Physical Sensory Impairments

Disability results from the interaction between individuals with a health condition, such as cerebral palsy, Down syndrome and depression, with personal and environmental factors including negative attitudes, inaccessible transportation and public buildings, and limited social support.

A person’s environment has a huge effect on the experience and extent of disability. Inaccessible environments create barriers that often hinder the full and effective participation of persons with disabilities in society on an equal basis with others. Progress on improving social participation can be made by addressing these barriers and facilitating persons with disabilities in their day to day lives.

Disability is part of being human. An estimated 16% of the global population currently experience significant disability. This number is increasing due in part to population ageing and an increase in the prevalence of noncommunicable diseases. (Source: Disability).

The Social Model of Disability was developed by disabled people and describes people as being disabled by barriers in society, not by impairment or difference. If modern life was set up in a way that was accessible for disabled people, then disabled people would not be excluded or restricted. (Source: Social Model of Disability: Language | Disability Rights UK).

The social model of disability helps to recognise barriers that make life harder for disabled people. These barriers are identified as being the physical environment, people’s attitudes, the way people communicate, how institutions and organisations are run, and how society discriminates against those who are perceived as ‘different’. Removing these barriers creates equality and offers disabled people more independence, choice, and control. (Source: Social Model of Disability: Language | Disability Rights UK). 

A person is disabled, under the Equality Act 2010, if they have a physical or mental impairment that has a ‘substantial’ and ‘long term’ negative effect on your ability to do normal daily activities. Substantial is defined as more than minor or trivial, long term is defined as more than 12 months. (Source: Definition of disability under the Equality Act 2010 – GOV.UK).

The term ‘sensory impairment’ encompasses visual impairment (including those who are blind or partially sighted), hearing impairment (including those who are profoundly deaf, deafened or hard of hearing) or with dual sensory impairment (deafblindness). These impairments can be congenital or acquired at any age.

National Institute for Health and Care Excellence states:

• The reported prevalence of hearing loss is likely to be underestimated, as it is often unrecognised and a person may not present to healthcare services [Nieman, 2020] [RNID, 2022].  
• Hearing loss is a common condition which can occur at any age. 
• The Royal National Institute for Deaf People (RNID) web statistics state that hearing loss affects more than 12 million people in the UK, and provides a breakdown of the prevalence of hearing loss by NHS and local authority area in the UK [RNID, 2020]. 
• A key RNID Hearing Matters report states that [RNID, 2020]: There is evidence of an average delay of 10 years in people seeking help for their hearing loss. When people do seek help, GPs fail to refer 45% of people reporting hearing loss to NHS hearing services. 
• Most people with hearing loss are aged over 50, and prevalence increases with age. It cites evidence from a previous Medical Research Council national study of hearing, which found: 
• Hearing loss affects 41.7% of people over 50 in the UK, increasing to 71.1% of people over 70. 
• With an increasingly ageing population, it is estimated that by 2035, over 15.6 million people in the UK (one-fifth of the population) will be affected by hearing loss. 
• About 900,000 people have severe or profound deafness, and at least 24,000 of these people use sign language as their main form of language. However, the report notes that this is likely to be an underestimate. 

(Source: nice.org.uk)

An estimated 75% of people in care home settings have hearing loss. This is expected to increase to 80% by 2032.

Additional RNID guidance on care settings is available from RNID Action on Hearing Loss.

Around 2 million people in the UK are living with some form of sight loss, with this expected to rise to 2.7 million by 2030. Maintaining good eye health is central to maintaining good mental, social and physical health. Vision loss is associated with a reduction in overall quality of life, mental health, independence, mobility, educational attainment, and employment. (Source: Vision | Fingertips | Department of Health and Social Care).

