Sight Loss Data Tool Version 2.2: Guidance Notes
December 2014 Version 2.2 2
Contents Sight Loss Data Tool Version 2.1: Guidance Notes...... 1 Contents...... 2 1. Introduction...... 5 2. Geography...... 8 3. Area profile...... 9 3.1 General population – number and proportion by age band9 3.2 General population – number and proportion by ethnic group...... 10 3.3 Local area deprivation...... 11 4. Living with sight loss...... 13 4.1 Number of people living with sight loss...... 13 4.2 Prevalence of sight loss...... 14 4.3 Future projections of the number of people living with sight loss and the prevalence of sight loss in 2020 and 2030...... 15 5. Certification...... 16 5.1 Number of Certifications of Vision Impairment...... 16 5.2 Rate of Certifications of Vision Impairment by specific eye conditions...... 16 5.3 Change in rate of Certifications of Vision Impairment from 2010/11 to 2011/12...... 17 6. Registration...... 19 6.1 Number of people registered as blind or partially sighted19 6.2 Proportion of people registered blind or partially sighted also recorded as having an additional disability...... 20 6.3 Rate of registration per 100,000 people...... 21 6.4 Percentage change in registration over time...... 22 7. Children and young people...... 24 7.1 Number of children and young people...... 24 7.2 Number of blind and partially sighted children and young people...... 24 7.3 Number and proportion of children with visual impairment as primary SEN...... 26 7.4 Proportion of visually impaired children and young people aged 0-16 with primary a SEN of visual impairment...... 27 8. Older people...... 28 8.1 Number of older people...... 28 8.2 Number of older people living with sight loss...... 28 8.3 Number of older people living in care homes...... 29 9. NHS sight tests...... 31
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9.1 Number of NHS sight tests...... 31 9.2 Rate of NHS sight tests...... 33 10. Cost of sight loss...... 35 10.1 Total and proportion of NHS expenditure on problems of vision or ophthalmic services...... 35 10.2 NHS expenditure on problems of vision per person...... 37 10.3 Total indirect cost of sight loss...... 38 10.4 Indirect cost of sight loss per person...... 39 11. Sight threatening eye conditions...... 40 11.1 Number of people living with age-related macular degeneration; 2011, 2015 and 2020...... 40 11.2 Number of people living with cataract in 2011, 2015 and 2020...... 42 11.3 Number of people living with glaucoma in 2011, 2015 and 2020...... 43 11.4 Number of people living with diabetes in 2011, 2015 and 2020...... 44 11.5 Proportion of people with diabetes attending retinal screening...... 46 11.6 Number of people living with diabetic retinopathy in 2011, 2015 and 2020...... 46 12. Support...... 49 12.1 Eye clinic support...... 49 12.2 Rehabilitation support...... 50 12.3 Number of blind and partially sighted people in receipt of adult social care services...... 51 12.4 Number of blind and partially sighted people in receipt of Disability Living Allowance...... 51 13. Other health conditions and disability...... 53 13.1 Falls...... 53 13.2 Dementia...... 54 13.3 Stroke...... 55 13.4 Hearing impairment...... 56 Appendix A – Additional resources...... 58 1. Toolkits and guides for using data...... 58 2. Directory of services...... 58 3. Other useful data tools...... 58 Appendix B – References...... 63 Appendix C – Geographical areas...... 67
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1. Introduction Sight Loss Data Tool RNIB’s Sight Loss Data Tool provides information about blind and partially sighted people and those at risk of sight loss at a local level throughout the UK.
The data tool is aimed at supporting expert local knowledge by providing a range of different indicators. These indicators are broadly either based on official statistics (for example Census 2011, register of blind and partially sighted people, s) or modelled estimates based on existing research (for example number of people living with sight loss). These indicators can support a number of different activities, including: Better understanding of blind and partially sighted people and those at risk of sight loss in your area. Local, relevant and evidence based statistics to engage with funders or commissions. Population data to use in planning services or strategy development.
You can find the latest version of the Sight Loss Data Tool, guidance notes and a user guide at www.rnib.org.uk/datatool.
Guidance notes These guidance notes have been developed to accompany the Sight Loss Data Tool. This document provides further details of the sources of data and evidence, calculations that have been used to develop the indicators and limitations that may need to be considered when interpreting the data.
The structure of this document follows the chapters used in the reports generated in the data tool: General population Registration Certification Living with sight loss Children and young people Older people
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NHS sight tests Cost of sight loss Sight threatening eye conditions Support Other health conditions and disability
Indicators have been grouped together where they share sources and methodology. There is a brief introduction to each group of indicators and the following information:
Coverage and type The coverage of an indicator relates to which parts of the UK are covered by the data. This is particularly relevant for official statistics as coverage and availability often varies between the countries within the UK.
The type of indicator highlights whether or not the data is based on official statistics or is an estimate calculated by RNIB.
Sources References for each indicator are provided. An overview of all the sources used in the Sight Loss Data Tool can be found in Appendix B.
Definitions Information related to how the data was collected, what it includes and any information about terminology.
Calculation Details of any calculations used in developing the indicators are highlighted.
Modelled estimates Some of the indicators in the data tool are estimates based on existing research and evidence. These estimates are often the only way that we can provide information on certain topics, and they have been included as a guide for further discussion. They do not take into account local variation or additional demographic factors that are not included in the base prevalence rates. If you have any
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Feedback Your feedback is extremely important to RNIB. Prioritisation of the development of features included in Version 2 of this data tool was based on the feedback we received for Version 1. If different geographical boundaries would be helpful, or if information you would like to see included is missing then please let us know.
We would also like to hear which aspects of the data tool you find most useful, how you are using it and of any impact having access to this data has had on the support to blind and partially sighted people and those at risk of sight loss in your area.
Sight loss UK and Evidence-based reviews Sight loss UK is an annual evidence review, which uses a range of indicators that show us what life is like for people with experience of sight loss and those at risk of sight loss at national level.
Our Evidence-based reviews look in more detail at the experiences of blind and partially sighted people in different age groups. They include a profile of the group, the policies that govern and impact upon their lives, and a commentary on what the evidence tells us.
You can access “Sight loss UK 2013” and the Evidence-based reviews at www.rnib.org.uk/research.
Further information If you have any questions about the Sight Loss Data Tool or require any additional statistics or evidence related to blind and partially sighted people or those at risk of sight loss, then please contact [email protected].
The best way to keep up to date with RNIB’s research, including future updates to the Sight Loss Data Tool, is to sign up for email notifications on the RNIB website. You can add your contact details at www.rnib.org.uk/research in order to receive these notifications.
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2. Geography The aim of the Sight Loss Data Tool is to provide information at a local level throughout the UK. Below is a brief summary of the geographical boundaries used in the data tool, a complete list can be found in Appendix C.
England Data in England is provided for upper-tier council areas, that is Unitary Authority and County level. Data is also provided for the nine government office regions in England. Data is not provided at a district council level or for any form of health boundaries (for example Care Commissioning Group).
If you require information based on health boundaries we have provided further information about a range of other data tools that will be able to help in Appendix A.
Wales Data in Wales is provided for all local authorities and regional Health Boards.
Scotland Data in Scotland is provided for all local authorities and regional NHS Health Boards.
Northern Ireland Data in Northern Ireland is provided for all local government districts and NHS Trusts.
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3. Area profile This section provides information about the characteristics of a local area. This includes the age and ethnicity of the residents of the area, and information about the average level of deprivation.
3.1 General population – number and proportion by age band These indicators provide an overview of the age profile of the general population. Data is provided on specific age bands covering both number and proportion of the area population in each age band.
Coverage and type All areas; official statistics.
Sources ONS (2012) 2011 Census: Usual resident population by single year of age, unrounded estimates, local authorities in the United Kingdom. Office for National Statistics.
Definitions For 2011 Census purposes, a usual resident of the UK is anyone who, on census day, was in the UK and had stayed or intended to stay in the UK for a period of 12 months or more, or had a permanent UK address and was outside the UK and intended to be outside the UK for less than 12 months.
The age bands used in the data tool are: 0–4 years 5–17 years 18–29 years 30–49 years 50–64 years 65–74 years 75–84 years 85 years and over
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Calculation The proportion of people in each age band was calculated as follows: Proportion in age band = (Number in age band/Total number of people)
3.2 General population – number and proportion by ethnic group These indicators provide an overview of the population by ethnic group. Data is provided for both the number and proportion of the area population in each ethnic group.
Coverage and type All areas; official statistics.
Sources ONS (2012) 2011 Census: Key Statistics for local authorities in England and Wales, Ethnic group. Office for National Statistics.
NRS (2013) 2011 Census: Ethnic groups. National Records of Scotland.
NISRA (2013) 2011 Census: Ethnicity, Identity, Language and Religion. Northern Ireland Statistics and Research Agency.
Definitions Ethnic group classifies people according to their own perceived ethnic group and cultural background in response to the 2011 Census.
