Community paediatrics

  • Community Paediatrics

    Community Paediatricians are specialised children’s doctors who provide high quality specialist care in the assessment of range of developmental conditions. The Community Paediatrics service also provides statutory health assessments of looked after children and input for children with complex health care needs. We also take leadership responsibility for SEND, Safeguarding and Looked After Children.

    This website is designed to give you an insight into the care that the team provides and what you should expect from this service.

    Whether you’re visiting us for diagnosis and/or treatment, our team of specialists are here to support you. Please use the links on this site to find out more about what we do and how to access our services.

     

    Community Paediatricians

    Community paediatricians are doctors who have specific expertise in assessing children with neurodevelopmental difficulties such as Delayed Development, Cerebral Palsy, Autism, Dyspraxia, Down and various other syndromes and other conditions.

    We work as part of a wider child development team which includes occupational therapists, physiotherapists, speech therapists, and have close links with preschool educational advisers. We also work closely with heath visitors, school nurses, community children’s nurses, audiology, social care, nurseries and schools, hospital paediatricians, and children’s emotional wellbeing and mental health services.

    Referral to Community Paediatrician

    We are able to accept children and young People who are registered with a Hertfordshire GP

    Our services are for children between 0-16 years. It extends for young people with Severe Learning Disability until 18 years, if they are at a special school.

    We need a referral with all relevant details about your child’s needs for us to accept.

    We only accept referrals from NHS professionals.

    Professionals’ referrals to Community Paediatrics are through Electronic Referral System (ERS) or internally through SystmOne as usual.

    Advice and guidance is available through the Electronic Referral System (ERS).

     

    Consent

    We expect that your child’s referrer will have discussed the reasons for referral with you before sending through documentation to us. If you are unsure why your child has been referred, please contact the person who made the referral for clarification.

    We do not accept referrals without informed parental consent.

     

    Conditions assessed by Community Paediatrician

    • Children with complex health needs and disability

    This includes diagnoses such as

    • Cerebral Palsy
    • Down Syndrome
    • Muscular Dystrophy,
    • Other genetic syndromes and many others.

     

    The diagnosis may have already been made by another doctor before we see your child but often our team is involved in the identification of the cause of underlying difficulties.

    Children with these diagnoses typically need specialist input in more than one area of their development and general health.

    Community paediatricians provide medical input and work in partnership with parents in holistic planning for your child’s needs.

     

    • Children with neurodevelopmental disorders


    This includes diagnoses such as autistic spectrum disorder, developmental coordination disorder, learning difficulty, and many others. Children with these diagnoses are typically physically healthy but have difficulty in gaining skills in a range of developmental areas. These areas include language skills (speaking, listening and reading), physical skills (writing, riding a bicycle), social skills (friendships, family relationships), academic achievement. Community paediatricians provide a medical perspective and explanation to families and staff from other organisations. We aim to foster understanding of an individual child’s strengths and areas of need. We may advise on strategies that may help, that have scientific evidence to support their use. We may make referrals to other health professionals.

     

    • Medical advice on child protection and safeguarding children
      Community paediatricians have broad and specific knowledge and experience of child protection and safeguarding. We are sometimes asked to give our opinion on a child’s health and wellbeing, and some of our team carry out ‘safeguarding medicals’ on request by social services. Safeguarding and promoting the welfare of children depends on effective joint working between professionals that have different roles and expertise.

    For more information

    https://www.hertfordshire.gov.uk/media-library/documents/childrens-services/hscb/child-protection-medical-information-for-patients-and-carers.pdf

     

     

    • Medical advice on the impact of health problems in educational settings
      If a child has health or developmental needs that are impacting on their education, community paediatricians may be asked to share information about the child with the school and also the education authority. Parents will be asked to provide consent for this. Children may also be assessed by a community paediatrician if the education authority has decided to initiate an Education Health and Care Plan (EHCP). This is usually a one off appointment to complete a profile of the child’s health and developmental needs and how this impacts on their education.

     

    • Statutory medical assessments for children living in special circumstances e.g. children looked after by the local authority and medical input to the adoption process
      Community paediatricians assess children who have recently come into the care of the local authority, to ensure that their health needs are met. Parents or peoplewith parental responsibility will be asked to provide consent for information about the child to be shared between community paediatricians and the local authority.


    Location

    The child development teams are based at one of the three Children’s Centres:

    • Peace Children’s Centre, Watford
    • Marlowes Health and Wellbeing Centre, Hemel Hempstead
    • St Albans Health and Wellbeing Centre

     

    Contact the Service:

    Referral Hub: 01923 470680 Option 2

    Initial Appointments – email: hct.cypspecialistservices@nhs.net

    Follow Up Appointments – email: wh.compaeds@nhs.net

    For Autism assessments only if your child is already on our Autism waiting list, you can contact the ASD Administration team by emailing hct.autism@nhs.net.

     

    Appointments:

    Where possible we will contact you ahead of time by letter, text message with the date and time of the appointment but sometimes the paediatrician may call without prior notice.

    Initial appointment

    The structure of the Initial appointment depends on why we have been asked to see your child.

    Most of our referrals are for neurodevelopmental disorders or complex health needs.  For these conditions, at the Initial appointment we meet with your child and parents/ carers. This initial assessment can take between 60 to 90 minutes. We will talk with you about your concerns, ask about your child’s medical and social history and your family history; do a physical examination and where appropriate developmental assessment. Depending on the likely diagnosis, further specific assessments and in some cases a more formal questionnaire may be used.

