Medway Community Child Health Services Information for schools September 2018
Your care
School Newsletter This is our second newsletter from MCH written for Medway schools to keep all education staff informed of new developments and changes to the way we deliver children’s community health services. The newsletter will be available on our website for you to download. On the front cover you will see all the pathways are depicted on the rainbow of services. Starting at red you will see the universal health contacts through the colours of the rainbow to Violet which is the pathway for children with complex disability. For a greater understanding in how we now operate our children’s community health services, items in this newsletter refer to the pathways.
New referral form MCH has policy of keeping our carbon footprint to a minimum. To this end we are now only accepting referrals electronically. You can submit referral forms from www.medwaycommunityhealthcare.nhs.uk/. All the accompanying paperwork such as ASD profiles, Snap and Strengths and Difficulties questionnaires should be attached. Referrals will be returned if the accompanying paperwork is not sent with the referral form. We have changed the referral form to match the new services we are offering. It is important you check the referral criteria for each service so you do not refer a child that does not meet our criteria. LAC The Looked After Children and Care Leavers Team has now moved into MCH. We are available to schools if they would like the team to do a presentation to staff regarding the health needs of Looked after Children or to discuss the needs of a particular child. We can be requested to attend the PEP if a Looked After Child’s health needs are affecting their education. The nursing email address is Lacnursingteam@nhs.net.
Children’s Public Health Nursing Service Red and Orange Pathway
The Medway Children’s Public Health Nursing Service is part of Medway Children’s Community health services. We deliver the healthy child programme for Children and families aged 0 to 19 years. The service is a combination of Health visiting, School nursing and other specialist services such as infant feeding and Oral health. Health visiting Health visitors are registered nurses who have additional qualifications in Community Public health Nursing. We offer services to all families. We work with parents during the ante-natal period through to aged 7 years. Health visitors offer universal contacts at stages to assess the child’s development and advice on child health. Contact maybe by home visiting, or at a clinic. We also work with partners such as Gps, other health professionals the voluntary sector. School Nursing School nurses are qualified nurses who have additional qualifications in Public health. We work with the local communities, the family and individual children or young people. We work in different settings for example schools. School nurses also deliver the healthy child programme. We work mainly with school aged children to ensure their health needs are met. If it is needed we can carry out a health assessment. School nurses are trained to identify young people’s needs at an early stage to offer intervention and support to avoid issues escalating. We can provide training and advice to families and educational settings on topics such as sleep, emotional wellbeing, toileting, immunisations and behaviour.
Specialist School Nursing - Blue Pathway It is important that children with medical conditions are properly supported so that they can have full access to education (Department for Education. [2015]. Supporting pupils at school with medical conditions). Within Medway’s Specialist Community Health Services we have a team of nurses that can support schools with this group of children: Children with Learning Disabilities Registered learning disability nurses can provide specialist support and advice to schools and families in the management of children with learning disabilities, as well as delivering key public health messages so that they are accessible for all children. They will be delivering these services and continence assessment & support to Danecourt, Bradfields and Rivermead schools, but can also work with children who attend mainstream schools with learning disabilities. The Learning Disability Nurses also work with children who have significant sleep, behaviour and continence difficulties and provide post diagnostic support to families. Our Nurses are looking forward to hearing from you to ensure that we can work together effectively to meet the health needs of the local children both at home and in School. Please do not hesitate to contact us. Children in Special Schools Children attending Abbey Court schools will continue to have a registered children’s nurse present in the school, except on Wednesday mornings when they attend team meetings/education sessions. Their role is to train and support staff to manage children with complex medical needs in school, provide continence assessment and support, ensure safe medicines management and deliver key public health messages so they are accessible to children in the school . Children with Chronic Health Conditions Many children now attend mainstream schools with chronic health conditions that require some awareness of the condition by school staff in order to keep the children safe whilst carrying out normal activities. The children’s community nursing team manage these children in the home, and are very keen to ensure that they attend school whenever they are well enough to. They always like to arrange visits to the school for individual children to talk to key staff who will have contact with the child. (This service is offered by the COaST Team at Medway Hospital for children with cancer, diabetes and cystic fibrosis). Asthma The children’s community nursing team is working closely in the wider community to improve the management of children with asthma. As part of this work we are happy to speak to groups of staff in school to advise them how best to manage children with asthma at school. Health advice for schools can also be found at www.asthma.org.uk . Continence Any child with issues around continence should be referred initially to the Public Health Nursing Service who will give advice and refer for more specialist support if required. We would also recommend that staff access the ERIC website (www.eric.org) which gives excellent advise for schools in their help and support’ section.’
