Community children's doctors

Our services

Our aim is to provide care as close to home as possible so our services are based in different parts of the county, for example our usual working sites are as below, but there has been some changes to our usual offer in the current COVID-19 situation, as access to the hospital and school sites is now more limited.

• Outpatient clinics at Telford, Bridgnorth, Oswestry, Whitchurch, and the Robert Jones and Agnes Hunt and Ludlow Hospitals
• Outpatient clinics at the Stepping Stones Centre and Coral House
• Specialist Child Development Centres based at Monkmoor Campus and Stepping Stones Centre
• Special schools such as the Bridge and Severndale
• Home visits (by exception only)

As a result of the COVID -19 pandemic we have had to change how we deliver our service. In order to offer services as safely as possible you may be offered appointments over the phone or online by video, using the Attend Anywhere platform. Any face to face appointments are being limited both in duration of time, locations and arrangements within the clinic rooms e.g the number of people who can attend and the toys available.

About our services

We are able to offer a holistic child (paediatric) service as our focus is on identifying and working with others to meet each child's needs - medical, educational and social.

We deliver this by:

• providing medical reports as part of statutory processes for children with special educational needs, children in care and in child protection procedures.
• carrying out developmental assessments such as Schedule of Growing Skills (SOGs) and Griffiths in the under 5s.
• referring children to the Child Development Centres if they have complex medical needs or clinical assessments indicate an Autism diagnostic assessment is required.
• leading the multidisciplinary developmental assessments in the Child Development Centres.
• contributing to Autism multidisciplinary assessments; we use DSM-V (Diagnostic and Statistical Manual of Mental Disorders) criteria to diagnose Autism and are trained to use the 3Di Autism assessment support tool.

Connections, links and training

• We have close links with the paediatric and neonatal units at The Shrewsbury and Telford Hospital NHS Trust and the paediatric team at the Robert Jones and Agnes Hunt Hospital
• We provide education and training to students and training opportunities in the community for specialist registrars.

The people we see

Our service is for children and young people aged 0-16 years old but this extends to under 19 years for children with complex neurodisability educated full time in a local specialist provision, if they require ongoing health surveillance.

We are able to medically assess and care for children with neurodevelopmental issues, or complex neurodisability and offer health surveillance for the related chronic health needs. Children we typical see, include those with

• Cerebral Palsy and other complex neurodisabling conditions requiring Community Paediatric surveillance
• chromosome or syndrome disorders (e.g Down's Syndrome) requiring Community Paediatric surveillance
• developmental difficulties identified at preschool age (contributing to assessing the level of difficulty in the different domains)
• concerns of Autism identified at preschool age (contributing to the assessment pathway and confirming the diagnosis if appropriate)
• coordination difficulties 'dyspraxia' (medical assessment, only to exclude neuromuscular conditions and confirming the diagnosis if appropriate)
• severe learning difficulties in school age children (medical assessment, only looking for linked health conditions)
• Tics and Tourettes concerns (medical assessment, only to exclude neurological conditions)
• specialist audiology services (hyperacusis and to investigate children with hearing loss)

New patients

We accept referrals from a wide range of health professionals working with children e.g GPs, other health professionals as well as hospital paediatricians, especially paediatric neurologists and neonatologists.

In order to be offered an appointment, someone must have referred you to our service, e.g. GP or other healthcare professional (you cannot self refer to this service).

Please be aware that a new patient appointment may take up to an hour.

Our statutory responsibilities require that we provide certain medical reports in very short time frames. Therefore, we need to know as soon as possible if you need to cancel your appointment so that we can try and offer you another one in time. However, there are often several children on the waiting lists so we cannot guarantee you will be next on the list.

Clinic appointments are only offered after you have responded to an initial invite letter and your child will be discharged if you do not contact us for an appointment.
If you subsequently do not bring your child to the pre-arranged appointment or you cancel successive appointments, your child will also be discharged and the appointment will be recorded as 'Was Not Brought'.

Existing patients

Clinic appointments are only offered after you have responded to an initial invite letter and your child will be discharged if you do not contact us for an appointment.

If we have your up-to-date contact phone number, you will receive text reminders before the scheduled clinic. On average appointments take 20-30 mins.