The following broad categories have been used in the data tool: White (this includes British, Irish and Other White) Mixed Ethnicity (this includes White and Black Caribbean; White and Black African; White and Asian; and Other Mixed) Asian or Asian British (this includes Indian; Pakistani; Bangladeshi; and Other Asian or Asian British) Black or Black British (this includes Black Caribbean; Black African; and Other Black or Black British)
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Chinese or Other Ethnic Group
Calculation The proportion of people in each ethnic group was calculated as follows: Proportion in ethnic group = (Number in ethic group/Total number of people)
3.3 Local area deprivation These indicators provide information on the extent of deprivation in a local area. For some areas, there is also information on how the local authority ranks in terms of overall deprivation when compared to others in the same country.
Coverage and type Extent of deprivation is available for all areas, rank of local authority is available for England and Northern Ireland; official statistics.
Sources DCLG (2010) English Indices of Deprivation 2010: county summaries. Department for Communities and Local Government.
NISRA (2010) Northern Ireland Multiple Deprivation Measure 2010. Northern Ireland Statistics and Research Agency.
Scottish Government (2012) Scottish Index of Multiple Deprivation. Scottish Government.
Welsh Government (2012) Welsh Index of Multiple Deprivation 2012. Welsh Government.
Definitions The extent of deprivation is a measure of the proportion of people in a local authority who are living in the most deprived Lower Layer Super Output Areas (LSOAs) in the country. (Note: LSOAs are called Data Zones in Scotland.) LSOAs were developed to improve the reporting of small area statistics, with the unit of geography
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Official statistics on deprivation in England and Northern Ireland also provide an overall rank for local authorities. This was calculated by using the average for all LSOAs in a council area across all indices of deprivation.
Full details of the definitions used in each country and the weightings used to calculate the extent of deprivation can be found in the original sources.
Calculation None.
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4. Living with sight loss Almost two million people in the UK are living with sight loss that has a significant impact on their daily lives. This figure includes people who are registered blind or partially sighted and those whose sight is just better than the level which qualifies for registration. It also includes people who are awaiting or having treatment and people whose vision could be improved by wearing correctly prescribed glasses.
4.1 Number of people living with sight loss These indicators provide an estimate for the number of people living with sight loss and severe sight loss in 2011.
Coverage and type All areas; RNIB estimate.
Sources Access Economics (2009) Future Sight Loss UK 1: The economic impact of partial sight and blindness.
ONS (2012) 2011 Census: Usual resident population by single year of age, unrounded estimates, local authorities in the United Kingdom. Office for National Statistics.
Definition Blindness (severe sight loss) is defined as best-corrected visual acuity of <6/60 in the better-seeing eye. Partial sight is defined as best-corrected visual acuity of <6/12 to 6/60 in the better-seeing eye.
This definition differs from that used in the Certification of Vision Impairment process. Further details about the methodology used to calculate this data can be found in the “Future Sight Loss UK 1” report (Access Economics, 2009). For comparison, further details on the definitions used in the certification process can be found in the “Certification and Registration Processes” report (Boyce, 2012).
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However, the modelling does not take into account a number of factors that may influence the results for each area. For example: BME communities; local good practice on the eye care pathway, deprivation, etc.
Calculation Base prevalence rates split by age, gender, severity and cause were applied to 2011 Census population estimates split by age and gender. There are around 600 base prevalence rates in this calculation, further details can be found in the “Future Sight Loss UK 1” report.
4.2 Prevalence of sight loss Estimates on how common sight loss is amongst the general population in a given area.
Coverage and type All areas; RNIB estimate.
Sources Access Economics (2009) Future Sight Loss UK 1: The economic impact of partial sight and blindness.
ONS (2012) 2011 Census: Usual resident population by single year of age, unrounded estimates, local authorities in the United Kingdom. Office for National Statistics.
Definition The prevalence of sight loss highlights what proportion of the general population is living with sight loss at any one time.
Age is the key factor in the prevalence of sight loss. Areas that have a larger proportion of older people will have a higher estimated prevalence of sight loss when compared to an area with a younger age profile.
Calculation The prevalence of sight loss for each area was calculated as follows:
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Prevalence of sight loss = Number of people living with sight loss/Total population from 2011 Census
4.3 Future projections of the number of people living with sight loss and the prevalence of sight loss in 2020 and 2030 The base prevalence rates highlighted in the “Future Sight Loss UK 1” report have been applied to sub-national population projections. This provides an estimate of the projected number of people living with sight loss in 2020 and 2030.
Coverage and type All areas; RNIB estimate. (Note: sub-national population projections in Northern Ireland were only available to 2023, and so estimates for 2030 are not available for this area.)
Sources Access Economics (2009) Future Sight Loss UK 1: The economic impact of partial sight and blindness. RNIB.
ONS (2012) 2010-based subnational population projections for England. Office for National Statistics.
NISRA (2010) Sub-Northern Ireland Population Projections (2008 based). Northern Ireland Statistics and Research Agency.
GRO Scotland (2012) 2010-based Population Projections for Scottish Areas. General Register Office for Scotland.
Welsh Government (2010) 2008-based local authority population projections for Wales. Welsh Government.
Definition See sections 4.1 and 4.2.
Calculation See sections 4.1 and 4.2.
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5. Certification A Certification of Vision Impairment (CVI) formally certifies a person as either sight impaired (partially sighted) or severely sight impaired (blind). Each CVI form is completed by a consultant ophthalmologist in an eye clinic, with a copy being sent to the local social services department which provides a formal route to social care services.
5.1 Number of Certifications of Vision Impairment These indicators provide an overview of the number of new Certifications of Vision Impairment issued in 2011/12.
Coverage and type England and Wales; official statistics.
Sources Moorfields Eye Hospital (2013) Number of Severely Sight Impaired and Sight Impaired Certificates of Vision Impairment by local areas in England and Wales.
Definition All Certification of Vision Impairment forms sent to Moorfields Eye Hospital are included. The totals for England and Wales include any “location unknown” CVI forms.
Details of the eligibility criteria used by consultant ophthalmologists in the certification process can be found in the “Certification and Registration Processes” report (Boyce, 2012).
Calculation None.
5.2 Rate of Certifications of Vision Impairment by specific eye conditions The rate of CVIs shows us how many people have experienced sight loss as a result of a specific eye conditions out of every 100,000 people at risk.
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Coverage and type England; official statistics.
Sources Public Health England (2013) Public Health Outcomes Framework Data Tool; indicators on avoidable sight loss: data for 2011/12.
Definition Cause of sight loss, age of patient and location are taken from the Certification of Vision Impairment form, a copy of which is sent to Moorfields Eye Hospital.
The specific indicators are: Rate of Age related Macular Degeneration (AMD) CVIs for people aged 65 and over per 100,000 population Rate of glaucoma CVIs for people aged 40 and over per 100,000 population Rate of diabetic retinopathy CVIs for people aged 12 and over per 100,000 population Rate of CVIs for all ages per 100,000 population
Full details of how these indicators are calculated can be found on the Public Health Outcomes Framework Data Tool website www.phoutcomes.info.
Calculation None.
5.3 Change in rate of Certifications of Vision Impairment from 2010/11 to 2011/12 How the overall rate of certification (all ages) has changed from 2010/11 to 2011/12.
Coverage and type England; RNIB estimate.
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Sources Public Health England (2013) Public Health Outcomes Framework Data Tool; indicators on avoidable sight loss.
Definition The Public Health Outcomes Framework Data Tool contains information on the rate of certifications per 100,000 people in 2010/11 and 2011/12. This indicator highlights the percentage change in these rates between the two years.
It cannot be assumed that an increase in the rate of certification is bad, nor can it be assumed that a decrease in the rate of certification is a sign of successfully tackling avoidable sight loss. Changes in the rate of certification could be influenced by a range of factors, such as care pathways or local practice by individual consultants. These are factors that need to be explored locally.
Calculation The percentage change in the rates of certifications per 100,000 people between 2010/2011 and 2011/2012 was calculated as follows: Percentage change in rate of CVIs = ((Rate of CVIs in 2011/12/Rate of CVIs in 2010/11)-1)
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6. Registration Upon receipt of a completed Certification of Vision Impairment form, a social services department offers registration and other relevant advice and support. Registers of blind and partially sighted people are maintained by all local authorities to help them plan and deliver services.
6.1 Number of people registered as blind or partially sighted Data on the number of registered blind or partially sighted people in each local area is published each year in Wales and every three years in England. This data is not published in Northern Ireland, and has not been updated in Scotland since 2010.
Registration as blind or partially sighted in voluntary, however it can lead to some benefits and concessions such as blind person’s tax allowance, access to loan equipment and help with the cost of travel. The individual should be contacted by the local authority once a Certification of Vision Impairment (CVI) form is received to invite them to receive an assessment of need. If the person consents, and even if the assessment does not lead to provision of service, the registration should be affected.