    Where appropriate, especially if your child has complex health needs or disability a joint assessment with other members of the child development centre team will take place. This is to provide you with a range of expertise and opinions without unnecessary duplication of your time.

    For some children we will request further tests, including blood tests, x-rays and brain scans. We may also refer to other therapists and professionals for further diagnosis or treatment. We may arrange for a more detailed developmental check to be done.

    At the end of the Initial appointment, we will summarise our findings and if possible, give a diagnosis. Sometimes we need to see you and the child again and or arrange for further observations or tests. Sometimes even with all this information it is not possible to give a definitive diagnosis. The neurodevelopmental disorders like autism, developmental coordination disorder, ADHD and learning difficulties all have a range of severity or spectrum and often overlap each other.

     

    Further Information for long waiting times: West Herts Community Paediatric Service

    Please note there are waiting times involved for more specific assessments like Autism.

    Autism Assessments:

    We are currently offering a hybrid service of virtual and face-to-face appointments depending on the needs of your child. Most of our ASD assessments are face-to-face with some being undertaken as virtual video-based assessments with the Multidisciplinary team. This means you and your child or young person can be seen at home via video link. A clinician will contact you in advance of an appointment to discuss the process and how the assessment will be carried out on the day. This model of working is helping the team ensure that children, young people and their families can receive support based on their individual needs.

    When your child or young person is nearing the top of the waiting list, we would be grateful if you and/or the school setting where appropriate could complete and return all the forms which we will send. The forms will typically be sent by email by us.

     

    ADHD Assessment

    At present ADHD assessments are being provided by CAMHS services via Step2

    A self-referral to Step2 services can be made to them using the link below

    https://www.hct.nhs.uk/service-details/service/child-and-adolescent-mental-health-camhs-step2-61/

     

    How long will your child be under a Community Paediatrician

    The length of time a community paediatrician will continue to see your child depends on the needs of your child identified after the initial assessment. We may need to see you and your child again and gather extra information to complete the assessment process.

    Once this is complete we will discharge your child if we feel that there is no further role for the community paediatrician. Some children may have needs that are best met by other NHS services or School. This includes school age children with learning difficulties or autism without continuing medical problems. If we have prescribed medication for your child, we will offer regular reviews.

    We will discharge or arrange a transfer to another service for your child when they reach the age of 16 years.

    We will discharge your child if you do not attend, or you cancel without good reason with less than 24 hours’ notice for two appointments in a row. If your child is on medication that we are monitoring, we will contact you about this. Once your child is discharged you will need a new referral to receive further input from the service.

    If your child’s needs have changed and you no longer require an assessment appointment, please let us know as soon as possible so that we can offer the appointment to another family. You can email us on hct.cypspecialistservices@nhs.net

     

    For Autism assessments only if your child is on our autism assessment waiting list, you can contact the ASD Administration team by emailing hct.autism@nhs.net.

     

    Useful Information

    In case of emergency or in a crisis, if you do not feel that you are able to keep your child or family safe, please contact your GP, the emergency services via Accident and Emergency or by calling 999. If your child is under 5, you can also contact your Health Visitor for support and guidance.

    Whilst you are waiting for an assessment appointment, we suggest you review the information available from the Hertfordshire County Council Local Offer

    Local Offer

    The Local Offer includes a range of materials, bookable courses and workshops which can provide invaluable guidance on supporting your child or young person, both before and after their assessment. The Local Offer website is www.hertfordshire.gov.uk/localoffer.

     

    The Neurodiversity Hub

    For those children and young people with suspected Autism/ADHD, The Neurodiversity Support Hub can offer support. It is open Monday - Friday 9am-1pm. 

    The Hub can be contacted by phone on 01727 833963, with an answerphone facility for out of hours or by email at support@add-vance.org

    Further Support:

    Bowel & Bladder (potty training): ERIC www.eric.org.uk

    Sleep package: www.thesleepcharity.org.uk/information-support/children/

    OT website: https://www.hct.nhs.uk/our-services/childrens-occupational-therapy

    DSPL Leaflet: Support in the local area can also be accessed through the ‘Delivering Special Provision Locally’ (DSPL) partnership. DSPL provides a range of support across the county for children and young people with special educational needs and disabilities. Further information about DSPL can be accessed at the following address

    https://www.hertfordshire.gov.uk/microsites/local-offer/education/dspl/delivering-special-provision-locally.aspx

    For Dacorum specifically:

    http://www.dacorumdspl.org.uk/#

    For St Albans and Hertfordshire

    http://dspl7.org.uk/#

    For Watford

    http://dsplarea9.org.uk/#

     

    Parenting Courses

    http://www.dacorumdspl.org.uk/courses-for-parents-carers-and-professionals/  

    SENDIAS Leaflet

    www.herts.sendiass.org.uk

    www.familylives.org.uk  - Family Lives is a national charity providing help and support in all aspects of family life, including parenting courses.

     

     

    Autistic Spectrum Disorder:

    www.autism.org.uk/parents   National Autistic Society website includes information about autism and Asperger syndrome, the NAS and its services and activities.

    www.spaceherts.org.uk/index.htm  Space is a Hertfordshire based charity supporting parent/carers of children and young people on the Autistic Spectrum, with Attention Deficit Hyperactivity Disorder (ADHD) or a related condition.

     https://angelssupportgroup.org.uk  - Hertfordshire charity supporting families of children with Autistic Spectrum Condition and/or ADHD.

     www.nasbranch.org.uk/Hertfordshire   -  the Hertfordshire branch of the National Autistic Society. Email hertfordshire@nas.org.uk

    www.hopeforautism.org - A local support group for families who have a child with autism.

    www.familiesinfocus.co.uk  - offer free autism parenting courses https://www.hertsfamilycentres.org/family-centres.aspx    Information about Hertfordshire family centres (offer parenting courses etc.)

