Specialist Children s Service

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1 Specialist Children s Service Information and Guidelines for Referrers March 2009, Version 3.0

2 Contents CONTENTS... 2 INTRODUCTION... 3 TEAMS BASED AT THE WOOD STREET HEALTH CENTRE:... 3 TEAMS BASED ELSEWHERE IN THE BOROUGH:... 3 HOW DO I MAKE A REFERRAL TO TEAMS WITHIN THE SPECIALIST CHILDREN S SERVICE? 5 GENERAL REFERRALS SEND TO:... 5 URGENT REFERRALS... 5 REFERRALS FROM PROFESSIONALS... 6 REFERRALS FROM PARENTS AND CARERS... 6 WHAT HAPPENS WHEN I MAKE A REFERRAL?... 6 ARE THERE DIFFERENT REFERRAL CRITERIA FOR TEAMS IN SPECIALIST CHILDREN S SERVICE?... 7 CRITERIA OF TEAMS WITHIN THE SPECIALIST CHILDREN S SERVICE... 8 CHILD DEVELOPMENT TEAM... 8 COMMUNITY PAEDIATRICIAN CHILDREN S COMMUNITY NURSING TEAM PHYSIOTHERAPY TEAM SPEECH AND LANGUAGE THERAPY OCCUPATIONAL THERAPY TEAM CHILDREN S NUTRITION AND DIETETIC SERVICE DISABLED CHILDREN S SOCIAL WORK TEAM SPECIAL NEEDS INFORMATION PARTNERSHIP SNIP (CHILDREN WITH DISABILITIES REGISTER) CONTACT NUMBERS FOR SPECIALIST CHILDREN S SERVICE APPENDICES APPENDIX A: SCS REFERRAL FORM APPENDIX B: CAF FORM Contents 2

3 Introduction The Specialist Children s Service is the main statutory health and social care provider within the London Borough of Waltham Forest to disabled children and their parents and carers. The Specialist Children s Service provides a multi-disciplinary service to disabled children, children with complex health needs, their parents and carers. The Specialist Children s Service aims to provide a coordinated service for children and their families by offering: A single point of referral Coordinated assessment, planning and review Information sharing across the service. Co-location of teams in a purpose-built centre. Most of these teams are now based at The Wood Street Health Centre (6 Linford Road, Walthamstow, E17 3LA) but some staff may be based at other locations. Teams based at The Wood Street Health Centre: Child Development Team Community Paediatricians Speech and Language Therapy Physiotherapy Occupational Therapy Children s Community Nurses Special Schools Nurse Team Leader Disabled Children s Social Work Team Portage Team Early Support Programme Special Needs Information Partnership (Children s with Disabilities Register) Child Health Team Teams based elsewhere in the Borough: Special Schools Nurses based in the designated school 92 Leyton Green Road Short Breaks Centre Mobility Officers based at Joseph Clarke School Paediatric Dietetic Service based at Whipps cross University Hospital Introduction 3

4 Speech and Language Therapists based in special schools, children s centres and other health centres. Introduction 4

5 How do I make a referral to teams within the Specialist Children s Service? The Specialist Children s Service Referral Form means that referrers only complete one referral form for a child to refer to any of the teams within Specialist Children s Service. The single point of referral for the service means we will then identify which team or teams need to respond. Complete the referral form as fully as possible. This helps our staff make recommendations about the service needed by the child and their family/ carers. Parental agreement to the referral is required before the referral is made (with the exception of the urgent referrals listed below). General Referrals Send to: Referrals Centre Specialist Children s Service The Wood Street Health Centre 6 Linford Road, Walthamstow E17 3LA Tel: /7901 Fax: Urgent Referrals There are specific urgent referrals where you should contact the relevant team within the Specialist Children s Service directly in the first instance. These referrals are set out below. Child Protection Referrals to the Disabled Children s Social Work Team, please phone the team on or to provide details of the referral and concerns. This telephone referral should be followed up in writing immediately. Children s Community Nursing Team urgent referrals, please phone the team on to provide details of the request and fax the request to Speech and Language Therapy referrals from Acorn Ward or Special Care Baby Unit (Whipps Cross University Hospital) for acute intervention, please phone the team on or 7972 to provide details of the request. How do I make a referral to teams within the Specialist Children s Service 5