Speech and Language School aged children Don’t forget refer to us using our new electronic form Children who fall in to the following list of criteria can be referred for assessment under the NHS. Cleft Lip and Palate or Velopharyngeal Dysfunction Voice (If you are concerned about a child with a voice problem, please ask parents to see their G.P. in the first instance, and ask for an ENT referral) Non-verbal children Looked after children Home educated children Head Injury (or other acquired brain injury) Hearing Impairment with severe to profound bilateral sensorineural hearing loss. Has an EHCP that stipulates Speech and Language needs. A request for EHCP from Medway Council (if there are SLT concerns) Profound speech difficulties Significant concerns over dysfluency/stammering (evidence that the stammer is having a negative impact on the child e.g. causing frustration and anxiety) Schools can independently commission speech and language therapy for children that do not meet the above NHS criteria at www.medwaycommunityhealthcare.nhs.uk > Therapy for schools, individuals and other organisations > MCH+ Children’s traded service leaflet. Indigo Pathway Indigo pathway is launched to meet NICE guidance. NICE stands for National Institution Clinical Excellence and is the gold standard guidance that all health care providers should meet. We launched the Indigo pathway on 1st June to meet NICE standards. The changes you will see are: We require all paperwork to be returned to us electronically We will review the paperwork in a multidisciplinary panel and decide the next steps We will offer support in a variety of ways including parent education, behavioural management workshops, screening clinics and classroom observations A full medical assessment to rule out any associated medical conditions A full multiagency assessment ( SLT, OT and paediatrician) for differential diagnosis . A report issued within two weeks of assessment. A follow up home visit for children given a formal diagnosis within 6 weeks. A nurse led ADHD service We expect to see these changes making a big difference in the next few months as the service stabilises and new children are accepted onto the pathway.
Indigo Pathway Schools requesting formal diagnosis for ASD and ADHD should refer through the Indigo pathway. Please note we do not accept children in secondary school. Before we will accept a child for diagnosis you should note that we will have expected the school to discuss the challenges the child has in relation to their ability to learn with parents. Schools must be able to demonstrate they have implemented strategies and programmes to help the child both in school and at home. We will be interested to know the outcome of these. Please note that referral into the Indigo pathway does not mean that the child will see a paediatrician and parents should be informed accordingly. We will ensure the most appropriate health care professional is available to fully assess the child. Diagnosis for children of school age is only started once we have received all the necessary evidence through school reports and questionnaires with evidence that schools and parents have exhausted all strategies to manage the child’s behaviour or learning challenges in school and at home. We can offer parent information sessions, screening clinics and classroom observations before taking the step to make a differential diagnosis. Once we receive the school referral we will decide the most appropriate next steps please notes we will only formally assess the child if we can see definite links to either ASD or ADHD. At the referral stage we will ask for information in relation to both ASD and ADHD so there will be several forms for school to complete. This allows us to look at all possibilities before clinically making the decision to formally assess for a neurodevelopmental condition. We are also asking that school work with parents to fill out the parental questionnaires and that these are scanned alongside the referral form and school questionnaires so that we receive all of the paperwork from both parents and schools together.
Violet Pathway Update on the development of this pathway for children that have a neurodisability such as cerebral palsy, Down syndrome and genetic disorders. Since June, the team have been offering multi-disciplinary appointments (including the paediatricians) in Snapdragons for children who have complex, long-term physical conditions. Working in the centre has enabled the team to be able to access to the appropriate equipment required to meet the individual needs of each child/young person. During the holiday period the therapy team have run weekly activity groups for children with complex needs which have been really well attended. The children and families have expressed that they enjoyed the different activities which aimed to support their child’s on-going development.
The therapy team have been out and about during the holiday period visiting children and young people at home in order to assess the equipment that families have at home which has been provided by health. This is a programme of visits that is carried out during the school holiday periods throughout the year. As the children/young people return to school the team are planning to visit schools where children are known to have equipment, in order to support each school to ensure the equipment is set up correctly for each child/young person. The summer period is often a time where the children/young people have a growth spurt or equipment is moved into a new classroom environment. If you have not heard from the team or have any queries about school equipment, please contact us either by telephone to speak to duty (weekday mornings: 01634 333366) or by email on medch.childrenscommunity@nhs.net
School Support Surgeries MCH are providing the opportunity for your school to send a representative to this free support for TA’s, teachers and SENCO’s working with children known to the Children’s service. Each surgery will last 3 hours. There are up to 25 places on each session. The session will run as follows: First 2 hours; Each school will bring questions / case studies of children they are working with for discussion with the children’s service team. All participants will decide together which case studies / questions they wish to work on in that session. Therapists will be available to talk through solutions and options to help schools provide the best action plan and environment or ways to help your children in school Last hour; There will be an option decided by the participants as to whether they wish to continue to talk around more cases or therapists to demonstrate different strategies / intervention techniques. Through the session, resources will be available to look at and therapist on hand to discuss best practise. The surgeries run 3 times a year, between 9-12 or 1-4pm at Snapdragons Centre, Cliffe Road, Strood The first session is 16th October 2018 Booking is now open for the October session and we will fill places on a first come first served basis. Please email MEDCH.childrenscommunity@nhs.net for the attention of Maxine Shepherd to book a place. Kindly note one applicant per school. We will need to know applicants name, job title and school contact details. Please indicate your preferred morning or afternoon session.
