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Click one of the sections below:

• Triage and assessment
• Intervention
• Intervention: Groups and pathways
• Discharge, transitions and signposting

 

Triage and Assessment

“Is there a waiting list to be seen by PALMS?”

Unfortunately, there is a wait to receive assessment and intervention from PALMS.

When the referral has been accepted by PALMS, the family will be offered an initial assessment Appointment (IAA). The purpose of the IAA is to consider the needs of the child and family, the related goals and to ensure PALMS is an appropriate service to support the current needs. In addition, other services are identified when some of the needs cannot be met within the remit of PALMS.

Following the IAA, a pathway is agreed with the family and if PALMS is an appropriate service the intervention(s) will be explained. Family and professionals can contact PALMS directly if there are any concerns and/or changes in need that they would like to discuss prior to the intervention beginning.

“Do children need to have a diagnosis before they can be referred to PALMS?”

PALMS offers intervention to children who have a diagnosis of moderate to severe learning disability and / or autism which has a moderate to severe impact on cognitive functioning who meet the criteria for the remit of the service, PALMS also accept referrals for children who are waiting for an autism assessment where it is highly likely that the diagnosis of autism will be confirmed and they meet the criteria for the remit of PALMS.

“Will PALMS meet my child at the Initial Assessment Appointment (IAA)?”

The first appointment is called the Initial Assessment Appointment (IAA).

We appreciate that some appointments can be difficult for children and young people and that you may wish to have sensitive conversations about the concerns at home.  We would like to meet both yourself and your child at the initial assessment and will work with you to ensure that this experience is as positive as possible.  If you anticipate that attending the initial assessment will cause significant stress or upset for your child/young person, please contact our team to discuss the options. You can also contact us to let us know in advance if there are any adjustments that may be helpful. 

“Do PALMS contact the family when their referral has been accepted?”

Once a referral is accepted by PALMS, the family, referrer and GP (if not the referrer) will receive a letter advising of the next steps.    

If the referral is not accepted, a letter will be sent to the referrer to explain why this referral was not accepted. The family are always sent a copy of this letter. Signposting to alternative services and support are included in this letter so that more appropriate services can be accessed without delay.

If the referral is not accepted and the family have additional information that they understand would indicate that PALMS is an appropriate service, they are very welcome to contact us directly to provide this information.

If you believe that you have been referred to PALMS but have not received any correspondence from us, please talk to the referrer initially to ensure that this referral has been made. If they confirm it has then please contact PALMS.

“What happens at the IAA?”

During this assessment, the clinician(s) will aim to gather an in depth understanding of what would be most beneficial to support your child and your input will be invaluable to this process. This includes: identifying the goals from accessing PALMS; ensuring PALMS is the most appropriate service to support these goals; discussing what intervention looks like and will require from the family; and, identifying any alternative signposting. 

Following the IAA you will receive a summary letter that will set out the care plan and explain what the suggested pathway is for your child.  This intervention plan will be continually reviewed with you by your allocated PALMS’ clinician.

“Do PALMS prescribe medication?”

As a service, PALMS are committed to reducing the usage of medication prescribed to children and young people with a learning disability, autism, or both. This commitment is in line with the STOMP and STAMP initiatives which have been developed by NHS England.

Whilst there may be times when medication is a useful intervention to support a child, in line with best practice guidelines other therapeutic interventions are always provided first with the aim that medication is not needed. If medication is required, the prescriber will work hard to ensure that this is prescribed for the minimum duration necessary.

PALMS do not provide medication as a sole intervention.

“Do I need to access PALMS before I can have input from social care?”

No. A referral can be made to social care at any time, without having input from PALMS.

“Do PALMS assess and prescribe medication for ADHD?”

PALMS do not assess for or provide medication for ADHD.

If your child requires an assessment for ADHD, you should speak to your child’s paediatrician or see your GP in the first instance. They will be able to refer you to the correct service within Hertfordshire.

“Do PALMS only see children who are in crisis?”

PALMS is not a crisis service. However, PALMS have an Intensive Intervention Team who provide Intensive Intervention and Priority Assessments (within 5 working days) as part of the Hertfordshire joint crisis offer.

Please do not contact us in an emergency.  This may delay you receiving the help that is needed.

Please contact 999 or take your child/ young person to A&E if you do not believe that the situation can be safely managed. 

The Hertfordshire Mental Health Helpline is also available 24/7 on 0800 6444 101 or by contacting 111 and selecting option 2.

Hertfordshire Social Care can be contacted by dialling 0300 123 4043 24/7.

“How can I contact PALMS?”

PALMS principally operates between 07.00-19.00 Monday to Friday.

Our administration team are available 08.30-17.30 Monday to Friday

Please contact us on: 01727 582122 or via email: hct.palms@nhs.net

We will respond to your query within 5 working days.

 

Intervention

“Will I have to attend a PALMS’ intervention group before receiving an intervention?”

PALMS provides different intervention pathways to support the child and their families.  This includes intervention groups which are an effective and evidence based intervention. 

Each pathway aims to offer an individualised plan that is suitable to the needs of the child. Parents/carers do not have to attend an intervention group unless it is assessed as being an appropriate intervention. Intervention groups are stand alone and evidence based and it is anticipated that no further interventions are required following attendance at an intervention group.

“Are the intervention groups offered by PALMS parenting courses?”

The intervention groups offered by PALMS are direct interventions and not parenting courses though most often, our intervention groups are attended by parents. PALMS’ intervention groups do not focus on ‘parenting’ though parents/carers do learn strategies that will enable the intervention and support the whole family. 

Currently, three intervention groups are provided. These are: Feeding Intervention Group, Positive Behaviour Support (PBS) Intervention Group, and Sleep Intervention Group.