Coverage and type England, Wales and Scotland; official statistics.
Sources HSCIC (2014) Registered Blind and Partially Sighted People - England, Year ending 31 March 2014. Health and Social Care Information Centre.
Scottish Government (2010) Registered Blind and Partially Sighted Persons, Scotland 2010. Scottish Government.
Welsh Government (2013) Local Authority Registers of People with Disabilities, 31 March 2012. Welsh Government.
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Definitions The register of blind and partially sighted people can be a useful indicator for people living with serious and permanent sight loss. However, there are limitations to the data which mean it is not considered to be a definitive measure of the number of blind and partially sighted people in an area: Certifications of Vision Impairment are not issued to all eligible patients. There is uncertainty as to how often councils update the register, for example removing people who have died. People may be living with sight loss that has a significant impact on their daily lives but are not eligible for certification or registration.
Age banding varies between England, Wales and Scotland. The age bands available for areas within these countries are as follows: England: 0–4; 4–17; 18–49; 50–64; 65–74; 75 and over. Wales: 0–17; 18–64; 65 and over. Scotland: 0–64; 65 and over.
Calculation None.
6.2 Proportion of people registered blind or partially sighted also recorded as having an additional disability The register of blind and partially sighted people can also record details of any additional disability. This indicator highlights the proportion of the registered population that are recorded as having an additional disability.
Coverage and type England; official statistics.
Sources HSCIC (2014) Registered Blind and Partially Sighted People - England, Year ending 31 March 2014. Health and Social Care Information Centre.
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Definitions The following broad categories are used to record any additional disabilities: Hard of Hearing Deaf without speech Deaf with speech Physical Disability Learning Disability Mental health
It is not clear how complete the additional disability elements of the register of blind and partially sighted people are. It is likely that this will vary considerably between local areas. Therefore, this data is not a definitive measure of the number of people with sight loss and an additional disability.
Calculation The proportion of registered population recorded with an additional disability was calculated as follows: Proportion of registered population with additional disability = (Number of people with additional disability /Total number of registered blind and partially sighted people)
6.3 Rate of registration per 100,000 people This indicator provides data on how many people are registered blind or partially sighted per 100,000 people in the general population.
Coverage and type England, Wales and Scotland; RNIB estimate.
Sources HSCIC (2014) Registered Blind and Partially Sighted People - England, Year ending 31 March 2014. Health and Social Care Information Centre.
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ONS (2012) 2011 Census: Usual resident population by single year of age, unrounded estimates, local authorities in the United Kingdom. Office for National Statistics.
Scottish Government (2010) Registered Blind and Partially Sighted Persons, Scotland 2010. Scottish Government.
Welsh Government (2013) Local Authority Registers of People with Disabilities, 31 March 2012. Welsh Government.
Definition See sections 1.1 and 4.1 for definitions of 2011 Census and registration data.
Calculation The rate of registered blind and partially sighted people per 100,000 people was calculated as follows: Rate of registration per 100k people = (Number of people registered as blind or partially sighted /Total population)*100000
Raw population data has been used to calculate the crude rate of registration. No weightings or age standardisation were used in this indicator.
6.4 Percentage change in registration over time This indicator provides data on the percentage change in the number of registered blind and partially sighted from between 2010/11 and 2013/14.
Note: This indicator only currently available in the main data table and does not appear in any of the custom reports.
Coverage and type England only.
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Sources HSCIC (2011) Registered Blind and Partially Sighted People - England, Year ending 31 March 2011. Health and Social Care Information Centre.
HSCIC (2014) Registered Blind and Partially Sighted People - England, Year ending 31 March 2014. Health and Social Care Information Centre.
Definition See 4.1 for definitions of registration data.
Calculation The percentage change is calculated as follows: Percentage change = (Number of people registered as blind or partially sighted in 2014/Number of people registered as blind or partially sighted in 2011)-1
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7. Children and young people We estimate that there are around 25,000 blind and partially sighted children and young people aged 0-16 in the UK, and 15,000 aged 17-25. Around half of these will have additional disabilities and/or special educational needs. Many of these children and young people will need help and support in order to maximise their potential in education and in other activities.
7.1 Number of children and young people These indicators provide Information on the number of children and young people in the general population. They are similar to the indicators in the area profiles (section 3), but these indicators use different age banding.
Coverage and type All areas; official statistics.
Sources ONS (2012) 2011 Census: Usual resident population by single year of age, unrounded estimates, local authorities in the United Kingdom. Office for National Statistics.
Definitions The age bands used here are 0–16 and 17–25.
For 2011 Census purposes, a usual resident of the UK is anyone who, on census day, was in the UK and had stayed or intended to stay in the UK for a period of 12 months or more, or had a permanent UK address and was outside the UK and intended to be outside the UK for less than 12 months.
Calculation None.
7.2 Number of blind and partially sighted children and young people By applying base prevalence rates to population statistics from Census 2011 we are able to estimate the number of blind and
rnib.org.uk 24 partially sighted children and young people by local areas. Indicators are provided for both blind and partially sighted children and young people aged 0–16 and 17–25 years.
Coverage and type All areas; RNIB estimate.
Sources Keil (2013) Key statistics on number of blind and partially sighted children and young people in England. RNIB.
Morris and Smith (2008) Educational provision for blind and partially sighted children and young people in Britain: 2007. National Foundation for Educational Research (NFER) for RNIB.
ONS (2012) 2011 Census: Usual resident population by single year of age, unrounded estimates, local authorities in the United Kingdom. Office for National Statistics.
Definitions The base prevalence of visual impairment in children and young people was estimated to be: 0.05 per cent for blind 0.15 per cent for partially sighted
Based on Morris and Smith (2008) and Keil (2013), we estimate that around half of these children will have an additional disability.
Calculation The number of children and young people in each age band was calculated as follows: Number of blind children = Total number of children x 0.05%
Number of partially sighted children = Total number of children x 0.15%
Number of children with an additional disability = Total number of blind and partially sighted children x 50%
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7.3 Number and proportion of children with visual impairment as primary SEN Children with special educational needs (SEN) who are known to VI services are recorded by the local authority. In England and Scotland this information is published annually, and provides an overview of the number and proportion of pupils who are recorded as having a primary SEN of visual impairment.
Coverage and type England and Scotland; official statistics.
Sources DfE (2013) Special educational needs in England: January 2013. Department for Education.
Scottish Government (2012) Supporting Children's and Young People's Learning: A report on progress of implementation of the Education (Additional Support for Learning) (Scotland) Act 2004. Scottish Government.
Definitions In England we are able to provide both overall totals and a breakdown by educational setting: Primary school Secondary school Special schools
These indicators only highlight children with visual impairment recorded as their primary SEN. There are other children with a visual impairment whose primary SEN is recorded under a different disability. Therefore, these indicators are not a definitive measure of the number of blind and partially sighted children in an area.
Calculation None.
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7.4 Proportion of visually impaired children and young people aged 0-16 with primary a SEN of visual impairment This indicator uses data on the number of blind and partially sighted children and young people (RNIB estimate) and compares this to pupils who have a primary SEN of visual impairment (official statistics).
Coverage and type England only; RNIB estimate.
Sources DfE (2013) Special educational needs in England: January 2013. Department for Education.
Morris and Smith (2008) Educational provision for blind and partially sighted children and young people in Britain: 2007. National Foundation for Educational Research (NFER) for RNIB.
ONS (2012) 2011 Census: Usual resident population by single year of age, unrounded estimates, local authorities in the United Kingdom. Office for National Statistics.
Definitions See section 6.1 and 6.2.
Calculation Proportion of blind and partially sighted children with VI as primary SEN = Number of children with VI as primary SEN / Estimated number of blind and partially sighted children
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8. Older people The older you are, the more likely your chances are to be living with sight loss. One in five people aged 75 and over are living with sight loss; compared to one in two aged 90 and over. Older people with sight loss are also much more likely to have additional health conditions or disabilities.
8.1 Number of older people These indicators provide an overview of the number of older people in the general population. The data is the same as used in the Area Profile indicators (section 3), and has been included here for convenience.
Coverage and type All areas; RNIB estimate.
Sources ONS (2012) 2011 Census: Usual resident population by single year of age, unrounded estimates, local authorities in the United Kingdom. Office for National Statistics.
Definitions The age bands used in these indicators are: 65–74 years; 75–84 years; and 85 years and over.
Calculation None.
8.2 Number of older people living with sight loss Estimates for the number of older people living with sight loss based on the age bands: 65–74 years; 75–84 years; and 85 years and over.
Coverage and type All areas; RNIB estimate.
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Sources Access Economics (2009) Future Sight Loss UK 1: The economic impact of partial sight and blindness.
ONS (2012) 2011 Census: Usual resident population by single year of age, unrounded estimates, local authorities in the United Kingdom. Office for National Statistics.