Children’s Pilates Group The Pilates group is run by a Physiotherapist and a Gym Instructor, both qualified in teaching Pilates. It takes place in the Gym at MCH House (MCH House, Bailey drive, Gillingham Business Park, Gillingham, Kent, ME8 0PZ) every Friday afternoon after school at 4.30pm. We encourage children to engage in local leisure facilities/ classes, however there is often not the provision for Under 16s.This class is available to all children aged 10 years and over, and provides and safe and comprehensive tuition in Pilates. The aim of Pilates is to work on retraining the correct activation of the deep abdominal, back and pelvic floor muscles. If you have a child in year 6 who finds PE difficult, cannot attend to lessons without having to prop themselves up or is very uncoordinated and clumsy, then you may consider recommending this group to parents. Pilates is a great foundation to improving general strength and fitness. Once the core muscle groups have regained full strength and balance then the body works more efficiently. Any child can attend for a competitive price of £5 per session, no referral is necessary. To book a place parents should ring us at Snapdragons Centre on 01634 333366
MCH+ MCH+ also offers specialised training for all staff working in schools, pre-schools and nurseries. Our training is recognised to be informative and practical so that delegates always leave the course with strategies which can be implemented immediately in their settings. Our course leaders have a wealth of professional experience, knowledge and all work for the NHS offering treatment to children in all education settings. All of our training is held at Unit 7 – 8, Ambley Green, Bailey Drive, Gillingham, Kent ME8 0NJ. Free parking permits will be issued upon registration of a course.
Help with Handwriting training course is to be held on 9th November 2018 from 9am – 3pm costing £120. This course outlines the underlying components that contribute to handwriting difficulties and raises awareness of strategies that can be implemented with the school environment.
ADHD training course is being held on 2nd April 2019. Attention deficit hyperactivity disorder (ADHD) is a group of behavioural symptoms that includes inattentiveness, hyperactivity and impulsiveness. Estimates suggest it affects around 2-5% of schoolaged children although there continues to be controversy on why the numbers of diagnosed children are increasing at such a high rate. A full day’s training from 9am – 3pm costs £120 per delegate. From our patients We have received some wonderful feedback from delegates that have attended previous training: “Very well delivered and well organised”
“Really helpful, interactive and flexible”
“This course was well structured, informative and the trainers answered any questions.”
“Made me feel confident in dealing with a deaf girl in my class”
“Great course with excellent pace and educational activities”
For further formation regarding our courses please email medch.childrenservices@nhs.net or visit our website: https://www.medwaycommunityhealthcare.nhs.uk/our-services/childrens-services/childrensherapy/training/
Traded Services Schools can directly commission MCH+ for speech and language and occupational therapy We offer full day packages of care to schools and academies as well as one off assessments for children who do not meet the enclosed NHS criteria. For example, packages may include: Classroom observations to help improve the learning experience of the child. 1:1 assessments and interventions. Attendance at parents evening and access to parent education. Collaborative working with teachers to enable effective differentiation to deliver lessons and IEP. TA coaching. twilight training for school staff which can be in: help with handwriting sensory motor selective mutism stammering vocabulary bilingualism social communication setting up a group top tips workshop supporting communication skills on the playground workshop Language and behaviour. We don’t charge for added extras such as travel expenses, reports, programmes or making individual resources for pupils. Once a package is in place, your staff will be able to prioritise children catering to their needs .Therapists will be available for 6 hours of contact time each day.
Medway Community Healthcare CIC providing services on behalf of the NHS Registered office: MCH House, Bailey Drive, Gillingham, Kent ME8 0PZ Tel: 01634 337593 Registered in England and Wales, Company number: 07275637
Sharing your information Your information will only be disclosed to those who have a genuine need to know and who agree to keep your information confidential. For your direct care we often share information with: NHS hospitals and clinics GPs Social care / early help ________ Who to contact Children’s community health services T: 01634 333366 Snapdragons Centre, Cliffe Road, Rochester Kent ME2 3DL medch.childrenscommunity@nhs.net ________ Medway Community Healthcare provides a wide range of high quality community health services for Medway residents; from community nurses and health visitors to speech and language therapists and out of hours urgent care. Customer care Please send any comments about Medway Community Healthcare services to: Customer care coordinator Medway Community Healthcare MCH House, Bailey Drive, Gillingham, Kent, ME8 0PZ t: 01634 334650 medwaycustomercare@nhs.net All contact will be treated confidentially _________ This information can be made available in other formats and languages. Please contact: medch.communications@nhs.net