schools and colleges will also receive NHS hearing and dental checks, NHS England said.
Hearing tests will be carried out at school entry and at transition points, such as when a child moves from primary to secondary school, or secondary school to sixth form college.
Face-to-face dental checks will be carried out at least once annually.
The sight, audiology and dentistry package will be known as the Sensory Checks Programme.
The programme will reach around 18,000 children and young people up to the age of 25 in England, NHS England confirmed.
Staff carrying out eye, hearing or dental examinations will undertake the Oliver McGowan Mandatory Training in learning disability and autism.
They will also be trained in how to make appropriate, person-centered reasonable adjustments.
NHS Education England has developed an e-learning programme for performers undertaking sensory checks in special schools.
The programme includes advice and guidance on how practitioners can personalise their examinations to meet the needs of the learning disability patient group.
The AOP, which has called for eye examinations in special schools to be rolled out more widely through its Sight for SEN campaign, welcomed the Sensory Checks announcement, but emphasised that questions on the eye examinations component remain.
More details are needed on the fees to be offered to performers and the contractual regulations, the association said.
Adam Sampson, AOP chief executive, said that children with special educational needs “face real challenges in accessing eye care due to the potential for anxiety or distress when getting their sight tested in unfamiliar settings.”
“Having annual sight checks in their school will ensure they can access the crucial eye care they require, with eye conditions identified and treated as soon as possible,” Sampson added.
He noted, however, that “as much as it’s a promising announcement which will benefit thousands of pupils, necessary discussions now need to be had to ensure the best delivery of the service is possible for providers.
“Without clarity on the provisions, eye care providers could find it difficult to offer the service, deepening inequalities in the consistency of the delivery of the service.”
The AOP raised concerns in May 2024 that the budget for the SSECS could be cut by 30% by child, with the fee lowered from £116 to around £81.
At the time, the AOP urged the Government to “meet its commitment and fund the service at £116 for all children who need it.”
OT understands that discussions on fees and regulations are ongoing with the Optometric Fees Negotiation Committee.
Learning disability charity, SeeAbility, currently holds a contract to provide eye care and dispensing services for 3000 children across 25 schools.
The charity said that the announcement is “hugely welcome,” but added that “there is an urgent need for clarity as to the timing of the rollout and what the eye care service will consist of.”
“Eye care professionals in hospitals and the community have been standing ready to deliver this service for many years, once they have a contract from local health bodies,” Lisa Donaldson, head of eye care and vision at SeeAbility, said.
Keeping the existing model of care means “huge potential for this service to reduce health inequalities, make better use of community eye care, reduce hospital waiting lists and improve disabled children’s health and educational outcomes,” Donaldson believes.
She added: “Special schools across the country desperately want this support, as do children and parents.”
Minister of State for Care, Stephen Kinnock, said that the sensory checks will tackle health inequalities by giving children and young people “access to the right high-quality care and support faster.”
“I am pleased we will be able to support vital sensory checks for all pupils in special educational settings, in a comfortable and known environment for them,” he said.
Children with learning disabilities are 28 times more likely than the general population to have an issue with their sight.
Despite this, 44% of children in special schools have never had an eye examination.
Currently, only 9% of children in special schools – around 11,000 children – have access to the SSECS.
In audiology, 80% of children with learning disabilities will have had at least one long term episode of middle ear infection (otitis media) with effusion by 10 years of age.
Anne Worrall-Davies, NHS England’s children and young people’s learning disability and autism and SEND clinical lead, said that the sensory checks will help to “identify unmet needs and provide any necessary treatment and follow-up support” for children in special schools.
Children and young people in residential special schools will be “able to lead happier, healthier lives, with minimal disruption to their education and routine,” Worrall-Davies said.
NHS England noted that the eye examinations are the beginning of a “broader ambition” to improve access to eye care services for everyone with a learning disability or autism, including children in mainstream schools and adults.
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