Child vision screening standards
Updated 5 October 2023
Applies to England
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This publication is available at https://www.gov.uk/government/publications/child-vision-screening-providing-screening/child-vision-screening-standards
CVS-S01: population: completeness of offer
Description
The proportion of eligible children who are offered vision screening.
Rationale
To maximise the benefit of the screening programme all eligible children should be offered a screen. A child should not miss out on the opportunity to accept screening because they were not invited by the provider.
Definitions
Numerator
The total number of eligible children who were offered vision screening to occur on or before the last day of the school academic year running from 1 September to 31 August. The offer must provide all families of eligible children with complete information about the screening programme using the programme’s:
Denominator
The total number of children who turn 4 years of age in the year preceding the beginning of the school year and who either:
- attend any school (see additional information on types of school) within the area covered by the local authority service provider at the end of the academic year, or
- are home schooled and resident within the area covered by the local authority service provider at the end of the academic year
Exclusions
Children are excluded from the eligible population for screening if they:
- are educated in special schools as they should be offered visual assessments using a test appropriate for their developmental stage in line with current national guidance - special schools are those that provide an education for children with a special educational need or disability
- have left the area before the end of the academic year
Performance thresholds
We calculate performance by dividing numerator by denominator and multiplying by 100 to give a percentage.
Acceptable level: greater than or equal to 95.0%
Achievable level: greater than or equal to 99.0%
Caveats
None.
Data collection and reporting
Data source: service provider (denominator) and local authority upper tier (numerator).
Responsible for data quality and completeness: service provider and local authority upper tier.
Responsible for submission: service provider.
Reported by: service provider.
Published by: local authority upper tier.
Reporting period
Annually, within 6 months of the end of the academic school year (31 August).
Review dates
Date standard introduced: 12 July 2022.
Date standard last updated: not applicable.
CVS-S02a: coverage for opt-in services
Description
The proportion of children eligible for vision screening who have a completed screen.
An opt-in service is where parental acceptance is sought prior to the screening examination.
Rationale
To provide assurance that screening is offered to parents of all eligible children and that each child (for whom the offer is accepted) has a completed screening outcome.
Definitions
Numerator
The total number of eligible children who were vision screened on or before the last day of the school academic year. Screening outcomes that comprise a complete screen (see the child vision screening pathway are:
- screen negative (pass) – no referral required
- screen positive (below threshold) – referral for further investigation
- screen positive (unable to test due to unsettled child) – referral for further investigation
Each child’s final screening outcome is counted only once.
Denominator
The total number of children who turn 4 years of age in the year preceding the beginning of the school year (with the school academic year running from 1 September to 31 August) and who either:
- attend any school (see additional information on types of school) within the area covered by the local authority service provider at the end of the academic year, or
- are home schooled and resident within the area covered by the local authority service provider at the end of the academic year
Exclusions
Children do not meet the eligibility criteria for this standard if they:
- are educated in special schools, as they should be offered visual assessments using a test appropriate for their developmental stage in line with current national guidance
- defer their start to school - parents are advised to arrange for an NHS sight test with a local optometrist of their choice in order to complete the sight test at the age appropriate time (between ages 4 and 5)
- have left the area before the end of the academic year
Performance thresholds
We calculate performance by dividing numerator by denominator and multiplying by 100 to give a percentage.
Acceptable level: greater than or equal to 65.0%
Achievable level: greater than or equal to 80.0%
Caveats
If a child is absent when the screening visit takes place, a second opportunity should be offered where possible. If screening could not be carried out due to absence, the parent should be informed and advised to obtain an NHS sight test (see template letter 5).
Children may already be under the care of eye services so their parents may decline screening. These children should be accounted for in the commentary.
Children who are included in the denominator because they have moved into a local authority may not be included from the numerator if the local authority has been unable to determine their screening status. These children should be accounted for in the commentary.
Lower coverage may be seen as some children are at multiple disadvantages and need further support to take up the offer of screening.
Data collection and reporting
Data source: service provider.
Responsible for data quality and completeness: service provider.
Responsible for submission: service provider.
Reported by: local authority lower tier.
Published by: local authority upper tier.
Reporting period
Annually, within 6 months of the end of the academic school year (31 August).
Review dates
Date standard introduced: 12 July 2022.
Date standard last updated: not applicable.
CVS-S02b: Coverage for opt-out services
Description
The proportion of children eligible for vision screening who have a completed screen.
An opt-out service is where acceptance of the screening offer is assumed unless the parents, carers or guardians decline screening.
Rationale
To provide assurance that screening is offered to parents of all eligible children and that each child (for whom the offer is accepted) has a completed screening outcome.
Definitions
Numerator
Complete screens is the total number of eligible children who were vision screened on or before the last day of the school academic year. Screening outcomes that comprise a complete screen are:
- screen negative (pass) - no referral required
- screen positive (below threshold) - referral for further investigation
- Screen positive (unable to test due to unsettled child) - referral for further investigation
Each child’s final screening outcome is counted only once.
