Medway Community Child Health information for schools

Medway Community Child Health Services Information for schools June 2018

Your care

Community nursing, therapy and medical child health services in Medway are changing how they deliver their services into your school.

Why are services changing?

Children’s community health services are being brought together in an integrated model to ensure that service delivery is more joined up, collaborative and efficient. Services delivered under the new contracts for children’s community health services will be able to better respond to the needs of families and individual children and young people, and will focus on delivering positive outcomes rather than focusing on numerical targets. Schools and colleges are key partners for us, to ensure that the support we offer is aligned in the best interests of children and families in Medway.

What is changing?

In January 2018 MCH were awarded the contract to run an integrated children’s community health service. MCH already deliver therapy, continence services and health visiting and now they will also deliver  School nursing including specialist school nursing 

Learning disability services

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Nursing for children at home with long term medical conditions

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Consultant paediatric community medical services

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Audiology

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Looked after children nursing service

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Special need nursery based at Snapdragons

The service is funded by Medway Council’s Public Health directorate and the Medway Clinical Commissioning Group.

MCH will deliver screening, assessment and interventions to children from universal contacts such school nursing screening through to complex health interventions for children with long term disability.

What does the model look like?

Our pathways can be seen in the Rainbow model below, together with our ambitions for the children and families we work with.

How MCH will transform services?

MCH are committed to supporting families, children and young people to develop resilience to realise their potential. The emphasis of all contacts will be on training and coaching all those who are involved in the care of the child or young person.

Schools will be given direct support to ensure staff feel confident to deliver appropriate care and interventions within the scope of their roles and responsibilities In the past services such as therapies have been traditionally delivered in schools. MCH will continue to see children in your school but will also deliver care in family homes and clinics.

Research tells us that to ensure optimum outcomes, carers and parents should be fully engaged in any programme that has been individually designed for a child or young person and that both the school and families have a responsibility to work with MCH to help children and young people achieve. To facilitate this MCH will ensure every child or young person has a personalised Medway My Plan that outlines all programmes of care with clear lines of responsibility so that everyone is kept informed

How MCH will help your school?

We will offer  A duty desk service every working day so that anyone can ring us with concerns and questions which will be dealt with promptly  Free training for schools to help deliver individual programmes for pupils  Access to our family engagement officer who can advise on suitable out of school activities and family support  Parent education sessions available as a group activity or on line  A full resource pack for ideas to implement in schools to support SLT, Physio and OT  Medway My Plans individualised for all pupils on an intervention programme  A named school nurse for all schools  SENCo surgeries each term so that schools can have face to face contact regarding the management of individual pupils care  Clear referral criteria and pathways of care  A termly newsletter that offers advice and information to school  A buy back service to compliment NHS provision for Speech and Language therapy and Occupational therapy  Public health screening  More complex and paid training opportunities available

Start date

This new way of working starts on 1st April 2018 and will be gradually phased in through the summer term. Full roll out will be from 1st September 2018.

Working in partnership with schools School are key partners in helping Children and Young People achieve. To enable an integrated approach we hope schools will:  Ensure a member of school staff is available to receive the pupil’s Medway My Plan so that we can coach and support staff to deliver programmes or interventions  Keep a simple record of success and difficulties so we can all monitor progress and record outcomes  Ensure programmes or strategies are delivered as outlined in Medway My Plan  Keep us informed of any changes that may be needed to keep the Medway My Plan relevant so we can arrange updates as needed.  Encourage parents to attend free training or access our on line resources.  Access the SENCo surgeries for further advice and support,

Services School Aged Nursing Each school will have a named school nurse who will be able to offer a confidential health service and can support the physical and emotional health and wellbeing of children, young people and families.

Advice and support can be provided on a range of health issues for example healthy eating, sleep, behaviour, toileting and emotional health.

We will provide screening in Year R, Year 6 and Year 10. Immunisations will continue to be provided by Medway Foundation Trust.

Our team will be able to help deliver key public health messages in your school. Special schools listed below will also be able to participate in public health campaigns adapted to the needs of their pupils.

Learning Disability Nursing This service is available to children with a recognised diagnosis which includes learning disability.

Sessions will occur mostly within the home and through support groups. Our specialist LD nurses will offer support to families around specific needs to include  Post diagnostic family support  Sleep  Behaviour  Sex and relationships  Continence The following schools will have direct support as needed;  Danecourt  Bradfields  Marlbourogh  Rivermead  The Werburgh Centre  Abbey Court

Specialist School Nursing Our specialist school nursing team will ensure all children attending specialist provisions will have an up to date health care plan as appropriate. They support all children with a complex disability in schools, but have dedicated support at  Abbey Court School Primary  Abbey Court School Secondary  Twydall PD Unit Our Nurses will follow the 2018 Royal College of Nursing guidance for training and delegation of tasks and will work closely with our Public Health nursing and Learning Disability team to ensure any key public health messages are also accessible to children attending special school provision Paediatric Medical Services Paediatricians will work with the multidisciplinary team and will offer full medical reviews for children needing ongoing care, jointly with their nursing and therapy colleagues. Clinics previously offered in schools may be offered in a clinic setting to ensure we are able to meet national guidance on long term condition management. Following an annual review, schools will receive a written report to be included in the pupil’s annual education plan. Any changes to the pupil’s health care plan will be discussed with the school and any appropriate training will be provided.