If you subsequently do not bring your child to the pre-arranged appointment or you cancel successive appointments, your child will also be discharged and the appointment will be recorded as 'Was Not Brought'.

Services we do not offer

We do not accept referrals to assess children who are acutely ill or those likely to need hospital or in-patient based assessment or care.

We sometimes receive inappropriate referrals for the following conditions:

• General medical conditions - for example asthma, eczema, headaches, epilepsy
• Autism assessments in the over 5s.
• ADHD assessments - we do not offer this service.
• Behavioural issues - this should initially be referred to the Local Authority Early Help Services. Family Connect for Telford (Tel 01952 385385) or First Point of Contact (FPOC) for Shropshire (Tel 0345 678 9021).
  In children under 5 years in whom the behaviour is suspected to be part of an underlying neurodevelopmental or neurodisabling condition for example Autism, we may offer an initial medical assessment looking for clinical supporting evidence of a medical condition, but we are not able to provide on-going behaviour management support.
  
• Emotional/Mental Health concerns - we are a service for physical health and neurodisabilities. Mental health and Wellbeing is commissioned separately and locally BEAM (AskBeam@childrenssociety.org.uk) offers a drop-in service for this.
• Tics and Tourette's syndrome diagnosis
  
• 'dyslexia' and specific learning difficulties - this is assessed by educational professionals
• Obesity and growth problems - if you have concerns please address these to primary care (i.e. by seeing your GP) or help and advice can be found on the Keeping healthy pages
• Constipation - our Trust runs a Nurse-led children's constipation service.
• Sleep - we do not have specialised expertise to comprehensively assess for sleep disorders or provide on-going management for behavioural sleep problems.
• Feeding problems
• Identifying Learning Disability in children not already under our care. Community Paediatricians are not trained to carry out cognitive (IQ) assessments, one of the 3 criteria commonly used to identify a Learning Disability, as we are Neurodevelopmental Paediatricians which means we assess childrens’ development and the tools we use are only able to be administered on the under 5's.

What to bring with you

ALL children should be accompanied by a parent or guardian; if you wish to discuss matters without your child being present, please bring someone to sit with your child as there is usually no nurse assisting in clinic. Children issued with a Personal Child Health Record (red book) should bring this with them.

Please note we do not have the staff or facilities to look after your other children while you attend the appointment, please bring someone to assist you with this.

If you require a chaperone please notify us in advance of your appointment.

If you could arrive in plenty of time as this will enable any reception staff to confirm your address and contact details and sometimes there may be other forms to be pre-filled in that can aid the later clinical consultation.

Where are we?

• Telford & Wrekin
  Stepping Stones Centre
  Brunel Road
  Malinslee
  Telford
  TF3 2BF
• Shropshire
  Coral House
  11 Longbow Close
  Harlescott Lane
  Shrewsbury
  SY1 3GZ

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Patient leaflets

Who are we?

Community Paediatricians are specialist doctors with skills and knowledge in child development and related health issues.

We focus on the care of children with long-term neurodisabling conditions and their families.
We are able to assess, diagnose and monitor the health of children with complex neuro-disability.
For some of our diagnostic processes eg Autism, they have to be accepted onto our pathway before the child starts school.

We work in consultant-led teams and liaise closely with professionals from other health disciplines (such as nurses or therapists) and agencies (such as social workers and teachers).

Our Team includes Paediatricians, a Nurse Consultant and Specialist Nursery Nurses.

Our doctors lead in a number of county-wide expert services e.g. in the roles of:

• Designated and Named Doctor for Looked after Children
• Medical Advisers for Adoption and Fostering
• Lead Doctor for Child Deaths
• Lead Consultant for Education Health Care Plan (EHCP previously SEN)
• Lead Consultant for Child Development Centres (CDCs)
• Lead Consultant for the Newborn Hearing Screening Programme
• Lead Consultant for Palliative Care
• Paediatric Adviser to the Nurse-Led Paediatric Urinary Incontinence Clinic

We provide our services to children whose GP is based in Telford & Wrekin or Shropshire County. We can support other children who are outside of Shropshire, Telford and Wrekin area with prior arrangement with specific commissioners.

Special Educational Needs and Disability (SEND) and our "Local Offer"