“What can I expect from the intervention group that PALMS has offered me?”

Through the group intervention process families will be allocated two clinicians who will develop an individualised bespoke intervention plan in collaboration with families for each child. This plan is implemented at home; supported by the clinicians who will provide both follow up telephone calls and outreach sessions.

PALMS always view families as the experts on their child. By meeting in a small group forum (no more than 8 families), families have the opportunity to share and hear from others who are facing similar challenges alongside working collaboratively with PALMS’ clinicians.

“Will PALMS work with my child’s school?”

PALMS recognises the importance of a whole system approach when supporting a child.  Whilst it is recognised that Education is an important part of every child’s life that can significantly impact on well-being, PALMS are not commissioned to work in or for schools. However, we believe it is essential to work collaboratively with schools, teachers and SEND professionals to share ideas, understanding and strategies to support the child successfully in this environment.  We are also required to contribute to SEND processes such as Education, Health Care Plans (EHCP’s) if this is relevant to your child.

“Is PALMS a ‘behaviour’ service?”

PALMS provide intervention for children who have a diagnosis of moderate to severe learning disability and/or autism which has a of moderate to severe impact on cognitive functioning. PALMS is one of the CYP Mental Health services in Hertfordshire who provide intervention at the getting more help level for a variety of emotional, behavioural, and mental health difficulties.

Scan for PALMS Criteria:

“Will PALMS work with other services who are supporting my child?”

PALMS provides evidence based practice and therefore joint and collaborative working with children, their families, other professionals, agencies, and organisations is essential. Working collaboratively with the network surrounding a child provides opportunities for sharing knowledge, experiences, and expertise to achieve the best outcomes for the child.

 

Intervention: Groups and Pathways

“Do PALMS offer individual work to children/young people?”

PALMS offer individual work with children/young people based on their clinical needs. PALMS also work with parents/carers, the wider family and supporting professionals.

“Do PALMS offer a ‘Parent as Therapist’ model of intervention?”

The ‘Parent as Therapist’ model is one of the evidence based approaches implemented by PALMS. The evidence for this approach highlights the importance of primarily working with systems supporting children who have Autism Spectrum Disorder and/or a Learning Disability rather than solely provide individual intervention with the child. This approach recognises the huge amount of knowledge that parents/ carers hold about their children, the knowledge and skills professionals hold, and how both contributions play a key role in the success and sustainability of all interventions we provide.

To support any intervention, even when working directly with a child, PALMS requires parents/carers and families to develop understanding, skills and strategies, to ensure the success and sustainability of the intervention.

Does PALMS offer virtual appointments?

Yes, PALMS provide virtual video appointments when this is clinically appropriate. As part of the intervention the clinician and family develop a contract to understand what the intervention will look like going forward, a discussion regarding the remit and appropriateness of virtual appointments is had as part of this.

PALMS provide face to face sessions in a variety of community environments, such as clinic, home or school.

Will I see a Psychiatrist in PALMS?

As with all professionals within PALMS, Psychiatry input is allocated according to the clinical needs of the child following assessment by the multi-disciplinary team. If you think that psychiatry support would be beneficial to your child this should be discussed with your PALMS’ clinician in the first instance.

As a service, PALMS are committed to reducing the usage of medication prescribed to children and young people with a learning disability, autism, or both. This commitment is in line with the STOMP and STAMP initiatives which have been developed by NHS England (NHSE).

Whilst there may be times when medication is a useful intervention to support a child, in line with best practice guidelines other therapeutic interventions are always provided first with the aim that medication is not needed. If medication is required, the prescriber will work hard to ensure that this is prescribed for the minimum duration necessary.

PALMS does not provide medication/psychiatry as a sole intervention.

 

Discharge, Transitions and Signposting

“Is PALMS the only service who support children with Autism/Learning Disability?”

PALMS is one of the many services in Hertfordshire that support children with Autism/ Learning Disabilities.  PALMS works collaboratively with these services to ensure that the most appropriate service(s) are accessible when it is needed.

If you need to discuss PALMS’ criteria before making a referral, please contact PALMS directly on: 01727 582122.

For most up to date information on where you can access other local services, please scan QR code:

Website (Local offer): https://www.hertfordshire.gov.uk/microsites/Local-Offer/The-Hertfordshire-Local-Offer.aspx

Hertfordshire County Council:  0300 123 4043 or  https://www.hertfordshire.gov.uk

“Can my child be re-referred to PALMS if we’ve been discharged?”

We know that it is possible that needs change as children develop, and therefore PALMS do accept re-referrals for those concerns that are within the remit of PALMS. 

“Is PALMS a long-term service who will be involved until my child turns 18?”

PALMS is not a long-term service. We understand that our CYP have lifelong needs, however we offer targeted interventions based on a child’s specific needs and goals at the time of assessment. From the point of being accepted into PALMS, we will be working towards discharge. PALMS interventions are evidence based, goal focussed and time-bound.  Our aim is to empower families to continue independently with the sustainable ideas and interventions developed during your time with PALMS.

A typical journey through PALMS can look like this:

• Families are offered an initial assessment where goals are discussed and agreed, an outline of what is required of families to access PALMS is provided and to ensure PALMS is the most appropriate service.
• Families are offered an intervention in line with the goals that are within the service remit.
• Goals will be reviewed throughout the intervention to work toward discharge.

Discharge can be agreed for a number of reasons, including:

• Progress on goals
• Agreement that this is not the right time for intervention
• A number of sessions have been missed by the child or family in accordance with the Do Not Attend (DNA) and cancellation policy.
• Another service has been identified as being more appropriate to offer the required intervention.
• Transition to adult services.