     

    Special Educational Needs and Disabilities:

    www.kids.org.uk/hub  - The KIDS East and West HUB services offer information and support for parents and carers of disabled children/children with additional needs aged 0-19 in Hertfordshire.

    https://www.hertfordshire.gov.uk/microsites/local-offer/the-hertfordshire-localoffer.aspx  Information about the local offer - services for children and young people with Special Educational Needs in Hertfordshire

    https://www.hertfordshire.gov.uk/microsites/local-offer/support/sendiass.aspx  - Special Educational Needs and Disability Information Advice and Support Service (SENDIASS) impartial information, advice and support service funded by Hertfordshire County Council for parents, carers, young people (0-25) and professionals.

    https://www.hertfordshire.gov.uk/microsites/local-offer/tell-us/hertfordshire-additionalneeds-database.aspx  - Information on Hertfordshire Additional Needs Database (HAND), with an online newsletter, Information on benefits, activities, support groups https://www.thegrid.org.uk/learning/sen/whole_school/dspl/news/documents/herts_a utism_report_exec_summary.pdf - Review of educational provision in Hertfordshire for children and young people on the autism spectrum 2015

    www.mencap.org.uk   - Support group and services for learning disabled children and their families.

    www.minded.org.uk  – free educational resource on children and young people’s mental health.

    More information on supporting sensory challenges in the classroom can be found at http://network.autism.org.uk/knowledge/insight-opinion - ‘Sensory challenges for autistic pupils.

     

     

How the service is provided

First appointment

The first appointment depends on why we have been asked to see your child. Most of our referrals are for neurodevelopmental disorders or complex health needs.

At the first appointment we meet with your child and parents/ carers. This initial assessment can take between 60 to 90 minutes. We will talk with you about your concerns, ask about your child’s medical and social history and your family history; do a physical examination and where appropriate a developmental assessment will be undertaken. Depending on the likely diagnosis, further specific questions and in some cases a more formal questionnaire may be used.

Where appropriate, especially if your child has complex health needs or disability a joint assessment with other members of the child development centre team will take place. This is to provide you with a range of expertise and opinions without unnecessary duplication of your time.

For some children we will request further tests, including blood tests, x-rays and brain scans. We may also refer to other therapists and professionals for further diagnosis or treatment. We may arrange for a more detailed developmental check to be done at a later date.

At the end of the initial appointment we will summarise our findings and if possible give a diagnosis. Sometimes we need to see you and the child again, arrange for further observations or tests. Sometimes even with all this information it is not possible to give a definitive diagnosis. The neurodevelopmental disorders like autism, developmental coordination disorder, ADHD and learning difficulties all have a range of severity or spectrum and often coincide each other, so sometimes it is not possible to give a categorical diagnosis.

Length of time spent with a community paediatrician

The length of time a community paediatrician will continue to see your child depends on the needs of your child identified after the initial assessment. We may need to see you and your child again, and gather extra information to complete the assessment process. Once this is complete we will discharge your child if we feel that there is no ongoing role for the community paediatrician. This includes school age children with learning difficulties or autism without continuing medical problems. If we have prescribed medication for your child, we will offer regular reviews.

We will discharge or arrange a transfer to another service for your child when they reach the age of 16 years.

We will discharge your child if you do not attend or you cancel without good reason with less than 24 hours’ notice for two appointments in a row. If your child is on medication that we are monitoring we will contact you about this. Once your child is discharged you will need a new referral to receive further input from the service.

Who is eligible for the service

  • Those registered with a GP in Hertfordshire
  • Children and young people up to 16 years (West Hertfordshire)
  • Children and young people up to 19 years in special schools

What will happen at your appointment

  • At the first appointment we meet with your child and parents/ carers. This initial assessment can take between 60 to 90 minutes.
  • Where appropriate a joint assessment with other members of the child development centre team will take place. This is to provide you with a range of expertise and opinions without unnecessary duplication of your time.
  • We will take your child’s history; do a physical examination and a thorough developmental check. Depending on the likely diagnosis, further specific questions and in some cases a more formal questionnaire may be used.
  • For some children we will request further tests, including blood tests, x-rays and brain scans. We may also refer to other therapists and professionals for further diagnosis or treatment.

Useful information

Hertfordshire’s Special Educational Needs and Disabilities Local Offer

Hertfordshire's Special Educational Needs and Disabilities (SEND) Local Offer is a one-stop shop for information, support, services and activities available for children and young people with special educational needs and disabilities, and their families. It is a comprehensive, up to date resource with information relevant to families in Hertfordshire.

There are links to provide reliable information about many of the neurodevelopmental conditions, complex health conditions and disabilities that we see at our child development centres.

If you are looking for support for any of these conditions there are further links to the relevant organisations.

There is information about special educational needs and disabilities in education, and how to get support for your child. This includes Special Educational Needs and Disability Information Advice and Support Service (SENDIASS) who provide impartial and confidential information, advice and support.

There are links to accessing finance and benefits for your child; there are links on ‘things to do’, specially aimed at children and young people with SEND giving them the chance to spend time with others doing fun activities.

For young people and their families there is the preparing for adulthood link.