Sight loss is not an inevitable part of ageing, an estimated 50% of sight loss is avoidable. Sight loss prevention actions can be taken at all levels:

• Primary prevention of sight loss is closely linked to maintaining overall good health. Public health prevention programmes to reduce obesity, increase exercise and stop smoking may prevent or delay the onset of eye disease. 
• Secondary prevention is central to maintaining vision or slowing the progression of diseases which can result in sight loss and is dependent on the organisation and delivery of health services to meet need and demand. 
• Tertiary prevention requires social services and voluntary organisations to support people who are blind or partially sighted to live independently and to adapt to living with their eye condition.

Deafblindness means that someone has sight loss/impairment and hearing loss that affect the person’s everyday life. Access to information, communicating with people and getting about on their own can be much more difficult. Source: Deafblindness – Sense.

Deafblindness is more common in older people, because loss to sight and hearing is common with ageing.

There are more than 450,000 deafblind people in the UK. It’s thought there will be more than 610,000 by 2035 due to our ageing population.

‘Deaf blindness is sight and hearing loss that impacts communication, mobility and ability to access information. It affects different people in different ways’ (Deafblind.org.uk). This combination of impacts presents barriers to achieving success in education, in a vocation and for all manner of social outcomes.

Research shows that sensory impairment is now recognised as both a risk factor for developing dementia and a major factor shaping the experience of people already living with dementia. Contributing to 8% of all dementia cases world-wide, people with uncorrected hearing and vision loss are 24% higher risk of cognitive decline/dementia. (Source; Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission – The Lancet).

Many people with sensory impairment face challenges related to communication, access to information due to the traditional ways it’s provided and presented, and getting around due to environmental design not responding to people’s diverse requirements.

There are specific health inequalities associated with sensory impairments, such as:

• Approximately 40% of people with learning disabilities are reported to have a hearing impairment; people with Down syndrome have a particularly high risk of developing vision and hearing loss, they also have a higher risk of dementia than the general public and combined with hearing and/or vision loss further increases this risk and symptoms can appear earlier and progress quicker. (Source; Public Health England) 
• Smoking, poor diet, physical inactivity, hypertension, and obesity are associated with increased risk of conditions such as glaucoma, diabetic eye disease and cognitive decline. (Source; Health disparities and health inequalities: applying All Our Health – GOV.UK) 
• People with vision and hearing loss are at an increased risk of developing dementia, they face greater barriers to diagnosis, treatment and ongoing support along with poorer outcomes. (Source: Hearing loss in adults: assessment and management | NICE).                            

Studies indicate an association between sensory impairment and challenging, self-injurious or suicidal behaviours (Source: BMJ). Unrecognised or undiagnosed sensory impairments may lead to miscommunication, frustration, fear, and in turn, challenging behaviour.

Key challenges for people with sensory impairments, highlighted by local, national and international research, include:

• A lack of accessible information; rehabilitation services; equipment to assist with loss of vision. This can reduce independence. These services are critical in enabling people with vision loss to interact with the built environment, maintain physical and emotional health, and participate in society. 
• People with significant hearing loss are often isolated because communication with the hearing world becomes increasingly difficult. Hearing loss has a major impact on the development of language and communication skills, as well many personal, socio-economic impacts throughout life.  
• Royal National Institute for Deaf People (RNID) report that 79% of people first receiving hearing aids are given no information regarding services at the ‘point of diagnosis’. The WHO estimates that, in the UK, adult-onset hearing loss will be in the ‘top ten’ of disease burdens by 2030, ranking above diabetes and cataracts. 
• Dual sensory impairment (combined hearing and vision loss) carries the highest risk. People who are deafblind often rely on touch, routine, and environmental cues to stay oriented. Dementia can disrupt these strategies, increasing vulnerability to disorientation, social withdrawal, and reduced independence. People with dual sensory loss are more likely to experience loneliness and depression, both of which are independently associated with increased dementia risk.