Definitions Blindness (severe sight loss) is defined as best-corrected visual acuity of <6/60 in the better-seeing eye. Partial sight is defined as best-corrected visual acuity of <6/12 to 6/60 in the better-seeing eye.
This definition differs from that used in the Certification of Vision Impairment process. It is a broader definition, and includes people who would not be eligible for certification.
Calculation Base prevalence rates split by age, gender, severity and cause were applied to 2011 Census population estimates split by age and gender.
8.3 Number of older people living in care homes Data from the 2011 Census allows us to identify what proportion of the general population live in different types of residence. This indicator uses this data is identify the number of people living in care homes.
Coverage and type All areas; Official statistics.
Sources ONS (2013) Census 2011: Communal establishment residents, local authorities in England and Wales. Office for National Statistics.
Scottish Government (2012) Scotland’s Census 2011: Communal establishment residents. Scottish Government.
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NISRA (2013) Communal Establishment Residents and Long- Term Health Problem or Disability. Northern Ireland Statistics and Research Agency.
Definitions The communal resident values from Census 2011 are: Medical and care establishment: Other: Care home with nursing Medical and care establishment: Other: Care home without nursing
Calculation None.
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9. NHS sight tests Sight tests paid for by the NHS are provided primarily by optometrists to eligible patients, such as children, people aged 60 and over, people on low incomes and some people suffering from or pre-disposed to eye disease. The exception is Scotland, where NHS sight tests are universally available to all patients.
Data on NHS sight tests is obtained from forms completed by providers, which are a payment mechanism. The nature of the way this data is collected has an impact on the quality of the data, and patients may be eligible for a NHS sight test under multiple eligibility criteria but only one will be recorded.
9.1 Number of NHS sight tests These indicators provide a summary of the number of NHS sight tests conducted in 2012/13.
Coverage and type Countries in the UK, council areas and regions in England and health boards in Wales, Scotland and Northern Ireland; Official statistics and RNIB estimates
Sources HSCIC (2013) General Ophthalmic Services, Activity Statistics, England, 2012-13. Health and Social Care Information Centre.
HSCNI (2013) General Ophthalmic Service Statistics in Northern Ireland 2012-13. Health and Social Care Northern Ireland.
ISD Scotland (2013) Ophthalmic Workload Statistics, Scotland, 2012-13. Information Services Division, NHS Scotland.
Welsh Government (2013) NHS ophthalmic statistics by Local Health Board, Wales, 2012-13. Welsh Government.
Definitions The number of NHS sight tests for a number of different eligibility criteria has been included in the data tool:
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60 years and over 15 years and under Students aged 16–18 years NHS sight tests related to benefits Total number of NHS sight tests
(Note: for Scotland and Northern Ireland only the total number of NHS sight tests has been included.)
Calculation In England, data on NHS sight tests for 2012/13 was published for Primary Care Trusts (PCTs). The degree of overlap between health and administrative boundaries varies, therefore in order to match PCTs to council areas, the following approaches were taken: PCTs where boundaries are coterminous with council areas - the figures were mapped directly across with no additional calculation. For example, Redbridge PCT maps directly to Redbridge local authority. Multiple PCTs where boundaries are coterminous with a council area - figures were combined. For example, three PCTs map directly to Birmingham local authority. Single PCTs boundaries are coterminous with multiple local authorities – the proportion of the PCT population in each local authority was calculated, and this was applied to each of the local authority areas. For example, Halton and St Helens PCT is coterminous with Halton and St Helens local authorities. Where there is no coterminosity between PCTs and local authorities, Lower Super Output Area (LSOA) population data was used to calculate weightings for each local authority. For example, Stoke on Trent PCT contains some LSOAs that form part of Staffordshire local authority.
Due to small population sizes, no data has been provided for the Isles of Scilly, City of London or Rutland.
In Scotland, Wales and Northern Ireland, official statistics have been used. Data on NHS sight tests is not published for local authorities in these areas. As a result data for NHS Health Boards
rnib.org.uk 32 have been provided. A full list of the local authorities in each NHS Health Board can be found in Appendix B of these guidance notes.
9.2 Rate of NHS sight tests The rate of NHS sights is a measure of how many people per 100,000 have had a sight test in the last year.
Coverage and type Countries in the UK, council areas and regions in England and health boards in Wales, Scotland and Northern Ireland; Official statistics and RNIB estimates
Sources HSCIC (2013) General Ophthalmic Services, Activity Statistics, England, 2012-13. Health and Social Care Information Centre.
HSCNI (2013) General Ophthalmic Service Statistics in Northern Ireland 2012-13. Health and Social Care Northern Ireland.
ISD Scotland (2013) Ophthalmic Workload Statistics, Scotland, 2012-13. Information Services Division, NHS Scotland.
Welsh Government (2013) NHS ophthalmic statistics by Local Health Board, Wales, 2012-13. Welsh Government.
Definitions The rate of NHS sight tests has been included for the following populations: All ages Aged 60 and over Aged 15 and under
(Note: for Scotland and Northern Ireland only the rate of NHS sight tests for all ages has been included.)
Calculation In England, data on NHS sight tests for 2012/13 was published for Primary Care Trusts. The degree of overlap between health and
rnib.org.uk 33 administrative boundaries varies, therefore in order to match PCTs to council areas, the following approaches were taken: PCTs where boundaries are coterminous with council areas - the rates of NHS sight tests were mapped directly across with no additional calculation. In all other instances (see section 9.1) new rates were calculated by dividing the number of NHS sight tests for each local authority by population estimates from the 2011 Census.
In Scotland, Wales and Northern Ireland, official statistics have been used. Data on NHS sight tests is not published to local authorities in these areas. As a result data for NHS Health Boards have been provided. A full list of the local authorities in each NHS Health Board can be found in Appendix B of these guidance notes.
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10. Cost of sight loss There are a number of different costs associated with the provision of eye health services, such as inpatient procedures, outpatient appointments and the ongoing treatment of eye conditions. There are also indirect costs caused by sight loss, including the provision of informal care to those with sight loss, often provided by family and friends.
10.1 Total and proportion of NHS expenditure on problems of vision or ophthalmic services NHS Programme Budgets provide detailed information on how money was spent on healthcare in England and Wales. This data is a key resource allowing commissioners to see where money is being spent, and it is increasingly being linked to outcome data in order to assess the value for money of outcomes, prioritise and drive reform and quality improvement initiatives.
In Scotland NHS expenditure data is provided under different clinical specialities, and the cost of ophthalmic services can be highlighted.
Coverage and type England and Wales, council areas and regions in England and health boards in Wales; Official statistics and RNIB estimates.
Scotland, NHS Health Boards; Official statistics.
Sources DH (2013) Programme Budgeting Benchmarking Tool, 2011/12. Department for Health.
ISD Scotland (2013) Expenditure on ophthalmic services, by NHS sector and board, 2012/13. Information Services Division, part of NHS National Services Scotland.
Welsh Government (2013) NHS Programme Budgets, 2011/12. Welsh Government.
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Definitions Data for England and Wales relates to the “problems of vision” disease category in NHS Programme Budgets and total Programme Budget expenditure.
Data for Scotland relates to hospital and Family Health Service expenditure related to ophthalmology.
Calculation In England, data on NHS Programme Budgets was published for Primary Care Trust geography. The degree of overlap between health and administrative boundaries varies, therefore in order to match PCTs to council areas, the following approaches were taken: PCTs where boundaries are coterminous with council areas - the expenditure was mapped directly across with no additional calculation. For example, Redbridge PCT maps directly to Redbridge local authority. Multiple PCTs where boundaries are coterminous with a council area – expenditures for the PCTs were combined to make a single local authority amount. For example, three PCTs map directly to Birmingham local authority. Single PCTs boundaries are coterminous with multiple local authorities – the proportion of the PCT population in each local authority was calculated, and this weighting was applied to expenditure data to obtain estimates for each local authority. For example, Halton and St Helens PCT is coterminous with Halton and St Helens local authorities. Where there is no coterminosity between PCTs and local authorities, Lower Super Output Area (LSOA) population data was used to create individual weightings for each local authority, and this was applied to expenditure data to obtain estimates for each local authority. For example, Stoke on Trent PCT contains some LSOAs that form part of Staffordshire local authority.
Due to small population sizes, no data has been provided for the Isles of Scilly, City of London or Rutland.
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In Wales official statistics have been used. Data on Programme Budgets is not published to local authority areas in this country. As a result data for NHS Health Boards has been provided.
In Scotland official statistics have been used. Data on ophthalmology expenditure is not published to local authority areas in this country. As a result data for NHS Health Boards has been provided.
The proportion of NHS Programme Budget spent on “problems of vision” was calculated as follows: Proportionate spend on problems of vision = Spend on problems of vision / Total spent
10.2 NHS expenditure on problems of vision per person Information on the amount of Programme Budget expenditure related to problems of vision per person.