The Local Offer has been created by parents and professionals and is very easy to access.

www.hertsdirect.org/localoffer

West Herts Community Paediatric Service

Websites and resources

ADHD and Autism

ADDISS
National Attention Deficit Disorder Information and Support Service. Their website offers information and resources about Attention Deficit Hyperactivity Disorderfor carers, young people and teachers.
www.addiss.co.uk

ADD-vance
Provide specialist information, training and advice on Autism and ADHD as well as coaching, group support and training courses for families
www.add-vance.org

Aspergers4Herts
Website which signposts to services for children, teenagers and adults with autism. Includes a link to Spectrum Girls, a social group for high functioning autistic girls of all ages.
www.aspergers4herts.org

The National Autistic Society
The leading UK charity for people with autism and their families. They provide reliable information and support.
www.autism.org.uk

Hope For Autism in West Herts
A local support group for families who have a child with autism.
www.hopeforautism.org

Space
Support groups with regular professional speakers for families of children with autism and ADHD. Also run workshops and seminars. Social events for the whole family. Has a lending library.
www.spaceherts.org.uk  

Sleep Hygiene Guide
Please find below a guide for parents on sleep and how we can help improve it, as well as an interactive PowerPoint puzzle that you can go through with your child to learn more about sleep together. 

Other neurodevelopmental problems and disabilities

Cerebra
Provides help and information for children with neurodevelopmental disorders including autism and intellectual disability. Offers a free library with an extensive collection of books, parent guides and advice from professionals in their sleep service.
www.cerebra.org.uk

Contact A Family
This website provides advice, information and support for the families of disabled children. Both common and rare conditions are covered with links to support groups.
www.cafamily.org.uk

Dyspraxia Foundation
Information and links to local support groups.
www.dyspraxiafoundation.org.uk

Epilepsy Action
Provides information on many aspects of living with epilepsy. Offers a confidential helpline, written resources and emotional support.
www.epilepsy.org.uk

The FASD Trust
Information and support for families and professionals for those with foetal alcohol syndrome disorders.
www.fasdtrust.co.uk

HemiHelp
a UK-based charity for people with hemiplegia and their families.
contact.org.uk/help-for-families/information-advice-services/hemihelp

Mencap
Support group and services for learning disabled children and their families.
www.mencap.org.uk

Muscular Dystrophy UK
Information and support for people with muscular dystrophy.
www.muscular-dystrophy.org

Nerve Tumours UK (formerly The Neuro Foundation)
Information and support for those affected by Neurofibromatosis.
nervetumours.org.uk

Scope
Information and support for families who have a child cerebral palsy.
www.scope.org.uk

Tourettes Action
Provides support to those affected by Tourette syndrome and their families, offers telephone helpline service and information.
www.tourettes-action.org.uk

Unique
The rare chromosome disorder support group with free guides on specific chromosome disorders
www.rarechromo.co.uk/html/home.asp  

Support for families and carers including parenting advice

Carers in Herts
Provides information, advice and support to carers in Hertfordshire along with links to support groups and carer’s assessments.
www.carersinherts.org.uk

Family Lives
Family Lives is a national charity providing help and support in all aspects of family life, including parenting courses.
www.familylives.org.uk

Families in Focus
Support Groups and parenting courses for parents caring for children with Autism, ADHD, PDA, Cerebral Palsy, Downs Syndrome, Learning Difficulties, Additional Needs and or Chronic Illness
www.familiesinfocus.co.uk

KIDS Hubs
The HUBs offer information and support for parents and carers of disabled children and young people aged 0-19 in Hertfordshire, including help finding activities and signposting specialist services. Offers a toy library and access to software to develop social stories.
www.kids.org.uk/hub

Support for Special Educational Needs

IPSEA (Independent Parental Special Educational Advice)
Free and independent legally based advice and support on education provision for children with special educational needs and disability.
www.ipsea.org.uk  

SENDIASS
Special Educational Needs and Disability Information Advice and Support Service  impartial information, advice and support service funded by Hertfordshire County Council for parents, carers, young people (0-25) and professionals.
www.hertfordshire.gov.uk/microsites/local-offer/support/sendiass.aspx

Support for Mental health problems

MindEd
Free educational resource on children and young people’s mental health for families and professionals
www.minded.org.uk

Young Minds
Information and support for young people and their parents at risk of or living with a mental health problem.Offers a free confidential online and telephone support service for parents/ carers and many links for young people.
www.youngminds.org.uk

Medicines advice

Medicines for Children
Practical and reliable advice about giving medicine to your child.
www.medicinesforchildren.org.uk

Making a referral

  • Referrals can be made by a GP, health visitor, school nurse for children attending schools in West Hertfordshire only, social worker in certain circumstances, speech and language therapist, occupational therapist, physiotherapist, child and adolescent mental health clinic and consultants from other specialties.
  • Most referrals are discussed within a multi-disciplinary professionals team meeting to determine the most appropriate services to meet your child’s needs.
  • Following receipt of the referral you may be asked to fill out various questionnaires in relation to your concerns about your child. You may be asked to provide a report from your child’s school or pre-school. This will be shared with you.
  • Once we have the relevant information an appointment will be sent.

Download and complete a referral form

Autism assessment referral forms and guidance

Our referral forms and information can be found on the link above and once completed should be emailed to HCT.CYPSpecialistServices@nhs.net

Electronic referrals are preferred but forms can also be sent to:
Referral Admin Hub
Peace Children’s Centre
Watford
WD17 3EW

 

Patient experience

Hertfordshire Community NHS Trust offers high quality services and aim to be as helpful as possible. We are interested in your views. If you are dissatisfied by our service then we would like to know so we can make improvements.

Please contact the Patient Experience team on 0800 011 6113 (local call 01707 388164) or email pals.hchs@nhs.net.

We would also love to hear about your experience on our service, please complete a survey by clicking here.

