Community Paediatrics 0 to 18 years (complex needs 0 to 19)

This is a pathway for children who present with:

• Neuro-disability (for example cerebral palsy)
• Motor delay
• Chromosomal, metabolic disorders or genetic, inborn or acquired disorders resulting in long term complex needs or disability previously un-investigated learning disability.

The service does not accept referrals for the following:

• Acute medical illness
• Primary eating disorders, for example anorexia and bulimia
• Acute psychiatric or chronic mental health illness
• Emotional and behaviour problems in children; these should first be reviewed by a health visitor, Early Help, or GP, and offered behavioural strategies, or signposting to local groups, including Supporting Smiles
• Dyslexia and dyscalculia
• Sleep difficulties in the absence of a diagnosed neuro-developmental disorder - refer to Sleep East either by email: joybishop@sleepeast.co.uk or 01692 402240. NANSA also offer a sleep service. You may also to wish to download a National Sleep Helpline flyer or National Sleep Helpline poster
• Long term chronic medical conditions such as epilepsy (unless associated with a secondary condition as described in inclusion criteria)
• Hearing - refer directly to Audiology NNUH for more information.

Please include (where possible) supporting evidence, this can include:

• Observation questionnaires (parent/carer, early years, teacher, as appropriate)
• Reports from other professionals (for example speech and language therapy, occupational therapist, physiotherapist)
• Ages and Stages Questionnaire/Schedule of Growing Skills.

How to Make a Referral

You can access our service through your GP, health visitor, speech and language therapist or school nurse. They will complete a referral form and supporting information may need to be obtained from other providers or agencies, for example school.

The referrals are sent to our Children's Single Point of Referral team, this is a single point of entry to all of NCHC's children's services. All referrals are examined weekly by a community paediatrician. If the referral is accepted you will receive an acceptance letter and then an appointment letter with date and time. It is important to notify the bookings team as soon as possible if you cannot attend.

What to Expect at Your Appointment

Your child will be seen by one of our specialist staff. The length of the appointment will vary and an estimate will be given in your appointment letter or email. You are expected to attend the appointment with your child.

• During the assessment we will talk about your concerns and how your child is managing at home, nursery or school
• We will discuss any concerns about behaviour and emotions
• We will ask for information about your child's health and development, for example, your child's birth and family situation
• The initial assessment may also include a physical examination
• We will gain a clearer understanding of your child's strengths and needs

What Happens After the Initial Appointment

After the initial appointment, there could be any of the following outcomes:

• During the appointment you may be offered some advice and strategies to help your child and no further appointment will be needed
• We may need to see your child and/or you again for further assessment
• We may need to refer your child to another professional for further assessment, for example a speech and language therapist, physiotherapist or occupational therapist or to another team of professionals
• You or your child may be offered support in the form of workshops for parents/carers, group interventions for children or individual work

We will write to you following your appointment summarising the assessment, our understanding of the difficulties and will include a plan of what will happen next.