6 Urgent Community Paediatric Referrals including requests for Child Protection Examinations, please phone the team on to provide details of the request. Referrals from Professionals Professionals such as GPs, Health Visitors or Teachers etc. can make a referral to the Specialist Children s Service using the CAF - Common Assessment Framework form accompanied by the Specialist Children s Service Referral form. The CAF - Common Assessment Framework is used to collect basic information about the child and family and any specialist information (such as medical related information) to support the referral should be entered on the Specialist Children s Service Referral form. The CAF - Common Assessment Framework form can be downloaded from and the Specialist Children s Service Referral form can be obtained by phoning /7901 or downloaded from Referrals from Parents and Carers Parents and carers can make a referral to the Specialist Children s Service by completing a Specialist Children s Service Referral form which can be obtained by phoning /7901 or downloaded from What happens when I make a referral? Referrals made to Specialist Children s Service (SCS) will be received by a Referral Officer. The referral will be dealt with by the Referral Intake Team. If the child s referral is for the involvement of a single team (e.g. Speech and Language Therapy) it will be forwarded to that team for follow up. If the child s referral needs the involvement of more than one team (multidisciplinary assessment or intervention) it will be presented to the weekly Specialist Children s Service Referral Panel. This referral panel will initiate the care pathway and plan the response, including identification of a key worker / lead professional when required. In cases where the referral does not meet the criteria set within the Specialist Children s Service, this will be communicated to the referrer with a written response. The referrer and the child s parents / carers will be provided with written confirmation of the referral outcome. How do I make a referral to teams within the Specialist Children s Service 6

7 Are there different referral criteria for teams in Specialist Children s Service? Yes. The wide ranging group of teams who are part of the Specialist Children s Service do have different referral criteria. However, our overall aim is to coordinate the best service available for the child. The rest of this booklet sets out the referral criteria for each team in Specialist Children s Service. This is to provide guidance when making a referral regarding the service that each team is able to offer. How do I make a referral to teams within the Specialist Children s Service 7

8 Criteria of Teams within the Specialist Children s Service Child Development Team The Child Development Team provides a multi-disciplinary service for diagnosis, assessment and ongoing management. Information regarding the child will be shared with all teams within Specialist Children s Service. General criteria for referral to Child Development Team: 1) Any child for whom there is a need for assessment / input from more than two or more health teams and a) Significant delay in their development. b) A diagnosis known to be associated with developmental difficulties e.g. Down Syndrome. c) A significant disorder of motor function. d) Sensory impairments (however children with a primary impairment of hearing are seen by the multi-disciplinary audiology service). e) Learning difficulties which may have associated neuro-developmental difficulties. f) Social and Communication Difficulties e.g. Autism. (Up to 7 years old, older children should be referred to Child and Family Consultation Service) 2) Any child requiring comprehensive developmental assessment by Community Paediatricians Criteria for complex joint assessment and a priority: Children with: a) Acute illness resulting in neuro-developmental problems (e.g. meningitis, encephalitis). b) Early identification of post-natal neurological or developmental problem (0-4 weeks old). c) Aged less than 18 months with neurological diagnosis. d) Child with history of regression (loss of physical or developmental skills or a deterioration of physical or learning functioning). When a child s referral is accepted for the Child Development Team, consideration will be given as to the involvement of a range of other teams. These include: Criteria of teams within the Specialist Children s Service 8

9 Specialist Nurses The Specialist Nurses provide early contact and support to children and their parent/carers when this is needed following a referral being accepted by the Child Development Team. This may include information gathering to determine the best response to the referral, completion of a Ruth Griffiths Assessment, referrals to other agencies etc. Specialist Nursery Nurses The Specialist Nursery Nurses lead general and specialist playgroups in the service. This is offered to children under 4 yrs old with no nursery place or in a part time place when it is agreed they would benefit from extra support. Early Support Coordinator The Early Support Coordinator provides assistance where it is identified that a family would benefit from a named keyworker to assist with the coordination of support from a range of professionals. We use the national Early Support Programme tools to provide families with this support. Portage Team Portage is a home-based intervention scheme for children under 4 years old with significant learning difficulty or significant delay in general development, motor development or language development. Portage home visitors work in partnership with families helping them teach their children new and useful skills Educational Psychologist (for pre-school) Educational psychologists work closely with parents/ carers and professionals offering consultation, assessment etc when there are concerns or issues about educational needs. If the child is pre-school, the Educational Psychologist with special responsibility for early years will contact the family. If the child is in school the EP for the school will contact the SENCO at school and/or the child s parents. Orthoptist The Orthoptist works closely with medical staff, ophthalmologists and opticians to maximise the children s visual health Criteria of teams within the Specialist Children s Service 9