New referrals will be triaged and if accepted, an appropriate member of the children’s health team will be assigned for review assessments. For children that do not meet the medical criteria we will be offer families a range of support to try at home.

Children’s Community Nursing Community nurses will support children with long term medical conditions at home and in the community, working closely with medical teams locally and specialist hospitals.

Nurses will provide schools with support in completing individual health care plans for children with complex long term medical conditions and appropriate training will be offered to schools to ensure children can access education, confident that their health needs are met.

Children who have Continuing care packages, cancer or leukaemia, diabetes and cystic fibrosis will continue to be supported by the services provided by Medway Foundation Trust.

Continence Support The nursing teams will offer a cohesive approach to continence support following the ERIC pathway.

For first level intervention and support for children, please see www.eric.org.uk Where level one support has not been effective, referrals to our level two support can be made.

Children and young people will be seen and support offered in clinics or in school Parent education will be offered for common difficulties such as bedwetting, constipation and toilet training.

Containment products (nappies) will be provided only where continence is unlikely to be attainable and after full co-operation in school and home with toilet training programmes.

Speech and language therapy For acceptance criteria please refer to www.medwaycommunityhealthcare.nhs.uk/childrens-referral Speechlink reports will no longer be essential for referrals as this will not be funded b MCH, however we would encourage schools to use online tools such as speechlink and language link to support pupils Intervention Package Children and young people may be placed on an intervention package and the following will be provided;  Face to face assessments/reviews twice per year  Face to face contact twice per year in school to teach school staff and parents how to implement programmes  Termly SENCo surgeries that all school staff can access for face to face consultation with SLT staff  Parents will be offered a full range of parent education both in groups or on line to help with their child’s communication difficulties Intervention Plus Package Occasionally children and young people may need a more intensive approach and MCH will offer up to an additional 10 sessions per year. This may be in school or in a clinic setting after school, on a Saturday or during the school holidays.

Schools will be informed of the level of intervention appropriate for each pupil following assessment.

Occupational therapy / physiotherapy For acceptance criteria please refer to www.medwaycommunityhealthcare.nhs.uk/childrens-referral Children entering school who are known to therapy team will be supported in their transition into school.

This will include a transition My Plan which will outline the child’s strengths and needs, their equipment requirements and their outlined therapy intervention package.

Children and young people may be placed on an intervention or intervention plus package and the following will be provided Intervention  Each child/young person will be offered a yearly multidisciplinary review/assessment including the paediatrician. In order to meet the needs of the child/young person, this appointment will be offered in a clinic setting where we are able to access appropriate equipment. During this appointment the child/young person’s My Plan will be agreed and updated.  Each child will have two face to face contacts in school, to handover the My Plan and support staff to deliver the intervention  If the child/young person requires a programme to be delivered in school, by school staff, the team will arrange for two face to face contacts in school. These appointments will include the handover the My Plan by the team to relevant staff members and to provide the specific support required to enable the school staff to deliver the intervention effectively.  The team will review the school equipment a minimum of once a year. Should any concerns be highlighted in an interim period, additional reviews may take place.  Orthotics and upper limb splinting will be provided in a clinic setting as required Intervention plus Some children/young people may require an increased package of therapy to meet a defined goal. This may be post-surgery or following medical intervention.

MCH will offer up to an additional 10 sessions per year. This may be in school or in a clinic setting after school, on a Saturday or during the school holidays.

Dietetics Children with long term conditions requiring specialist dietary advice will be supported along with their families in the following ways:  Parents will be offered a full range of parent education both in groups and on line to help with their child’s feeding difficulties or dietary needs.  Children requiring more individual advice will be offered an appointment with a Dietitian either at Snapdragons or if appropriate within the school (Special Schools only). Where indicated this will be in combination with a Speech Therapist trained in feeding. A report may be written, identifying recommendations. The need for further appointments to review progress will be agreed.

Health Visiting Service From September health visitors will offer their service to all families with children up to age 7 to improve school readiness and transition to primary school.

Health visitors work with parents who have new babies, offering support and advice from the antenatal period until the child is 7. Heath Visitors will continue to see children as they enter school until 7 years of age.

Looked After Children and Care Leavers services The Looked After Children Team offers health services to Looked After Children of all ages during the course of their education. The team is available to advise schools and foster carers on health issues that may arise. We also undertake the statutory health assessments which can take place within school should the child or foster carer request this.

From our patients MCH are committed to working in partnership with families, here are some of the things our patients had to say

Thank you for all your time and effort with him.

He has gained so much confidence and has loved attending the sessions with you!

He has come such a long way and we has an excellent service to help him in the future.

We are so grateful!

Feedback for MCH children’s therapy and health visiting teams April 2018

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