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.

• 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)

Following changes introduced during the COVID -19 pandemic, our service has evolved to recognise that sometimes appointments can be offered as phone or online video consultations. However, any face to face appointments may still be limited both in location and arrangements within the clinic rooms e.g the number of people who can attend and the toys available. Please refer to any appointment letter for the exact arrangements.

About our services

We are a Community Paediatrics service. We provide assessment and signpost to support, to promote and protect the health of children and their families.

We do not provide a service for acutely ill children even if they are already under our care as any appointments we offer are elective ie non-emergency and planned in advance.

We do look holistically at a child's needs ie medical, developmental, educational and social, and work with families and other professionals to meet those needs.

We deliver this by:

• Assessing children for neurodevelopmental and neurodisabling conditions and using where needed suitable developmental assessment tools such as Schedule of Growing Skills (SOGs) and The Griffiths Mental Developmental Scales in children under the age of 5 years old.
• Managing the chronic health complications of neurodisability in conjunction with the child's wider health and social care team.
• Leading the multidisciplinary team developmental assessments at the Child Development Centres for children with complex medical and learning needs with likely long term neurodisability, and for children suspected to have Autism who are under the age of 5 years.
  (we assess for Autism Spectrum Disorder using where needed additional recognised developmental assessment tools such as ADOS (Autism Diagnostic Observation Schedule) and the 3 Dimensional Interview (3Di); we currently adhere to DSM-V Criteria (5^th Edition of Diagnostic and Statistical Manual of Mental Disorders) to conclude on Autism Spectrum Disorder diagnosis.)
• Providing medical reports and specialist advice as part of statutory processes for children with special educational needs, children in care and in child protection and safeguarding procedures.

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 in a prechool child (contributing to assessing the level of difficulty in the different developmental skill domains)
• concerns of Autism identified before the child's 5th birthday (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)

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 - The children we routinely accept for a neurodevelopmental assessment are usually developmentally too young for this to be considered. BeeU have an assessment pathway accepting referrals on children over 6 years of age. ADHD_Pathway.pdf (mpft.nhs.uk)
• 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 the 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.
• Diagnosisng Tics and Tourette's Syndrome
  
• '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 criteria that can be used as part of the workup to identify a Learning Disability. 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

Who are we?

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

We focus on the healthcare of children with long-term neurodisabling conditions and their families.

We are able to medically assess children for neurodevelopmental and neurodisabling conditions, look for underlying medical explanations or linked physical health issues, and manage and monitor the chronic health complications of complex neuro-disability.

For some of our diagnostic processes eg Autism, the child has to be accepted onto the Community Paediatric caseload before their 5th birthday.

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 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"