Early intervention is key in preventing on-going needs across all sensory impairments. With the right information, advice, practical, and emotional support, a person with sensory impairments can lead a more independent, fulfilling life and reduce their risk of dementia.  The person needs support to be provided at the right time and in the right format. Undiagnosed or poorly supported sensory impairments leads to poorer health and wellbeing outcomes, and a reduction in independence.

Tablets, smart phones, and a range of specialist technologies enable people with sensory loss to remain independent and access information in different ways. For example, deaf people are now able to access a remote interpreter. Professionals and organisations must keep abreast of technological advances and of how people with sensory impairment are able to access it.

Key challenges and health inequalities associated with physical disabilities, highlighted by local, national and international research, include:

• Rurality: Long travel distances, limited public transport, and fewer nearby services can make it harder for people to access rehabilitation, equipment, treatment, ongoing support and preventative services. 

• Workforce and housing: Workforce shortages and digital solutions. A higher proportion of older housing stock and fewer accessible homes difficult to adapt increase the risk of falls and limit independence.  

• Higher risk of social isolation and mental health problems, social isolation is also a modifiable risk factor for dementia meaning people with physical disabilities may face increased risk of cognitive decline, rural isolation will intensify this.

Local, national, and international research consistently shows that people with physical disabilities face major challenges across accessibility, healthcare, transport, housing, employment, social participation, and independent living. In Lincolnshire, these inequalities are intensified by rurality, ageing demographics, and limited-service availability, creating avoidable and unfair differences in health, wellbeing, and life opportunities. 

(Sources: Healthwatch Lincolnshire; Lincolnshire ICB; Equality and Human Rights Commission; Office for National Statistics; Health Matters; Royal College of Nursing) 

The following are strategies and policies providing local and national information about planning to provide the best health and social care support for people with disabilities and sensory impairments:

• Lincolnshire Health and Care Digital Inclusion Strategy 2025 – 28 – Lincolnshire ICB 
• Statement of Information on Health Inequalities 
• Joint Health and Wellbeing Strategy 
• Adult Social Care Strategy 2026-2028 
• 10 Year Health Plan for England: fit for the future – GOV.UK 
• Disability Action Plan – GOV.UK 
• National Disability Strategy – GOV.UK 
• The Care Act 2014 
• Royal National Institute of Blind People (RNIB) Strategy  
• SCIE Strategy 2023–2026 
• NHS England: What Works Guides – Action Plan on Hearing Loss 
• National Institute for Health and Care Excellence (NICE): 
  • Glaucoma Overview 
  • Clinical Knowledge Summary: Macular degeneration – age-related 
  • NICE Guideline: Hearing Loss in Adults: assessment and management [NG98] 
  • NICE Quality Standard: Serious Eye Disorders [QS180] 
  • NICE Quality Standard: Hearing loss in adults [QS185] 
• Public Health England (PHE) Eye Health Needs Assessment: East Midlands and East of England Published: May 2018 

The 2021 Census highlighted that of the Lincolnshire population, 11.3% were disabled with day‑to‑day activities ‘limited a little’; 7.8% ‘limited a lot’; 80.9% were not disabled under Equality Act definitions. East Lindsey had among the highest proportions of households with two or more disabled people in England. Source: Census 2021

Sensory Impairment  

Sensory impairment prevalence increases with age; local projections (POPPI/PANSI 2025, using ONS 2022‑based sub‑national projections) indicate a sustained rise to 21,260 by 2035 in the 65+ age cohorts:  an increase of 1,883 to 21,260 for moderate and severe visual impairment, and a 15,563 increase to 167,085 for all hearing impairments. (Source: POPPI). The increase in people with visual impairment for under 65s is in single figures for the same period. There is a decline in the number of under 65s with hearing impairments for the same period. (Source: PANSI).

Hearing impairment, visual impairment, and multi-sensory impairment are common health problems among older adults and can hinder basic daily activities or result in social isolation and loneliness (Source: ONS). Over time this could contribute to low self-esteem, social anxiety or depression.