Community paediatrics

  • Community Paediatrics

    Community Paediatricians are specialised children’s doctors who provide high quality specialist care in the assessment of range of developmental conditions. The Community Paediatrics service also provides statutory health assessments of looked after children and input for children with complex health care needs. We also take leadership responsibility for SEND, Safeguarding and Looked After Children.

    This website is designed to give you an insight into the care that the team provides and what you should expect from this service.

    Whether you’re visiting us for diagnosis and/or treatment, our team of specialists are here to support you. Please use the links on this site to find out more about what we do and how to access our services.

     

    Community Paediatricians

    Community paediatricians are doctors who have specific expertise in assessing children with neurodevelopmental difficulties such as Delayed Development, Cerebral Palsy, Autism, Dyspraxia, Down and various other syndromes and other conditions.

    We work as part of a wider child development team which includes occupational therapists, physiotherapists, speech therapists, and have close links with preschool educational advisers. We also work closely with heath visitors, school nurses, community children’s nurses, audiology, social care, nurseries and schools, hospital paediatricians, and children’s emotional wellbeing and mental health services.

    Referral to Community Paediatrician

    We are able to accept children and young People who are registered with a Hertfordshire GP

    Our services are for children between 0-16 years. It extends for young people with Severe Learning Disability until 18 years, if they are at a special school.

    We need a referral with all relevant details about your child’s needs for us to accept.

    We only accept referrals from NHS professionals.

    Professionals’ referrals to Community Paediatrics are through Electronic Referral System (ERS) or internally through SystmOne as usual.

    Advice and guidance is available through the Electronic Referral System (ERS).

     

    Consent

    We expect that your child’s referrer will have discussed the reasons for referral with you before sending through documentation to us. If you are unsure why your child has been referred, please contact the person who made the referral for clarification.

    We do not accept referrals without informed parental consent.

     

    Conditions assessed by Community Paediatrician

    • Children with complex health needs and disability

    This includes diagnoses such as

    • Cerebral Palsy
    • Down Syndrome
    • Muscular Dystrophy,
    • Other genetic syndromes and many others.

     

    The diagnosis may have already been made by another doctor before we see your child but often our team is involved in the identification of the cause of underlying difficulties.

    Children with these diagnoses typically need specialist input in more than one area of their development and general health.

    Community paediatricians provide medical input and work in partnership with parents in holistic planning for your child’s needs.

     

    • Children with neurodevelopmental disorders


    This includes diagnoses such as autistic spectrum disorder, developmental coordination disorder, learning difficulty, and many others. Children with these diagnoses are typically physically healthy but have difficulty in gaining skills in a range of developmental areas. These areas include language skills (speaking, listening and reading), physical skills (writing, riding a bicycle), social skills (friendships, family relationships), academic achievement. Community paediatricians provide a medical perspective and explanation to families and staff from other organisations. We aim to foster understanding of an individual child’s strengths and areas of need. We may advise on strategies that may help, that have scientific evidence to support their use. We may make referrals to other health professionals.

     

    • Medical advice on child protection and safeguarding children
      Community paediatricians have broad and specific knowledge and experience of child protection and safeguarding. We are sometimes asked to give our opinion on a child’s health and wellbeing, and some of our team carry out ‘safeguarding medicals’ on request by social services. Safeguarding and promoting the welfare of children depends on effective joint working between professionals that have different roles and expertise.

    For more information

    https://www.hertfordshire.gov.uk/media-library/documents/childrens-services/hscb/child-protection-medical-information-for-patients-and-carers.pdf

     

     

    • Medical advice on the impact of health problems in educational settings
      If a child has health or developmental needs that are impacting on their education, community paediatricians may be asked to share information about the child with the school and also the education authority. Parents will be asked to provide consent for this. Children may also be assessed by a community paediatrician if the education authority has decided to initiate an Education Health and Care Plan (EHCP). This is usually a one off appointment to complete a profile of the child’s health and developmental needs and how this impacts on their education.

     

    • Statutory medical assessments for children living in special circumstances e.g. children looked after by the local authority and medical input to the adoption process
      Community paediatricians assess children who have recently come into the care of the local authority, to ensure that their health needs are met. Parents or peoplewith parental responsibility will be asked to provide consent for information about the child to be shared between community paediatricians and the local authority.


    Location

    The child development teams are based at one of the three Children’s Centres:

    • Peace Children’s Centre, Watford
    • Marlowes Health and Wellbeing Centre, Hemel Hempstead
    • St Albans Health and Wellbeing Centre

     

    Contact the Service:

    Referral Hub: 01923 470680 Option 2

    Initial Appointments – email: hct.cypspecialistservices@nhs.net

    Follow Up Appointments – email: wh.compaeds@nhs.net

    For Autism assessments only if your child is already on our Autism waiting list, you can contact the ASD Administration team by emailing hct.autism@nhs.net.

     

    Appointments:

    Where possible we will contact you ahead of time by letter, text message with the date and time of the appointment but sometimes the paediatrician may call without prior notice.

    Initial appointment

    The structure of the Initial appointment depends on why we have been asked to see your child.

    Most of our referrals are for neurodevelopmental disorders or complex health needs.  For these conditions, at the Initial appointment we meet with your child and parents/ carers. This initial assessment can take between 60 to 90 minutes. We will talk with you about your concerns, ask about your child’s medical and social history and your family history; do a physical examination and where appropriate developmental assessment. Depending on the likely diagnosis, further specific assessments and in some cases a more formal questionnaire may be used.