10 Community Paediatrician Criteria for referral to Community Paediatric Review Clinic: a) Locality Clinics- Paediatricians will see children pre-school or school age for initial assessment to provide opinion on developmental concerns. b) School based concerns re: Impact of health on School Attendance or learning. c) Medical assessment for Statement of Special Educational Needs. Child Protection Medicals Medical assessment of children where there are child protection concerns (according to the London Child Protection Procedures). Requests for medicals are made by contacting Community Paediatricians on Looked after Children - For medical assessment, please contact Paediatric Epilepsy Clinic - For advice please contact (or emergency contact ). Immunisation rapid advice on immunisation for health professionals can be obtained by ringing Dr Christine Sloczynska on Children and families requiring a consultation for more complex immunisation issues should be referred to Dr Christine Sloczynska (Consultant Community Paediatrician) at The Wood Street Health Centre. Neurodevelopmental Clinic- Follow up for developmental surveillance of babies identified by neonatal services Purely medical problems should be referred to General Practitioner or Hospital Paediatricians as appropriate, e.g. skin problems, chest problems, and heart murmurs. Children with primarily behavioural / emotional problems should be referred directly to the Child and Family Consultation Service (Shernhall Street, Walthamstow E17 3EA, Tel: ). Please use C.F.C.S. referral form. Criteria of teams within the Specialist Children s Service 10

11 Children s Community Nursing Team Children s Community Nurses visit children at home to provide nursing care. Criteria for referral: a) Children aged 0-16years, (up to 19 years if have complex medical/nursing needs), who require nursing care, support and advice for acute and long-term conditions. For example, children/infants requiring: Tube Feeding Palliative care Wound care Administration of intravenous antibiotics b) Support of children/infants who have: Diabetes Cancer/haematological disorders Respiratory problems Epilepsy HIV/AIDS Asthma c) Any other conditions requiring paediatric nursing input. Urgent referrals for immediate nursing care, please contact the team directly on: Tel: Fax: Physiotherapy Team Physiotherapy Team will accept a professional s referral for a child, aged 0-19 years, resident in the borough or attending a Special Needs School within Waltham Forest. a) Children with neurological / neuromuscular conditions b) Children presenting with any of the following: Abnormal muscle tone Motor disorders or delay Foot problems affecting foot posture and/or walking Loss of range of movement or deteriorating function Children with oncology or palliative care needs Criteria of teams within the Specialist Children s Service 11

12 c) Children with non-acute congenital or orthopaedic presentations e.g. torticollis, talipes, brachial plexus palsy, arthritic conditions d) Children who require rehabilitation in the community (where needs cannot be met by acute services) e.g. complex orthopaedic surgery Orthotic assessment can be accessed by referral to the Physiotherapy team. Speech and Language Therapy Will accept a referral for a child where: There are any concerns about the child s communication development. There are any concerns about a child s feeding ability. The team has an open referral system. Urgent referrals from Acorn Ward or Special Care Baby Unit at Whipps Cross University Hospital for acute intervention, please contact the team directly on: Tel: / 7972 Occupational Therapy Team The referral criteria for the specialities within this team are as follows: Assessment for Equipment and Adaptations Assessment for Equipment and Adaptation (Social services Occupational Therapy) are available to all children who meet the following criteria: Resident of Waltham forest. Have a permanent and substantial disability. Aged 0-19 years old until in fulltime education. The Occupational Therapist will assess for and recommend the most cost effective equipment or adaptation that will meet the child s needs and /or that of the carer. Referral to the Social Services Occupational Therapy can be made by any person. Assessment for functional health based needs (Health Occupational Therapy) These children must: Criteria of teams within the Specialist Children s Service 12