Denominator
‘Eligible children’ (denominator) is the total number of children who turn 4 years of age in the year preceding the beginning of the school year (with the school academic year running from 1 September to 31 August) and:
- attend any school (see additional information on types of school) within the area covered by the local authority service provider at the end of the academic year
or
- are home schooled and resident within the area covered by the local authority service provider at the end of the academic year
Exclusions
Children educated in special schools are excluded as they should be offered visual assessments using a test appropriate for their developmental stage in line with current national guidance.
Children who defer their start to school (see guidance for authorities on delaying school start for children born in the summer) are excluded from the denominator and numerator because they do not meet the eligibility criteria for the standard. Parents are advised to arrange for an NHS sight test, with a local optometrist of their choice in order to complete the sight test at the age appropriate time (between ages 4 and 5 years).
Performance thresholds
We calculate performance by dividing numerator by denominator and multiplying by 100 to give a percentage.
Acceptable level: greater than or equal to 80.0%
Achievable level: greater than or equal to 95.0%
Caveats
Eligible children may not be screened if absent when the screening visit takes place. A second opportunity should be offered where possible. If screening could not be carried out due to absence, the parent should be informed and advised to obtain an NHS sight test (see template letter 5).
Children may already be under the care of eye services and their parents may decline screening. These children should be accounted for in the commentary.
Children who are included in the denominator because they have moved into a local authority may not be included from the numerator if the local authority has been unable to determine their screening status. These children should be accounted for in the commentary.
An opt-out service has higher coverage levels but might risk a child being screened when their parents might have wished otherwise.
Data collection and reporting
Data source: service provider.
Responsible for data quality and completeness: service provider.
Responsible for submission: service provider.
Reported by: local authority lower tier.
Published by: local authority upper tier
Reporting period
Annually, within 6 months of the end of the academic school year (31 August).
Review dates
Date standard introduced: 12 July 2022.
Date standard last updated: not applicable.
CVS-S03: Test - timeliness of results to parents
Description
The proportion of children who have a screening outcome letter sent to their parents by or before 14 calendar days from the screen.
Rationale
To minimise anxiety for parents by communicating childhood vision screening results in a timely manner.
Definition
Numerator
‘Letters produced’ (numerator) is the number of result letters produced by or beofre 14 calendar days of the screening test outcome.
A ‘letter produced’ is defined as the electronic or postal sending of a formal communication of screening results to the child’s parent or guardian. ‘Letters produced’ is a proxy measure for the receipt of result letters as it is not possible to measure if they are received. Evidence of producing a letter does not guarantee that the parents have received the letter.
Denominator
Complete screens (denominator) is the number of eligible children who were vision screened on or before the last day of the school academic year running from 1 September to 31 August. Screening outcomes that comprise a complete screen are:
- screen negative (pass) - no referral required
- screen positive (below threshold) - referral for further investigation
- screen positive (unable to test due to unsettled child) - referral for further investigation
Each child’s final screening outcome is counted only once.
Performance thresholds
We calculate performance by dividing numerator by denominator and multiplying by 100 to give a percentage.
Acceptable level: greater than or equal to 95.0%
Achievable level: greater than or equal to 99.9%
Caveats
None.
Data collection and reporting
Data source: service provider.
Responsible for data quality and completeness: service provider.
Responsible for submission: service provider.
Reported by: service provider.
Published by: local authority upper tier.
Reporting period
Annually, within 6 months of the end of the academic school year.
Review dates
Date standard introduced: 12 July 2022.
Date standard last updated: not applicable
CVS-S04: Diagnosis or intervention - timeliness of referral
Description
The proportion of children referred from screening within the required timescale.
Rationale
To provide assurance that children who require further assessment are referred.
Definition
Numerator
‘Referred’ is the number of children who are referred for entry into the diagnostic pathway by or before 14 calendar days from the screening test.
A referral is defined as sending a letter or making an electronic referral. Evidence of onward referral does not guarantee that the referral has been received by the service providing diagnostic examination.
Denominator
The number of eligible children who screen positive (as defined in the screening pathway):
- screen positive (below threshold) - referral for further investigation
- screen positive (unable to test due to unsettled child) - referral for further investigation
Performance thresholds
We calculate performance by dividing numerator by denominator and multiplying by 100 to give a percentage.
Acceptable level: greater than or equal to 90.0%
Achievable level: greater than or equal to 99.0%
Caveats
None.
Data collection and reporting
Data source: service provider.
Responsible for data quality and completeness: service provider.
Responsible for submission: service provider.
Reported by: service provider.
Published by: local authority upper tier.
Reporting period
Annually within 6 months of the end of the academic school year (31 August).
Review dates
Date standard introduced: 12 July 2022.
Date standard last updated: not applicable.