    Where appropriate, especially if your child has complex health needs or disability a joint assessment with other members of the child development centre team will take place. This is to provide you with a range of expertise and opinions without unnecessary duplication of your time.

    For some children we will request further tests, including blood tests, x-rays and brain scans. We may also refer to other therapists and professionals for further diagnosis or treatment. We may arrange for a more detailed developmental check to be done.

    At the end of the Initial appointment, we will summarise our findings and if possible, give a diagnosis. Sometimes we need to see you and the child again and or arrange for further observations or tests. Sometimes even with all this information it is not possible to give a definitive diagnosis. The neurodevelopmental disorders like autism, developmental coordination disorder, ADHD and learning difficulties all have a range of severity or spectrum and often overlap each other.

     

    Further Information for long waiting times: West Herts Community Paediatric Service

    Please note there are waiting times involved for more specific assessments like Autism.

    Autism Assessments:

    We are currently offering a hybrid service of virtual and face-to-face appointments depending on the needs of your child. Most of our ASD assessments are face-to-face with some being undertaken as virtual video-based assessments with the Multidisciplinary team. This means you and your child or young person can be seen at home via video link. A clinician will contact you in advance of an appointment to discuss the process and how the assessment will be carried out on the day. This model of working is helping the team ensure that children, young people and their families can receive support based on their individual needs.

    When your child or young person is nearing the top of the waiting list, we would be grateful if you and/or the school setting where appropriate could complete and return all the forms which we will send. The forms will typically be sent by email by us.

     

    ADHD Assessment

    At present ADHD assessments are being provided by CAMHS services via Step2

    A self-referral to Step2 services can be made to them using the link below

    https://www.hct.nhs.uk/service-details/service/child-and-adolescent-mental-health-camhs-step2-61/

     

    How long will your child be under a Community Paediatrician

    The length of time a community paediatrician will continue to see your child depends on the needs of your child identified after the initial assessment. We may need to see you and your child again and gather extra information to complete the assessment process.

    Once this is complete we will discharge your child if we feel that there is no further role for the community paediatrician. Some children may have needs that are best met by other NHS services or School. This includes school age children with learning difficulties or autism without continuing medical problems. If we have prescribed medication for your child, we will offer regular reviews.

    We will discharge or arrange a transfer to another service for your child when they reach the age of 16 years.

    We will discharge your child if you do not attend, or you cancel without good reason with less than 24 hours’ notice for two appointments in a row. If your child is on medication that we are monitoring, we will contact you about this. Once your child is discharged you will need a new referral to receive further input from the service.

    If your child’s needs have changed and you no longer require an assessment appointment, please let us know as soon as possible so that we can offer the appointment to another family. You can email us on hct.cypspecialistservices@nhs.net

     

    For Autism assessments only if your child is on our autism assessment waiting list, you can contact the ASD Administration team by emailing hct.autism@nhs.net.

     

    Useful Information

    In case of emergency or in a crisis, if you do not feel that you are able to keep your child or family safe, please contact your GP, the emergency services via Accident and Emergency or by calling 999. If your child is under 5, you can also contact your Health Visitor for support and guidance.

    Whilst you are waiting for an assessment appointment, we suggest you review the information available from the Hertfordshire County Council Local Offer

    Local Offer

    The Local Offer includes a range of materials, bookable courses and workshops which can provide invaluable guidance on supporting your child or young person, both before and after their assessment. The Local Offer website is www.hertfordshire.gov.uk/localoffer.

     

    The Neurodiversity Hub

    For those children and young people with suspected Autism/ADHD, The Neurodiversity Support Hub can offer support. It is open Monday - Friday 9am-1pm. 

    The Hub can be contacted by phone on 01727 833963, with an answerphone facility for out of hours or by email at support@add-vance.org

    Further Support:

    Bowel & Bladder (potty training): ERIC www.eric.org.uk

    Sleep package: www.thesleepcharity.org.uk/information-support/children/

    OT website: https://www.hct.nhs.uk/our-services/childrens-occupational-therapy

    DSPL Leaflet: Support in the local area can also be accessed through the ‘Delivering Special Provision Locally’ (DSPL) partnership. DSPL provides a range of support across the county for children and young people with special educational needs and disabilities. Further information about DSPL can be accessed at the following address

    https://www.hertfordshire.gov.uk/microsites/local-offer/education/dspl/delivering-special-provision-locally.aspx

    For Dacorum specifically:

    http://www.dacorumdspl.org.uk/#

    For St Albans and Hertfordshire

    http://dspl7.org.uk/#

    For Watford

    http://dsplarea9.org.uk/#

     

    Parenting Courses

    http://www.dacorumdspl.org.uk/courses-for-parents-carers-and-professionals/  

    SENDIAS Leaflet

    www.herts.sendiass.org.uk

    www.familylives.org.uk  - Family Lives is a national charity providing help and support in all aspects of family life, including parenting courses.

     

     

    Autistic Spectrum Disorder:

    www.autism.org.uk/parents   National Autistic Society website includes information about autism and Asperger syndrome, the NAS and its services and activities.

    www.spaceherts.org.uk/index.htm  Space is a Hertfordshire based charity supporting parent/carers of children and young people on the Autistic Spectrum, with Attention Deficit Hyperactivity Disorder (ADHD) or a related condition.

     https://angelssupportgroup.org.uk  - Hertfordshire charity supporting families of children with Autistic Spectrum Condition and/or ADHD.

     www.nasbranch.org.uk/Hertfordshire   -  the Hertfordshire branch of the National Autistic Society. Email hertfordshire@nas.org.uk

    www.hopeforautism.org - A local support group for families who have a child with autism.

    www.familiesinfocus.co.uk  - offer free autism parenting courses https://www.hertsfamilycentres.org/family-centres.aspx    Information about Hertfordshire family centres (offer parenting courses etc.)