13 Live in Waltham Forest. Have a specific functional difficultly which is out of keeping with their overall developmental level and have the ability to understand the activity itself Be at risk of developing a deformity where splinting is indicated. Be under 11 years of age if referred with a motor coordination difficulty. Referral can be made by any professional. Hospital Occupational Therapy Some children need occupational therapy while in hospital. This service is provided to Acorn Ward at Whipps Cross Hospital NHS Trust. Babies on Special Care Baby Unit (SCBU) are also seen (Health provision) Children s Nutrition and Dietetic Service The service accepts referrals for children under the age of 18, from health professionals and other agency colleagues. The service provides nutrition and dietetic support and advice. The service includes a paediatric joint nutrition clinic, held at The Wood Street Health Centre on a regular basis. Other paediatric nutrition clinics are held at Whipps Cross University Hospital, local Health Centres and Special Schools. Referrals should be faxed or sent to:- The Nutrition and Dietetic Service A Block, Second Floor Junction 8, Whipps Cross University Hospital Tel: , Fax: Disabled Children s Social Work Team The team provide child in need assessments, social work support and advice to disabled children and their parents and carers. The team work with children and young people from 0 19 years old (until the young person leaves school) who have a diagnosed disability. Criteria for referral is where the child has a diagnosis of: Learning disability at level F and above Physical disability (permanent and substantial with an impact on daily functioning) Sensory impairment (visual and hearing) where this requires specialist support Criteria of teams within the Specialist Children s Service 13

14 Or Long term chronic health condition (life limiting or life threatening), Diagnosed autism/ autistic spectrum disorder Child whose life is affected by HIV/AIDS (joint work with Specialist Adults Team). Child Protection Concerns: This team respond to referrals regarding child protection concerns for children meeting the criteria. Tel: / 7946 Fax: Certificate of Visual Impairment (CVI) Registration visits When a CVI is received by the Disabled Children s Social Work Team, a home visit by the Mobility Officer will be arranged with the family to complete the CVI Registration (voluntary) for the child. Information and advice will be provided to the family at that visit. Please note: This team is not able to offer a social work service to children who have an identified emotional or behavioural difficulty, ADHD, speech and language difficulties only, mental health issues where these is the primary issue for the child. Where social work intervention is required, the team can assist with the referral to Children s First Response Team. Referrals can be made to the Children s First Response Team on Special Needs Information Partnership SNIP (Children with Disabilities Register) The Register is used to plan services for disabled children. Under the Children Act 1989, Social Services must keep a register of all disabled children in the Borough. The London Borough of Waltham Forest s Children with Disabilities Register is called SNIP (Special Needs Information Partnership). Being on the register ensures that you have access to an up-to-date copy of the Children with Disabilities Information Pack, a regular newsletter and a birthday card will be sent to your child on his / her birthday. If you wish to enter your child onto the SNIP or if you need more information about SNIP please contact Information Co-ordinator on the following address: Criteria of teams within the Specialist Children s Service 14

15 Information Co-ordinator Specialist Children's Service The Wood Street Health Centre 6 Linford Road Walthamstow, E17 3LA Tel: Criteria of teams within the Specialist Children s Service 15

16 Contact Numbers for Specialist Children s Service Team Telephone Number 92 Leyton Green Road Respite Team / 3000 Child Development Team Child Health Team Children s Community Nursing Team Children s Occupational Therapists Community Paediatricians /7910 Disabled Children s Social Work Team / 7946 Early Support Coordinator Paediatric Dietetic Service Physiotherapy Portage Team Special Needs Information Partnership (SNIP) Specialist Children s Service Management Team Speech and Language Therapy The Wood Street Health Centre General Enquiries Desk Ground Floor Reception First Floor Reception Contact numbers for Specialist Children s Service 16

17 Appendices Appendix A: SCS Referral Form Appendix A: SCS Referral Form 17

18 Appendix A: SCS Referral Form 18

19 Appendix B: CAF Form Appendix B: CAF Form 19

20 Appendix B: CAF Form 20

21 Appendix B: CAF Form 21

22 Appendix B: CAF Form 22

23 Appendix B: CAF Form 23

24 Appendix B: CAF Form 24

25 Appendix B: CAF Form 25

26 Appendix B: CAF Form 26

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