The College of Optometrists has reported that across the UK, falls are the most common cause of hospitalisation for people aged over 65 and that undetected and untreated visual impairment plays a significant role in this. (Source: Royal College of Optometrists).

Effective support is vital to prevent detrimental impacts on socio-cognitive and language development, independence, and quality of life.

Evidence says that hearing loss in mid-life is the largest modifiable (something that can be changed) risk factor for dementia, if left untreated people are 24% at higher risk of cognitive decline and developing dementia. (Source; Hearing loss in adults: assessment and management | NICE).

For people in Lincolnshire who already have hearing loss, the impact is significant. Rural isolation, limited public transport, and long travel distances to audiology services can make it harder to access timely assessment and hearing aid support. When hearing loss coexists with dementia, communication becomes more challenging, increasing the risk of withdrawal, anxiety, and reduced independence.

Sight Register shows in 22/23 that 5815 people in Lincolnshire are registered as blind or partially sighted, but many more live with unregistered or undiagnosed sight loss. Preventable sight loss—such as cataracts, glaucoma, or diabetic eye disease—remains a key issue, particularly in areas with higher levels of deprivation and long-term health conditions. People with significant sight loss may have a two to three times higher risk of developing dementia. For those already living with sight loss, dementia can make it harder to interpret visual information, recognise faces, or navigate safely. This increases the risk of falls, hospital admissions, and loss of confidence. In rural areas, reduced access to eye health services can delay diagnosis of treatable conditions. (Source; Facts and Figures – Lincoln & Lindsey Blind Society). 

Physical Disability  

An estimated 18–20% of adults in Lincolnshire live with a long-term physical disability or mobility limiting condition. Prevalence increases sharply with age: nearly 1 in 2 people aged 65+ report a condition that limits daily activities.

• Lincolnshire has a higher proportion of older residents (around 25%) than the national average, meaning physical disability is more common here than in many parts of England. 
• Rates are highest in coastal and rural districts, where there is inward migration of the older population, long term conditions, deprivation, and limited access to services intersect.

Several local factors contribute to higher levels of physical disability:

• Ageing population: East Lindsey, South Holland, and West Lindsey have some of the oldest populations in the country. 
• Long term health conditions: Higher rates of stroke, diabetes, cardiovascular disease, arthritis, and chronic pain increase the likelihood of physical disability.

The Care Act highlights ‘prevention’ as one of the seven key responsibilities for local authorities, with an inextricable link to the fundamental principle of promoting wellbeing. In early 2026 Lincolnshire County Council launched the Adult Social Care Strategy, 2026-28, which strengthens and prioritises early action and support. The term early action and support is used locally, recognising the negative connotations associated with prevention and disability, the importance of using strength-based language, particularly labels, and the views of disabled people.

The Adult Social Care Strategy is supported by an Improvement Programme with a workstream focussing on developing Early Action and Support and a newly formed service formed in 2025 which brings together the county’s preventative services in one place.

Current provision available includes:

• Support for Carers. 
• Wellbeing Service – which offers preventative support for people who do not meet Care Act eligibility thresholds.  
• Information and Advice. 
• Digital – The Innovation Team within Early Action and Support works on a programme of digital activity to improve outcomes for residents, enable earlier action and increase efficiency across Adult Social Care and increase the use of Technology Enabled Care (TEC).  A new enhanced TEC service will be launched in Autumn 2026.  
• Community Opportunities – across 11 locations the council provides both formal social care services and drop-in options for all residents, including social groups like Knit and Natter, Warm Welcome spaces, community cafés, craft workshops, dementia-friendly support, information and advice to support community development, offer opportunities to tackle loneliness and promote independence.

The Service will also be launching the Department of Work and Pensions funded programme, Connect to Work, supporting disabled people into work.

The workstream and service takes a population-based approach rather than being condition specific and work is underway to develop the evidence base for early action and support.