Coverage and type England and Wales, council areas and regions in England and health boards in Wales; Official statistics and RNIB estimates.
Sources DH (2013) Programme Budgeting Benchmarking Tool, 2011/12. Department for Health.
Welsh Government (2013) NHS Programme Budgets, 2011/12. Welsh Government.
Definitions See section 10.1 for information on NHS Programme Budgets, and section 3.1 for information on usual resident population estimates.
Calculation In England, published data on Programme Budget spend per person uses Hospital and Community Health Services weighting to adjust for variations in the demographic profile of an area. We were not able to use this published data because of the
rnib.org.uk 37 calculations used to provide information at a local authority level. Therefore we have used raw population data to calculate this indicator.
In Wales official statistics have been used. Data on Programme Budgets is not published to local authorities in this area. As a result data for NHS Health Boards have been provided.
10.3 Total indirect cost of sight loss It is estimated that the total indirect cost of sight loss to the UK economy is £5.3 billion each year. This indicator apportions this figure to all the local authorities in the UK based on the prevalence of sight loss in each area.
Coverage and type All areas; RNIB estimate.
Sources Access Economics (2009) Future Sight Loss UK 1: The economic impact of partial sight and blindness.
ONS (2012) 2011 Census: Usual resident population by single year of age, unrounded estimates, local authorities in the United Kingdom. Office for National Statistics.
Definitions Indirect costs include a range of costs, the largest element being informal care provided to blind and partially sighted people by family and friends. Other significant elements are lower rates of employment and the cost of specialist equipment. Full details can be found in the Access Economics report “Future Sight Loss UK 1”.
See section 4.1 for details on how estimates for the number of people living with sight loss are calculated.
Calculation Indirect cost of sight loss in a local authority = (Number of people living with sight loss in the local
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authority/Total number of people living with sight loss in the UK) x £5.3 billion
10.4 Indirect cost of sight loss per person This indicator provide data on the estimated indirect cost of sight loss per person.
Coverage and type All areas, RNIB estimates.
Sources Access Economics (2009) Future Sight Loss UK 1: The economic impact of partial sight and blindness.
ONS (2012) 2011 Census: Usual resident population by single year of age, unrounded estimates, local authorities in the United Kingdom. Office for National Statistics.
Definitions See section 10.3 for information on the indirect cost of sight loss, and section 3.1 for information on usual resident population.
Calculation Estimated indirect cost of sight loss per person = Total indirect cost of sight loss / Total population
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11. Sight threatening eye conditions There are a number of people who are living with a sight threatening eye condition. This includes people who have experienced sight loss as a result of age-related macular degeneration, cataract, glaucoma and diabetic retinopathy. It also includes people with the early stages of these diseases who have not experienced any reduction in their vision at this point.
11.1 Number of people living with age-related macular degeneration; 2011, 2015 and 2020 Aged-related macular degeneration is the leading cause of blindness in the UK, and is the most common cause of sight loss recorded on Certification of Vision Impairment forms. Many more people receive a diagnosis of AMD and are living either with the early or late stages of the disease.
Coverage and type All areas; RNIB estimate.
Sources GRO Scotland (2012) 2010-based Population Projections for Scottish Areas. General Register Office for Scotland.
NEHEM (2013) National Eye Health Epidemiological Model. Data and models by Public Health Action Support Team, published by Local Optical Committee Support Unit.
NISRA (2010) Sub-Northern Ireland Population Projections (2008 based). Northern Ireland Statistics and Research Agency.
ONS (2012) 2011 Census: Usual resident population by single year of age, unrounded estimates, local authorities in the United Kingdom. Office for National Statistics.
ONS (2012) 2010-based subnational population projections for England. Office for National Statistics.
Welsh Government (2010) 2008-based local authority population projections for Wales. Welsh Government.
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Definitions The indicators in the sight loss data tool provide information on: Early AMD/Drusen Late stage dry AMD (geographic atrophy AMD) Late stage wet AMD (neovascular AMD) Any late stage AMD (wet or dry)
See the National Eye Health Epidemiology Model (NEHEM) for further information about how age-related macular degeneration was defined: www.eyehealthmodel.org.
Calculation Base prevalence rates for AMD split by age and gender were taken from NEHEM and applied to population estimates from the 2011 Census and the relevant sub-national population projections for each country.
Base prevalence rates for AMD in males Age band Total late Late stage Late stage Early AMD/ stage AMD wet AMD dry AMD Drusen 50-54 0.09% 0.02% 0.06% 3.58% 55-59 0.20% 0.06% 0.11% 4.95% 60-64 0.43% 0.16% 0.22% 6.86% 65-69 0.90% 0.38% 0.51% 9.73% 70-74 1.97% 1.40% 0.56% 12.52% 75-79 4.07% 2.63% 1.91% 18.66% 80+ 6.94% 5.56% 1.39% 23.26%
Base prevalence rates for AMD in females Age band Total late Late stage Late stage Early AMD/ stage AMD wet AMD dry AMD Drusen 50-54 0.21% 0.25% 0.00% 4.36% 55-59 0.37% 0.39% 0.01% 5.89% 60-64 0.64% 0.60% 0.05% 7.97% 65-69 1.03% 0.92% 0.11% 9.89% 70-74 2.36% 1.42% 0.95% 17.29% 75-79 3.15% 2.17% 1.18% 18.09%
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80+ 15.00% 10.50% 5.75% 28.86%
11.2 Number of people living with cataract in 2011, 2015 and 2020 Cataract surgery is the most common surgical procedure performed in the NHS. There are around 400,000 cataract operations in the UK each year. This indicator provides information on the number of people who are estimated to be living with a cataract in either or both eyes.
Coverage and type All areas; RNIB estimate.
Sources GRO Scotland (2012) 2010-based Population Projections for Scottish Areas. General Register Office for Scotland.
NEHEM (2013) National Eye Health Epidemiological Model. Data and models by Public Health Action Support Team, published by Local Optical Committee Support Unit.
NISRA (2010) Sub-Northern Ireland Population Projections (2008 based). Northern Ireland Statistics and Research Agency.
ONS (2012) 2011 Census: Usual resident population by single year of age, unrounded estimates, local authorities in the United Kingdom. Office for National Statistics.
ONS (2012) 2010-based subnational population projections for England. Office for National Statistics.
Welsh Government (2010) 2008-based local authority population projections for Wales. Welsh Government.
Definitions See the National Eye Health Epidemiology Model for further information about how cataract was defined: www.eyehealthmodel.org.
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Calculation Base prevalence rates for cataract split by age were taken from NEHEM and applied to population estimates from the 2011 Census and the relevant sub-national population projections for each country.
Base prevalence rates for cataract Age band Prevalence of cataract (low estimate) 40-49 0.04% 50-59 0.17% 60-69 0.81% 70-79 3.91% 80+ 11.73%
11.3 Number of people living with glaucoma in 2011, 2015 and 2020 Glaucoma is one of the leading causes of avoidable sight loss; and was the main or contributory cause in around 15 per cent of Certifications of Vision Impairment in 2011/12.
Coverage and type All areas; RNIB estimate.
Sources GRO Scotland (2012) 2010-based Population Projections for Scottish Areas. General Register Office for Scotland.
NEHEM (2013) National Eye Health Epidemiological Model. Data and models by Public Health Action Support Team, published by Local Optical Committee Support Unit.
NISRA (2010) Sub-Northern Ireland Population Projections (2008 based). Northern Ireland Statistics and Research Agency.
ONS (2012) 2011 Census: Usual resident population by single year of age, unrounded estimates, local authorities in the United Kingdom. Office for National Statistics.
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ONS (2012) 2010-based subnational population projections for England. Office for National Statistics.
Welsh Government (2010) 2008-based local authority population projections for Wales. Welsh Government.
Definitions See the National Eye Health Epidemiology Model for further information about how glaucoma was defined: www.eyehealthmodel.org.
Calculation Population prevalence rates for glaucoma in each of the UK countries were taken from NEHEM and applied to the relevant 2011 Census and sub-national population projections.
Population prevalence rates of glaucoma by country in the UK taken from NEHEM: England = 1.47 per cent Northern Ireland = 1.29 per cent Wales = 1.37 per cent Scotland = 1.5 per cent
11.4 Number of people living with diabetes in 2011, 2015 and 2020 Diabetes is a common life-long health condition, where the amount of glucose in the blood is too high because the body cannot use it properly. Diabetes can lead to sight loss caused by diabetic eye disease, including diabetic retinopathy.
Coverage and type All areas; RNIB estimate.
Sources Diabetes UK (2013) Diabetes in the UK 2013. Diabetes UK.
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GRO Scotland (2012) 2010-based Population Projections for Scottish Areas. General Register Office for Scotland.
NISRA (2010) Sub-Northern Ireland Population Projections (2008 based). Northern Ireland Statistics and Research Agency.