     

    Special Educational Needs and Disabilities:

    www.kids.org.uk/hub  - The KIDS East and West HUB services offer information and support for parents and carers of disabled children/children with additional needs aged 0-19 in Hertfordshire.

    https://www.hertfordshire.gov.uk/microsites/local-offer/the-hertfordshire-localoffer.aspx  Information about the local offer - services for children and young people with Special Educational Needs in Hertfordshire

    https://www.hertfordshire.gov.uk/microsites/local-offer/support/sendiass.aspx  - Special Educational Needs and Disability Information Advice and Support Service (SENDIASS) impartial information, advice and support service funded by Hertfordshire County Council for parents, carers, young people (0-25) and professionals.

    https://www.hertfordshire.gov.uk/microsites/local-offer/tell-us/hertfordshire-additionalneeds-database.aspx  - Information on Hertfordshire Additional Needs Database (HAND), with an online newsletter, Information on benefits, activities, support groups https://www.thegrid.org.uk/learning/sen/whole_school/dspl/news/documents/herts_a utism_report_exec_summary.pdf - Review of educational provision in Hertfordshire for children and young people on the autism spectrum 2015

    www.mencap.org.uk   - Support group and services for learning disabled children and their families.

    www.minded.org.uk  – free educational resource on children and young people’s mental health.

    More information on supporting sensory challenges in the classroom can be found at http://network.autism.org.uk/knowledge/insight-opinion - ‘Sensory challenges for autistic pupils.

     

     

How the service is provided

First appointment

The first appointment depends on why we have been asked to see your child. Most of our referrals are for neurodevelopmental disorders or complex health needs.

At the first appointment we meet with your child and parents/ carers. This initial assessment can take between 60 to 90 minutes. We will talk with you about your concerns, ask about your child’s medical and social history and your family history; do a physical examination and where appropriate a developmental assessment will be undertaken. Depending on the likely diagnosis, further specific questions and in some cases a more formal questionnaire may be used.

Where appropriate, especially if your child has complex health needs or disability a joint assessment with other members of the child development centre team will take place. This is to provide you with a range of expertise and opinions without unnecessary duplication of your time.

For some children we will request further tests, including blood tests, x-rays and brain scans. We may also refer to other therapists and professionals for further diagnosis or treatment. We may arrange for a more detailed developmental check to be done at a later date.

At the end of the initial appointment we will summarise our findings and if possible give a diagnosis. Sometimes we need to see you and the child again, arrange for further observations or tests. Sometimes even with all this information it is not possible to give a definitive diagnosis. The neurodevelopmental disorders like autism, developmental coordination disorder, ADHD and learning difficulties all have a range of severity or spectrum and often coincide each other, so sometimes it is not possible to give a categorical diagnosis.

Length of time spent with a community paediatrician

The length of time a community paediatrician will continue to see your child depends on the needs of your child identified after the initial assessment. We may need to see you and your child again, and gather extra information to complete the assessment process. Once this is complete we will discharge your child if we feel that there is no ongoing role for the community paediatrician. This includes school age children with learning difficulties or autism without continuing medical problems. If we have prescribed medication for your child, we will offer regular reviews.

We will discharge or arrange a transfer to another service for your child when they reach the age of 16 years.

We will discharge your child if you do not attend or you cancel without good reason with less than 24 hours’ notice for two appointments in a row. If your child is on medication that we are monitoring we will contact you about this. Once your child is discharged you will need a new referral to receive further input from the service.

Who is eligible for the service

  • Those registered with a GP in Hertfordshire
  • Children and young people up to 16 years (West Hertfordshire)
  • Children and young people up to 19 years in special schools

What will happen at your appointment

  • At the first appointment we meet with your child and parents/ carers. This initial assessment can take between 60 to 90 minutes.
  • Where appropriate a joint assessment with other members of the child development centre team will take place. This is to provide you with a range of expertise and opinions without unnecessary duplication of your time.
  • We will take your child’s history; do a physical examination and a thorough developmental check. Depending on the likely diagnosis, further specific questions and in some cases a more formal questionnaire may be used.
  • For some children we will request further tests, including blood tests, x-rays and brain scans. We may also refer to other therapists and professionals for further diagnosis or treatment.

Useful information

Hertfordshire’s Special Educational Needs and Disabilities Local Offer

Hertfordshire's Special Educational Needs and Disabilities (SEND) Local Offer is a one-stop shop for information, support, services and activities available for children and young people with special educational needs and disabilities, and their families. It is a comprehensive, up to date resource with information relevant to families in Hertfordshire.

There are links to provide reliable information about many of the neurodevelopmental conditions, complex health conditions and disabilities that we see at our child development centres.

If you are looking for support for any of these conditions there are further links to the relevant organisations.

There is information about special educational needs and disabilities in education, and how to get support for your child. This includes Special Educational Needs and Disability Information Advice and Support Service (SENDIASS) who provide impartial and confidential information, advice and support.

There are links to accessing finance and benefits for your child; there are links on ‘things to do’, specially aimed at children and young people with SEND giving them the chance to spend time with others doing fun activities.

For young people and their families there is the preparing for adulthood link.