Services commissioned by Lincolnshire County Council:   

Homebased Reablement Services provide support to enable people to learn or relearn the skills necessary for daily living, which have been lost through illness, deterioration of health and/or increased support needs.

Lincolnshire Community Equipment Service (LCES): The provision of equipment in the community, ranging from simple to complex aids, to support people in remaining independent in their own homes.

Wellbeing Lincs is a countywide service, supporting adults across Lincolnshire to achieve confident, fulfilled and independent lives. The service includes trusted assessment, support, hospital and care in-reach, resettlement, telecare response and small aids and adaptations.

Lincolnshire Sensory Services works with people with sensory impairment to maintain independence by providing rehabilitation, information and advice and equipment. They are commissioned to maintain the register of sight-impaired and severely sight-impaired adults who are ordinarily resident in its area, a requirement under The Care Act 2014.

The Lincolnshire Telecare Service can help people with a disability live more independently.  The provision and maintenance of a 24/7 monitoring service which allows people to remain in their home and maintain their independence whilst preventing escalation into more costly Adult Care services.

Technology Enabled Care (TEC) — Lincolnshire’s Technology Enabled Prevention and Care (TEPaC) was piloted in 2024–25.  This trialled a range of digital solutions to maintain independence and reduce demand; and a new service will be launched in Autumn 2026 – see next steps.

Lincolnshire Partnership Foundation Trust have developed an online resource to support people’s awareness of dementia awareness opportunities Dementia prevention: Lincolnshire Partnership NHS Trust. 

Lincolnshire County Council, HealthWatch Lincs and the Lincolnshire ICB invited feedback via a survey in early 2026 from people with sensory impairment who have used health and social care services. The results of this survey will be available in Spring 2026.

BID Services have been delivering the Lincolnshire Sensory Service Lincolnshire since April 2022. The service supports people with sensory impairment to be as independent as possible through the provision of information and advice, equipment and rehabilitation. Through this work several British Sign Language users have explained some of the challenges they, and others face when engaging with statutory agencies and utility suppliers, particularly when complex words and jargon are used, and when BSL users are not able to read. Whilst there is technology available to provide, this group highlighted challenges associated with cost, quality and reliance on internet access.   

Transport systems, pavements and built environments are often not designed to be fully inclusive of people with a vision impairment. People with sight loss are unable to drive so, for journeys that cannot be made by walking, rely on public transport, taxis and lifts from friends or relatives. Navigating streets, public spaces and buildings can be a challenge for people with sight loss, particularly if the environment is unfamiliar, changeable or not designed in an accessible way. (Source: Key statistics about sight loss).

There are gaps in local and national information and data regarding the exclusion of BSL users and the prevalence of BSL users and literacy levels. This position means quantifying the need and developing an appropriate response is problematic and relies on identifying and connecting with as many people affected.

People with sight loss have a lower employment rate compared to the UK average. Only one in four registered blind and partially sighted people of working age are in employment [23]. The employment rate for blind and partially sighted people is the same as it was in 1991, and there has been no overall change in a generation. (Source: Key statistics about sight loss).

There are local and national challenges associated with the shortages of vision rehabilitation specialists with nearly a quarter of all local authorities citing vacancies (Source: RNIB).

Lincolnshire County Council’s Adult Social Care Strategy is introducing new ways of working and improvements to maximise the support available for people to prevent, reduce and delay the need for Adult Social Care support. This will inevitably benefit people with physical disabilities and sensory impairments.

The Lincolnshire County Council Innovation Team within Early Action and Support works on a programme of digital activity to improve outcomes for residents, enable earlier action and increase efficiency across Adult Social Care and increase the use of Technology Enabled Care (TEC).  A new enhanced TEC service will be launched in Autumn 2026 that will support the cultural and infrastructure changes associated with fully realising the benefits of TEC in Lincolnshire.

The DWP Connect to Work programme aims to support more disabled people into work. This service will be launching in Spring 2026.