ONS (2012) 2011 Census: Usual resident population by single year of age, unrounded estimates, local authorities in the United Kingdom. Office for National Statistics.
ONS (2012) 2010-based subnational population projections for England. Office for National Statistics.
Welsh Government (2010) 2008-based local authority population projections for Wales. Welsh Government.
Definitions The prevalence rates for diabetes taken from a Diabetes UK publication were sourced from the Health Survey for England 2010.
Calculation Base prevalence rates for diabetes split by age and gender were taken from the “Diabetes in the UK 2013” report applied to population estimates from 2011 Census and the relevant sub- national population projections for each country.
Base prevalence rates for diabetes Age band Prevalence of Prevalence of diabetes – men diabetes – women 16-34 1.80% 2.10% 35-54 9.40% 6.60% 55-64 11.10% 8.00% 65-74 15.20% 12.20% 75+ 15.90% 13.20%
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11.5 Proportion of people with diabetes attending retinal screening Diabetic retinopathy is a common cause of blindness in the UK, particularly amongst the working age population. Regular screening allows prompt identification and effective treatment if necessary of sight threatening diabetic retinopathy.
Coverage and type England only; official statistics.
Sources Public Health England (2013) Public Health Outcomes Framework Data Tool, Access to non-cancer screening programmes: diabetic retinopathy, 2011/12.
Definitions This indicator highlights the proportion of patient who were offered and attended retinal screening. Some people with diabetes are excluded from the screening programme, and they are not included in this indicator. Someone may be excluded from the screening programme for a number of reasons, possible reasons for exclusion are that the patient may have opted-out, already be attending an eye clinic or have a terminal illness.
Other supporting information related to this indicator can be found on the Public Health Outcomes Framework Data Tool website: www.phoutcomes.info.
Calculation None.
11.6 Number of people living with diabetic retinopathy in 2011, 2015 and 2020 Diabetic retinopathy is a complication of diabetes, resulting in damage to the blood vessels in the eye. It is a common cause of blindness in the UK, particularly amongst the working age population.
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Coverage and type All areas; RNIB estimate.
Sources GRO Scotland (2012) 2010-based Population Projections for Scottish Areas. General Register Office for Scotland.
Minassian and Reidy (2009) Future Sight Loss UK 2: An epidemiological and economic model for sight loss in the decade 2010-2020. EpiVision and RNIB.
NISRA (2010) Sub-Northern Ireland Population Projections (2008 based). Northern Ireland Statistics and Research Agency.
ONS (2012) 2011 Census: Usual resident population by single year of age, unrounded estimates, local authorities in the United Kingdom. Office for National Statistics.
ONS (2012) 2010-based subnational population projections for England. Office for National Statistics.
Welsh Government (2010) 2008-based local authority population projections for Wales. Welsh Government.
Definitions See the “Future Sight Loss UK 2” report for further information about how the various stage of diabetic retinopathy were defined: www.rnib.org.uk/research.
Calculation Population prevalence rates for different stages of diabetic retinopathy were applied to the relevant 2011 Census and sub- national population projections.
The prevalence rates used were: Background diabetic retinopathy = 28 per cent of people with diabetes. Non-proliferative and proliferative diabetic retinopathy = 3.2 per cent of people with diabetes.
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12. Support The provision of emotional and practical support at the right time can help people who are experiencing sight loss to retain their independence and access the support they need.
12.1 Eye clinic support Please note: in Version 2.2 these indicators have been temporarily removed from the Sight Loss Data Tool. We are committed to providing the most accurate and up to date information available. Our eye clinic support mapping is currently undergoing a major update, and we will provide more and better information on eye clinic support in Version 3 of the SLDT.
Patient experience in the eye clinic can be important to future independence. It is here that people receive their diagnosis, undergo treatment and potentially go through the process of receiving a Certificate of Vision Impairment. Support at any of these stages may be invaluable to someone experiencing sight loss
These indicators highlight the number of eye clinics with and without some form of emotional and practical support in place for patients.
Coverage and type All areas; RNIB estimate.
Sources RNIB (2013) Eye clinic mapping data. Unpublished.
Definitions Desk research was undertaken to identify hospital locations providing outpatient ophthalmology appointments. Each location providing outpatient ophthalmology appointments was contacted by telephone to enquire about the support in place. In addition, we have used contacts gained through our Eye Clinic Support Services course and the Early Intervention Support Network to keep this information up-to-date.
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A hospital was counted as having some form of emotional and practical support in place if: Eye Clinic Liaison Officers were in post. Other professionals were providing an ECLO-type role, for example an ophthalmic nurse with an element of patient support built into their role, or some form of Patient Support Service was in place. Volunteers were in place.
This indicator does not take into account the possible varying quality of support. It also does not take into account the varying sizes of eye clinics.
Calculation Hospital locations were mapped to specific local authorities using postcodes. Hospitals often provide services to patients from multiple local authorities, but the data tool does not provide information on this.
12.2 Rehabilitation support Please note: in Version 2.2 these indicators have been temporarily removed from the Sight Loss Data Tool. We are committed to providing the most accurate and up to date information available. Our rehabilitation services mapping is currently undergoing a major update, and we will provide more and better information on rehab support in Version 3 of the SLDT.
Visual impairment rehabilitation is an intervention delivered by specialist professionals. Rehabilitation Officers help people to maximise their functional vision and skills for confident daily living. A survey conducted by the Social Care Association in 2012 mapped the provision of this support in England.
Coverage and type England only; RNIB estimate.
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Sources SCA (2012) Estimated number of ROVIs currently working in the UK. Social Care Association
Definitions Data based on responses to a survey conducted by the Social Care Association in 2012. This outlined the number of Rehabilitation Officers – Visual Impairment in local authorities.
Calculation None.
12.3 Number of blind and partially sighted people in receipt of adult social care services Social care involves the provision of help with personal care and domestic tasks to enable people to live as independently as possible. This care can be provided in people's own homes or in a residential setting. This indicator relates to social care provided or paid for by councils with responsibilities for social care.
Coverage and type England only; official statistics.
Sources NASCIC (2013) Adult social care: Referrals, Assessments and Packages of Care data, 2012/13. National Adult Social Care Information Centre.
Definitions The indicator uses the Referrals, Assessments and Packages of Care dataset to estimate the number of blind and partially sighted people in receipt of social care in 2012/13.
Calculation Blindness and Deaf Blind categories have been combined to provide a total for blind and partially sighted people.
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12.4 Number of blind and partially sighted people in receipt of Disability Living Allowance Disability Living Allowance (DLA) is a benefit paid to help people with the extra costs incurred as a result of a disability, and it is paid at different rates depending on the level of need.
Coverage and type England, Wales and Scotland; official statistics.
Sources DWP (2013) Benefit claimants: Disability Living Allowance by disabling condition. Department for Work and Pensions.
Definitions Data on the number of Disability Living Allowance claimants by disabling conditions in November 2012 has been used in this indicator.
Calculation Blindness and Deaf Blind categories have been combined to provide a total for blind and partially sighted people.
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13. Other health conditions and disability The section on other health conditions and disability provides an overview of some of the common additional health problems that can impact on blind and partially sighted people. Indicators are provided on falls, dementia, stroke and hearing impairment.
13.1 Falls These indicators provide estimates on the number of people aged 65 and over who suffer at least one fall each year. Further estimates are provided for the number of serious falls that require hospital admission. We can use this data on falls within the general population to estimate the number of blind and partially sighted people who fall each year and how many falls were directly attributable to sight loss.
Coverage and type All areas; RNIB estimate.
Sources ONS (2012) 2011 Census: Usual resident population by single year of age, unrounded estimates, local authorities in the United Kingdom. Office for National Statistics.
Boyce T, Stone MK, Johnson S and Simkiss P (2013) Projecting numbers of falls related to visual impairment. British Journal of Healthcare Management 2013 Vol 19 No 6.
POPPI (2013) Projecting Older People Population Information System. Institute of Public Care for the Department of Health.
Definition Number of falls is defined as people who reported having at least one fall during the last 12 months.
Number of falls that required hospital admission is based on a study of A&E admissions.
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Calculation Prevalence rates for people who report falls or falls that required hospital admission were obtained from POPPI and were applied to Census 2011 population data. Methodology from Boyce et al (2013) was then applied to estimate the number of blind and partially sighted people who suffered a fall and the number of falls that were directly attributable to sight loss.
The number of falls occurring and directly attributed to visual impairment was calculated as follows: Number of falls which occurred in individuals with visual impairment = 8.04 per cent of total number of falls. Number of falls which can be directly attributed to the visual impairment = 3.80 per cent of total number of falls.
Base prevalence rates of people aged 65 and over reporting a fall in the general population Age range Percentage of males Percentage of reporting a fall females reporting a fall 65–69 18% 23% 70–74 20% 27% 75–79 19% 27% 80–84 31% 34% 85+ 43% 43%
Base prevalence rates of falls that require hospital admission for people aged 65 and over in the general population Age range Percentage of population with a fall requiring hospital admission 65–69 0.52% 70–74 0.92% 75+ 3.68%
13.2 Dementia These indicators provide estimates on the number of people aged 65 and over in the general population who are living with some form of dementia.