The Local Offer has been created by parents and professionals and is very easy to access.

www.hertsdirect.org/localoffer

West Herts Community Paediatric Service

Websites and resources

ADHD and Autism

ADDISS
National Attention Deficit Disorder Information and Support Service. Their website offers information and resources about Attention Deficit Hyperactivity Disorderfor carers, young people and teachers.
www.addiss.co.uk

ADD-vance
Provide specialist information, training and advice on Autism and ADHD as well as coaching, group support and training courses for families
www.add-vance.org

Aspergers4Herts
Website which signposts to services for children, teenagers and adults with autism. Includes a link to Spectrum Girls, a social group for high functioning autistic girls of all ages.
www.aspergers4herts.org

The National Autistic Society
The leading UK charity for people with autism and their families. They provide reliable information and support.
www.autism.org.uk

Hope For Autism in West Herts
A local support group for families who have a child with autism.
www.hopeforautism.org

Space
Support groups with regular professional speakers for families of children with autism and ADHD. Also run workshops and seminars. Social events for the whole family. Has a lending library.
www.spaceherts.org.uk  

Sleep Hygiene Guide
Please find below a guide for parents on sleep and how we can help improve it, as well as an interactive PowerPoint puzzle that you can go through with your child to learn more about sleep together. 

Other neurodevelopmental problems and disabilities

Cerebra
Provides help and information for children with neurodevelopmental disorders including autism and intellectual disability. Offers a free library with an extensive collection of books, parent guides and advice from professionals in their sleep service.
www.cerebra.org.uk

Contact A Family
This website provides advice, information and support for the families of disabled children. Both common and rare conditions are covered with links to support groups.
www.cafamily.org.uk

Dyspraxia Foundation
Information and links to local support groups.
www.dyspraxiafoundation.org.uk

Epilepsy Action
Provides information on many aspects of living with epilepsy. Offers a confidential helpline, written resources and emotional support.
www.epilepsy.org.uk

The FASD Trust
Information and support for families and professionals for those with foetal alcohol syndrome disorders.
www.fasdtrust.co.uk

HemiHelp
a UK-based charity for people with hemiplegia and their families.
contact.org.uk/help-for-families/information-advice-services/hemihelp

Mencap
Support group and services for learning disabled children and their families.
www.mencap.org.uk

Muscular Dystrophy UK
Information and support for people with muscular dystrophy.
www.muscular-dystrophy.org

Nerve Tumours UK (formerly The Neuro Foundation)
Information and support for those affected by Neurofibromatosis.
nervetumours.org.uk

Scope
Information and support for families who have a child cerebral palsy.
www.scope.org.uk

Tourettes Action
Provides support to those affected by Tourette syndrome and their families, offers telephone helpline service and information.
www.tourettes-action.org.uk

Unique
The rare chromosome disorder support group with free guides on specific chromosome disorders
www.rarechromo.co.uk/html/home.asp  

Support for families and carers including parenting advice

Carers in Herts
Provides information, advice and support to carers in Hertfordshire along with links to support groups and carer’s assessments.
www.carersinherts.org.uk

Family Lives
Family Lives is a national charity providing help and support in all aspects of family life, including parenting courses.
www.familylives.org.uk

Families in Focus
Support Groups and parenting courses for parents caring for children with Autism, ADHD, PDA, Cerebral Palsy, Downs Syndrome, Learning Difficulties, Additional Needs and or Chronic Illness
www.familiesinfocus.co.uk

KIDS Hubs
The HUBs offer information and support for parents and carers of disabled children and young people aged 0-19 in Hertfordshire, including help finding activities and signposting specialist services. Offers a toy library and access to software to develop social stories.
www.kids.org.uk/hub

Support for Special Educational Needs

IPSEA (Independent Parental Special Educational Advice)
Free and independent legally based advice and support on education provision for children with special educational needs and disability.
www.ipsea.org.uk  

SENDIASS
Special Educational Needs and Disability Information Advice and Support Service  impartial information, advice and support service funded by Hertfordshire County Council for parents, carers, young people (0-25) and professionals.
www.hertfordshire.gov.uk/microsites/local-offer/support/sendiass.aspx

Support for Mental health problems

MindEd
Free educational resource on children and young people’s mental health for families and professionals
www.minded.org.uk

Young Minds
Information and support for young people and their parents at risk of or living with a mental health problem.Offers a free confidential online and telephone support service for parents/ carers and many links for young people.
www.youngminds.org.uk

Medicines advice

Medicines for Children
Practical and reliable advice about giving medicine to your child.
www.medicinesforchildren.org.uk

Making a referral

  • Referrals can be made by a GP, health visitor, school nurse for children attending schools in West Hertfordshire only, social worker in certain circumstances, speech and language therapist, occupational therapist, physiotherapist, child and adolescent mental health clinic and consultants from other specialties.
  • Most referrals are discussed within a multi-disciplinary professionals team meeting to determine the most appropriate services to meet your child’s needs.
  • Following receipt of the referral you may be asked to fill out various questionnaires in relation to your concerns about your child. You may be asked to provide a report from your child’s school or pre-school. This will be shared with you.
  • Once we have the relevant information an appointment will be sent.

Download and complete a referral form

Autism assessment referral forms and guidance

Our referral forms and information can be found on the link above and once completed should be emailed to HCT.CYPSpecialistServices@nhs.net

Electronic referrals are preferred but forms can also be sent to:
Referral Admin Hub
Peace Children’s Centre
Watford
WD17 3EW

 

Patient experience

Hertfordshire Community NHS Trust offers high quality services and aim to be as helpful as possible. We are interested in your views. If you are dissatisfied by our service then we would like to know so we can make improvements.

Please contact the Patient Experience team on 0800 011 6113 (local call 01707 388164) or email pals.hchs@nhs.net.

We would also love to hear about your experience on our service, please complete a survey by clicking here.