The information on this page outlines available health services to children and young adults with special educational needs and/or a disability (SEND), including those without education, health and care plans (EHCPs).
Children's therapy services cover speech and language therapy (SALT), occupational therapy and more. They can be delivered as community services in the home, at GP surgeries, or at any of our health centres across the county. Many of our therapy services are available to children and young people, and are accessible through a referral from a GP, paediatrician, health visitor, or other health professional.
Community health services
The Shropshire Community Health NHS Trust provides a range of specialist services for babies, children and families, including specialist child and adolescent mental health services (CAMHS), a specialist service called the Family Nurse Partnership (FNP) for young mothers across the Shropshire area, and specialist wheelchair services.
Also included are outpatient clinics held at health centres in towns and villages across Shropshire. Some clinics, such as paediatric appointments, can be held at convenient locations so that families don't have to travel further than necessary to attend medical appointments. Some clinics or specialist services need to be held at bigger facilities such as community hospitals or main hospitals. These are based in our main towns such as Shrewsbury, Ludlow and Bridgnorth.
Shropshire Community Health NHS Trust provides a range of services from specialist nurses, nursing teams or clinicians. These services are for patients who need highly specialised support and care in order to manage an acute health condition or to reduce the possibility of becoming more poorly.
The trust also provides care and support to patients who have to live with long-term conditions, for which patients need specialist advice and support in being able to live a happy and healthy life despite the condition.
Specialist services are delivered from health centres or community hospitals across the county. These services can include:
- Hearing clinics
- Continence clinic
- Ear, nose and throat clinic
Designated medical officer (DMO)/Designated Clinical Officer (DCO)
Who/what is a DMO/DCO?
The SEND code of practice is clear that a Designated Medical Officer (DMO) and/or a Designated Clinical Officer (DCO) should be in post to support CCG’s in meeting their statutory responsibilities for children and young people with SEN and disabilities. (SEND Code of Practice 2014).
A DMO/DCO needs appropriate expertise, and links with other professionals to enable them to exercise it, in dealing with children and young adults with EHC plans from the age of 0 to 25 in a wide range of educational institutions. (SEND Code of Practice 2014).
In Shropshire we have a Designated Clinical Officer who is supported by the Designated Nurse for Safeguarding Children and the Commissioner for Children Services. The DCO is an active member of the EHC panel and also meets regularly with professional health care providers and the local authority around SEND this includes but is not limited to: paediatricians, social workers, headteachers, nurses, dieticians, physiotherapists, speech therapists, GPs and SEN Team.
What does a DMO/DCO do?
The DMO/DCO provides the point of contact and expertise, for local authorities, schools and colleges seeking health advice on children and young people who may have SEN or disabilities, and provides a contact for CCGs and health providers, so that appropriate notification, support and treatment can be commissioned and co-production across agencies can be agreed strategically across Shropshire for children and their families who have a SEN or disability .
The DMO can support schools with their duties under the ‘Supporting Pupils with Medical Conditions’ guidance.
The DMO/DCO wouldn't routinely be involved in assessments or planning for individuals, except in the course of their usual clinical practice, but would be responsible for ensuring that assessment, planning and health support is carried out. (SEND Code of Practice 2014).
For concerns around assessments or planning of EHCP’s in the first instance the original Health care provider should be contacted and if these issues are not resolved they can then be escalated to the CCG for resolution.
Identifying additional needs and disabilities
There are many ways that a child or young person can be identified as having additional needs and disabilities. Diagnosis can take place at various points in life, through a range of circumstances. Any health practitioner within a specialist field can make a diagnosis, or referrals made to specialist consultants to assess suspected medical needs.
Diagnosis can occur during pregnancy or at birth, during infancy and early childhood, and later. Sometimes additional needs and disabilities occur as a result of trauma resulting in cognitive or physical injury. We hope to have captured these possible pathways on this page to help you understand the role of each health service in identifying additional needs and disability.
Accessibility of services / adapting practice
All services are required to make 'reasonable adjustments' to meet the needs of their patients. This can include allowing home visits, meeting outside of normal working hours, making adjustments to the facilities to accommodate equipment or sensory needs, and much more.
If you have a specific need that should be considered when making an appointment or arranging a visit, you should always disclose and discuss this as soon as you're able. Practitioners are more able to accommodate needs if they have time to prepare for them effectively.
Although every effort should be made to accommodate need, sometimes it's not practicable to do so. If this is the case you're encouraged to share your concerns with the practitioner so that they can try to improve the experience you have when attending their service.
Feedback about good experiences is always helpful so that we can share it with colleagues to encourage consideration of need for families.
For more advice on access-to-health services, please take a look at the MENCAP FAQs.
Annual health checks
From the age of 14, all young people with an identified learning disability are entitled to an annual health check with their GP. This annual health check is important as it provides an opportunity to identify new medical concerns, monitor existing conditions, and develop a relationship with your GP.
It's recommended that any child or young person with SEN or disabilities have a ‘hospital passport’. This document captures all of their vital information and key details about their needs and medical conditions. It can include things like how you're able to communicate, your likes and dislikes, and any other important information that would help make your experience in hospital better. They're similar to an educational one-page profile. If you/your child has one it may be a useful starting point to help you think about what information is important to share with health professionals.
There are also some other great examples of how hospital passports can look and what you could include. Find out more from the following:
Personal health budgets
A personal health budget allows you to manage your healthcare and support such as treatments, equipment and personal care, in a way that suits you. It often improves the quality of a person’s life and sense of wellbeing. A personal health budget is an amount of money to support your health and wellbeing needs which is planned and agreed between you (or someone who represents you), and our Commissioning Group. It's not new money, but it may mean spending money differently so that you can get the care you need.
The SEND Code of Practice 2014 states that the local offer should be used:
"To make provision more responsive to local needs and aspirations by directly involving disabled children, young people and those with SEN and their parents and service providers in its development and review."
Together with partners, we intend to use the local offer to map gaps in service provision, and identify areas of need for children and young people with SEND and their families. To do this as effectively as possible, we need your feedback.
NHS England oversees the budget, planning, delivery and day-to-day operation of health services in England. It's responsible for commissioning the more specialist health services, with local clinical commissioning groups and local authorities commissioning health services for their local areas. It also provides further guidance on SEN on their Live Well pages.
Clinical Commissioning Group (CCG)
The Shropshire Clinical Commissioning Group is led by family doctors in Shropshire’s 44 GP practices, and responsible for buying a wide range of health services for patients. It's committed to involving the people of Shropshire in all major decisions about developing healthcare in the county. On their site is a dedicated page detailing how they support special educational needs and disabilities as part of the Local offer.
Shropshire Council Public Health
Shropshire Council Public Health is responsible for taking the lead on improving health and protecting the public’s health and wellbeing in Shropshire.
Alongside the Shropshire Health and Wellbeing Board, organisations from across Shropshire are working together to reduce health inequalities and improve the health and wellbeing of the local population. The vision for this work is for ‘a flourishing Shropshire’ where people are able to live healthy and happy lives. Find out more from the Shropshire Together website.