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Coverage and type All areas; RNIB estimate.
Sources ONS (2012) 2011 Census: Usual resident population by single year of age, unrounded estimates, local authorities in the United Kingdom. Office for National Statistics.
POPPI (2013) Projecting Older People Population Information System. Institute of Public Care for the Department of Health.
Definition The term “dementia” is used to describe a collection of symptoms, including a decline in memory, reasoning and communication skills, and a gradual loss of skills needed to carry out daily activities.
Calculation Prevalence rates for dementia, split by age and sex, were taken from POPPI and applied to Census 20111 population data.
Base prevalence rates men and women with dementia Age range Percentage of males Percentage of with dementia females with dementia 65–69 1.5% 1.0% 70–74 3.1% 2.4% 75–79 5.1% 6.5% 80–84 10.2% 13.3% 85–89 16.7% 22.2% 90+ 27.9% 30.7%
13.3 Stroke These indicators provide estimates on the number of people aged 65 and over who have a longstanding health condition caused by a stroke.
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Coverage and type All areas; RNIB estimate.
Sources ONS (2012) 2011 Census: Usual resident population by single year of age, unrounded estimates, local authorities in the United Kingdom. Office for National Statistics.
POPPI (2013) Projecting Older People Population Information System. Institute of Public Care for the Department of Health.
Definition Based on survey data where participants were asked if they had experienced a stroke.
Calculation Base prevalence rates for stroke, split by age and gender, were taken from POPPI and applied to Census 2011 population data.
Base prevalence rates of men and women reporting a stroke Age range Percentage of males Percentage of reporting a stroke females reporting a stroke 65–74 2.8% 1.2% 75+ 3.8% 1.9%
13.4 Hearing impairment These indicators provide an overview of the number of people living with hearing impairment by severity in the UK.
Coverage and type All areas; RNIB estimate.
Sources ONS (2012) 2011 Census: Usual resident population by single year of age, unrounded estimates, local authorities in the United Kingdom. Office for National Statistics.
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POPPI (2013) Projecting Older People Population Information System. Institute of Public Care for the Department of Health.
Definition Hearing loss and deafness is measured by finding the quietest sounds someone can hear using tones with different frequencies. Hearing thresholds are measured in decibels hearing levels (dBHL). Anyone with thresholds between 0 and 20 dBHL across all the frequencies is considered to have 'normal' hearing. The greater the threshold level is in dBHL the worse the hearing loss. Moderate deafness: The quietest sounds that can be heard in the better ear is on average between 35 and 49 decibels. Severe deafness: The quietest sounds that can heard in better ear is on average between 50 and 94 decibels. Profound deafness: The quietest sounds can be heard in the better ear is on average 95 decibels or more.
Calculation Base prevalence rates for hearing loss, split by age and gender, were taken from POPPI and applied to Census 2011 population data.
Base prevalence rates for moderate or severe and profound hearing loss Age range Percentage Percentage Percentage Percentage of males of females of males of females with with with with moderate moderate profound profound or severe or severe hearing hearing hearing hearing loss loss loss loss 20–24 0.18% 0.24% 0.0% 0.0% 25–34 0.0% 0.95% 0.0% 0.0% 35–44 0.78% 2.09% 0.0% 0.0% 45–54 7.15% 4.13% 0.0% 0.09% 55–64 14.81% 8.09% 0.12% 0.13% 65–74 22.69% 15.79% 0.43% 0.78% 75–84 60.63% 63.43% 0.41% 0.80% 85+ 85.05% 84.8% 3.45% 4.73%
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Appendix A – Additional resources This section provides information on some other useful data tools and resources. This is not a comprehensive list.
1. Toolkits and guides for using data
Effective eye care commissioning www.commissioningforeyecare.org.uk
Guidance published by the UK Vision Strategy to support commissioners. The resource includes of a range information, including data sources and key policy documents.
Making disability data work for you http://odi.dwp.gov.uk/fulfilling-potential/toolkit.php
The Office for Disability Issues has published a new toolkit that shows what data has been published about disability and how that data can be used. It aims to help organisation find and use data to support their work.
2. Directory of services
Sightline directory www.sightlinedirectory.org.uk
Sightline is an online directory of services and organisations that help blind and partially sighted people in the UK. The directory is maintained by RNIB.
3. Other useful data tools
Child Health Profiles www.chimat.org.uk/profiles
Child health profiles give a snapshot of child health and wellbeing for each local authority in England, using key health indicators.
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Users can compare this information to local, regional and national data.
Commissioning for Value www.england.nhs.uk/resources/resources-for-ccgs/comm-for- value/
Data packs published by NHS England for each Care Commissioning Group and area team. These packs aim to help commissioners access data, evidence and tools to help them make decisions and plan services for patients and populations in their areas.
Daffodil www.daffodilcymru.org.uk
Daffodil provides information to help plan care services might be required in local areas in Wales. Information from research and population projections show potential need for care over the next 20 years for children, adults and older people.
Health profiles www.healthprofiles.info/
Health Profiles is a programme to improve availability and accessibility for health and health-related information in England. The profiles give a snapshot overview of health for each local authority in England. Health Profiles are produced annually. Designed to help local government and health services make decisions and plans to improve local people's health and reduce health inequalities, the profiles present a set of health indicators that show how the area compares to the national average.
Local Health www.localhealth.org.uk
Developed by Public Health England, the Local Health resource provides interactive maps for a number of indicators from ward to local authority level.
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Longer Lives Data Tool http://longerlives.phe.org.uk/
Longer Lives highlights premature mortality across every local authority in England, giving people important information to help them improve their community’s health.
National Eye Health Epidemiological Model www.eyehealthmodel.org.uk
The National Eye Health Epidemiological Model (NEHEM) provides information of the number of people living with age- related macular degeneration, glaucoma, cataract and low vision. The tool is customisable, providing users with the option to input their own base prevalence rates or population data.
National General Practice Profiles http://fingertips.phe.org.uk/profile/general-practice
These profiles are designed to support GPs, clinical commissioning groups (CCGs) and local authorities to ensure that they are providing and commissioning effective and appropriate healthcare services for their local population.
Nomis www.nomisweb.co.uk
Nomis is an online database of UK labour market statistics. This includes a wealth of data from Jobcentre Plus, the Labour Force Survey and benefits such as Disability Living Allowance and Attendance Allowance.
Older People’s Health and Wellbeing Atlas www.wmpho.org.uk/olderpeopleatlas
The Older People’s Health and Wellbeing Atlas provides a snapshot profile of each local authority in England. Interactive maps and charts enable comparisons to be made nationally for over 100 indicators. The atlas can be used to highlight deficits in the health and care of older people and large variations between
rnib.org.uk 60 local authorities across England. The information will be of use to the wide range of organisations with an interest in the health and care of older people.
PANSI www.pansi.org.uk
Projecting Adult Needs and Service Information (PANSI) provides access to projections of the numbers, characteristics and care needs of people aged 18–64 in England at national, regional and council level.
POPPI www.poppi.org.uk
Projecting Older People Population Information (POPPI) provides access to projections of the numbers, characteristics and care needs of people over 65 in England at national, regional and council level.
Public Health Outcomes Framework Tool www.phoutcomes.info
The Public Health Outcomes Framework sets out a vision for public health, desired outcomes and the indicators that will help us understand how well public health is being improved and protected. The framework concentrates on two high-level outcomes to be achieved across the public health system, and groups further indicators into four ‘domains’ that cover the full spectrum of public health.
This tool currently presents data for available indicators at England and upper tier local authority levels, collated by Public Health England.
StatsWales https://statswales.wales.gov.uk
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StatsWales is the Welsh Government’s free-to-use online repository for detailed statistical data for Wales. The system covers nearly 1,000 datasets, including key information on a wide range of topics such as population, education, health and disability.
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Appendix B – References
Access Economics (2009) Future Sight Loss UK 1: The economic impact of partial sight and blindness.
Boyce T (2012) The Certification and Registration Processes: Stages, barriers and delays. RNIB.
Boyce T, Stone MK, Johnson S and Simkiss P (2013) Projecting numbers of falls related to visual impairment. British Journal of Healthcare Management 2013 Vol 19 No 6.
DCLG (2010) English Indices of Deprivation 2010: county summaries. Department for Communities and Local Government.
DfE (2013) Special educational needs in England: January 2013. Department for Education.
DH (2013) Programme Budgeting Benchmarking Tool, 2011/12. Department for Health.
Diabetes UK (2013) Diabetes in the UK 2013. Diabetes UK.
DWP (2013) Benefit claimants: Disability Living Allowance by disabling condition. Department for Work and Pensions.
GRO Scotland (2012) 2010-based Population Projections for Scottish Areas. General Register Office for Scotland.
HSCIC (2011) Registered Blind and Partially Sighted People - England, Year ending 31 March 2011. Health and Social Care Information Centre.
HSCIC (2013) General Ophthalmic Services, Activity Statistics, England, 2012-13. Health and Social Care Information Centre.
HSCNI (2013) General Ophthalmic Service Statistics in Northern Ireland 2012-13. Health and Social Care Northern Ireland.
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HSCIC (2014) Registered Blind and Partially Sighted People - England, Year ending 31 March 2014. Health and Social Care Information Centre.
ISD Scotland (2013) Expenditure on ophthalmic services, by NHS sector and board, 2012/13. Information Services Division, part of NHS National Services Scotland.
ISD Scotland (2013) Ophthalmic Workload Statistics, Scotland, 2012-13. Information Services Division, NHS Scotland.
Keil (2013) Key statistics on number of blind and partially sighted children and young people in England. RNIB.
Moorfields Eye Hospital (2013) Number of Severely Sight Impaired and Sight Impaired Certificates of Vision Impairment by local areas in England and Wales.
Morris and Smith (2008) Educational provision for blind and partially sighted children and young people in Britain: 2007. National Foundation for Educational Research (NFER) for RNIB.
NASCIC (2013) Adult social care: Referrals, Assessments and Packages of Care data, 2012/13. National Adult Social Care Information Centre.
NEHEM (2013) National Eye Health Epidemiological Model. Data and models by Public Health Action Support Team, published by Local Optical Committee Support Unit.
NISRA (2010) Sub-Northern Ireland Population Projections (2008 based). Northern Ireland Statistics and Research Agency.
NISRA (2010) Northern Ireland Multiple Deprivation Measure 2010. Northern Ireland Statistics and Research Agency.
NISRA (2013) Communal Establishment Residents and Long- Term Health Problem or Disability. Northern Ireland Statistics and Research Agency.
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NISRA (2013) 2011 Census: Ethnicity, Identity, Language and Religion. Northern Ireland Statistics and Research Agency.
NRS (2013) 2011 Census: Ethnic groups. National Records of Scotland.
ONS (2012) 2010-based subnational population projections for England. Office for National Statistics.
ONS (2012) 2011 Census: Usual resident population by single year of age, unrounded estimates, local authorities in the United Kingdom. Office for National Statistics.
ONS (2012) 2011 Census: Key Statistics for local authorities in England and Wales, Ethnic group. Office for National Statistics.
ONS (2013) Census 2011: Communal establishment residents, local authorities in England and Wales. Office for National Statistics.
POPPI (2013) Projecting Older People Population Information System. Institute of Public Care for the Department of Health.
Public Health England (2013) Public Health Outcomes Framework Data Tool; indicators on avoidable sight loss: data for 2011/12.
Public Health England (2013) Public Health Outcomes Framework Data Tool: indicators on non-cancer screening. Public Health England.
RNIB (2013) Eye clinic mapping data. Unpublished.
SCA (2012) Estimated number of ROVIs currently working in the UK. Social Care Association.
Scottish Government (2010) Registered Blind and Partially Sighted Persons, Scotland 2010. Scottish Government.
Scottish Government (2012) Scottish Index of Multiple Deprivation. Scottish Government.
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Scottish Government (2012) Supporting Children's and Young People's Learning: A report on progress of implementation of the Education (Additional Support for Learning) (Scotland) Act 2004. Scottish Government.
Scottish Government (2012) Scotland’s Census 2011: Communal establishment residents. Scottish Government.
Welsh Government (2012) Welsh Index of Multiple Deprivation 2012. Welsh Government.
Welsh Government (2013) Local Authority Registers of People with Disabilities, 31 March 2012. Welsh Government.
Welsh Government (2010) 2008-based local authority population projections for Wales. Welsh Government.
Welsh Government (2013) NHS ophthalmic statistics by Local Health Board, Wales, 2012-13. Welsh Government.
Welsh Government (2013) NHS Programme Budgets, 2011/12. Welsh Government.
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Appendix C – Geographical areas This section provides a summary of all of the geographical areas covered in the Sight Loss Data Tool.
1. England North East Darlington; Durham; Hartlepool; Middlesbrough; Northumberland; Redcar & Cleveland; Stockton-on-Tees; Gateshead; Newcastle- upon-Tyne; North Tyneside; South Tyneside; Sunderland.
North West Cumbria; Lancashire; Blackburn with Darwen; Blackpool; Cheshire East; Cheshire West and Chester; Halton; Warrington; Bolton; Bury; Knowsley; Liverpool; Manchester; Oldham; Rochdale; Salford; Sefton; St Helens; Stockport; Tameside; Trafford; Wigan; Wirral.
Yorkshire and the Humber North Yorkshire; East Riding; Kingston-upon-Hull; North East Lincolnshire; North Lincolnshire; York; Barnsley; Bradford; Calderdale; Doncaster; Kirklees; Leeds; Rotherham; Sheffield; Wakefield.
East Midlands Derbyshire; Leicestershire; Lincolnshire; Northamptonshire; Nottinghamshire; Derby; Leicester; Nottingham; Rutland.
West Midlands Staffordshire; Warwickshire; Worcestershire; Herefordshire; Shropshire; Stoke-on-Trent; Telford and Wrekin; Birmingham; Coventry; Dudley; Sandwell; Solihull; Walsall; Wolverhampton.
South West Devon; Dorset; Gloucestershire; Somerset; Bath & N E Somerset; Bournemouth; Bristol; Cornwall; Isles of Scilly; North Somerset; Plymouth; Poole; South Gloucestershire; Swindon; Torbay; Wiltshire.
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East Cambridgeshire; Essex; Hertfordshire; Norfolk; Suffolk; Bedford; Central Bedfordshire; Luton; Peterborough; Southend; Thurrock.
London Camden; Greenwich; Hackney; Hammersmith & Fulham; Islington; Kensington & Chelsea; Lambeth; Lewisham; Southwark; Tower Hamlets; Wandsworth; Westminster; City of London; Barking & Dagenham; Barnet; Bexley; Brent; Bromley; Croydon; Ealing; Enfield; Haringey; Harrow; Havering; Hillingdon; Hounslow; Kingston-upon-Thames; Merton; Newham; Redbridge; Richmond- upon-Thames; Sutton; Waltham Forest.
South East Buckinghamshire; East Sussex; Hampshire; Kent; Oxfordshire; Surrey; West Sussex; Bracknell Forest; Brighton & Hove; Isle of Wight; Medway Towns; Milton Keynes; Portsmouth; Reading; Slough; Southampton; West Berkshire; Windsor & Maidenhead; Wokingham.
2. Scotland NHS Ayrshire & Arran East Ayrshire, North Ayrshire and South Ayrshire
NHS Borders Scottish Borders
NHS Dumfries & Galloway Dumfries and Galloway
NHS Fife Fife
NHS Forth Valley Clackmannanshire, Falkirk and Stirling
NHS Grampian Aberdeenshire, City of Aberdeen and Moray
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NHS Greater Glasgow & Clyde City of Glasgow, West Dunbartonshire, East Dunbartonshire, Renfrewshire, East Renfrewshire and Inverclyde; plus parts of South Lanarkshire and North Lanarkshire.
NHS Highland Argyll and Bute and Highland.
NHS Lanarkshire North Lanarkshire, South Lanarkshire.
NHS Lothian City of Edinburgh, East Lothian, Midlothian, West Lothian
NHS Orkney Orkney
NHS Shetland Shetland
NHS Tayside City of Dundee, Angus and Perth and Kinross
NHS Western Isles Western Isles
3. Wales Abertawe Bro Morgannwg UHB Swansea, Neath Port Talbot and Bridgend
Aneurin Bevan Health Board Caerphilly, Blaenau Gwent, Torfaen, Monmouthshire and Newport
Betsi Cadwaladr UHB Anglesey, Gwynedd, Conwy, Denbighshire, Flintshire and Wrexham
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Cardiff & Vale UHB Cardiff and Vale of Glamorgan
Cwm Taf Health Board Rhondda Cynon Taf and Merthyr Tydfil
Hywel Dda Health Board Ceredigion, Pembrokeshire and Carmarthenshire
Powys Teaching Health Board Powys
4. Northern Ireland Belfast Health and Social Care Trust Belfast and Castlereagh
Northern Health and Social Care Trust Antrim, Ballymena, Ballymoney, Carrickfergus, Coleraine, Cookstown, Larne, Magherafelt, Moyle and Newtownabbey
South Eastern Health and Social Care Trust Ards, Down, Lisburn and North Down
Southern Health and Social Care Trust Armagh, Banbridge, Craigavon, Dungannon and Newry & Mourne
Western Health and Social Care Trust Fermanagh, Limavady, Derry, Omagh and Strabane
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