Health and care resources for SEND children and young people

Health and care services in North Yorkshire are provided by a number of different services as well as by us.

Health services are often commissioned on a locality basis, although some are delivered by a single health provider across the whole county. Each commissioned service will have its own:

agreed eligibility criteria (who can access the service)
agreed referral criteria (how to access the service)

A health services glossary has been developed to provide some general information on the types of health care provision for children and young people with special educational needs and disabilities in North Yorkshire. Please also see the important referral information below.

If you have any questions regarding any of the health services in the local offer, and whether your child might benefit from referral, please discuss these with your general practitioner or any of the existing health professionals involved with the care of your child.

Referrals

Health care referrals

During the time when you are meeting (and are involved) with health care professionals, they may suggest and organise a referral. This might be in relation to your child's health needs and / or in relation to any outcomes which may have been discussed at family meetings.

For the majority of services you will require a referral from a health professional and an appointment. To avoid any unnecessary travel, please do not opportunistically attend any of the service venues listed, unless the service description explicitly advises otherwise.

Funding for specialist equipment

Some children and young people will need specialist equipment in place at their educational setting.

The following is a brief summary of where responsibility for funding such equipment lies. Further guidance on responsibilities for equipment can be found via the links in the information for practitioners section.

Item	School	Health	Local Authority	Comment
Personal care	Yes			Items such as nappy bags, plastic gloves etc. are a reasonable adjustment for the school to provide and are personal protective equipment (PPE) rather than medical equipment
Medical		Yes		A child who needs things like syringes, continence pads, inhalers, blood glucose testers, sharps boxes etc. would get these prescribed.
Fixed hoists			Yes	For ceiling mounted hoists then strategic services may fund.
Mobile hoists	Yes		Yes	Mobile hoists are not particularly specialist equipment in a special school such as the Dales School, as it can be used by a number of pupils there. Therefore, these should be funded by the school as part of their standard equipment. However, in a special school such as Brompton Hall School which doesn’t generally cater for physical needs then it might be considered specialist and the equipment panel would need to consider this.
Slings			Yes	Slings, which are used with hoists, are individual to a child and a school can request funding from our children’s specialist equipment budget for these.
Wheelchairs		Yes		If a child or young person meets the criteria for a wheelchair then these come via the wheelchair centre. Find more information on wheelchair services on the Airedale NHS Foundation Trust website.
Specialist seating	Yes		Don't know	Many children and young people with physical needs who attend special schools require specialist seating. This is not the same as a wheelchair but some people confuse the terminology as they are on wheels. The first £625 rule applies and schools may also request top up, although this will not be automatic.

Many children and young people with physical needs who attend special schools require specialist seating. This is not the same as a wheelchair but some people confuse the terminology as they are on wheels.

The first £625 rule applies and schools may also request top up, although this will not be automatic.

More information about finance and the first £625 rule is available in the specialist equipment in schools and educational settings guidance (pdf / 531 KB).

Transforming care programme

Transforming care is about making health and care work better for children and young people with autism or learning disabilities. It is the name used to describe how health, social care and education should work together to improve health and care services in local areas. You can find out more about the Transforming Care Programme on the Council for Disabled Children's information sheet.

Care and education treatment reviews

If a young person is either in a mental health hospital, or there are concerns that they might need to be admitted to hospital for their mental health needs, then a care and education treatment review may be suggested. This is a multi-agency meeting that brings the professionals involved in a young person’s care together.

The care and education treatment review meeting

The meeting lasts for full day and is led by a panel that includes:

a chair person from the local integrated care board
a clinical expert
an expert by experience (a parent or carer who has similar experiences).

The panel look at the current care and treatment needs by reviewing care plans and assessments, and finding out the views and wishes of the young person, family and professionals. The panel then make recommendations that are shared with the family and the lead professionals involved, with the aim that these may help support the young person’s needs to be met in the community where possible.

Eligibility for care and education treatment review and referrals

Young people with a diagnosis of autism and / or a learning disability, who are either in hospital or being considered for admission to hospital due to their mental health needs, should have a review.

Referrals can be made by professionals involved in the young persons’ care. Families can request a review through their lead professional.

Young people with a diagnosis of autism and / or a learning disability who are receiving intensive support for their mental health needs should also be included on the dynamic support register. This is held by the local Integrated Care Board. This raises awareness with professionals that additional support may be required and ensures a review is offered at the right time.

Further information

Annual health checks

Annual health checks and learning disabilities

Annual health checks are for adults and young people aged 14 or over with a learning disability. An annual health check helps you stay well by talking about your health and finding any problems early, so you are able to get the right care. You do not have to be ill to have a health check. In fact, most people have their annual health check when they are feeling well.

Who's eligible?

Anyone aged 14 or over who is registered having a learning disability with their general practitioner can have a free annual health check once a year. You can ask to be registered if you think you have a learning disability. You do not need to be diagnosed with a learning disability to be registered.

There is a learning disability register and a register of social care needs managed by local councils. Check with your general practitioner's practice if you or the person you care for is on the register.

More information about annual health checks and learning disabilities can be found on the NHS website.

Personal health budgets

Personal health budgets are the allocation of NHS funding to support a person's health and wellbeing needs. A budget can be spent on anything that is set out in a support plan and agreed with the local NHS team. It can be held by the individual, a third party or a statutory body. Patients or service users, after an assessment, are able to personally control and use for the services they choose to support their health needs. Anyone eligible for continuing healthcare funding, including children, has a right to ask for and receive a personal health budget.

Parts of a personal health budget

The person with the personal health budget (or their representative) will:

be able to choose the health and wellbeing outcomes they want to achieve, in agreement with a healthcare professional
know how much money they have for their health care and support
be enabled to create their own care plan, with support if they want it
be able to choose how their budget is held and managed, including the right to ask for a direct payment
be able to spend the money in ways and at times that make sense to them, as agreed in their plan

Children and young people eligible for continuing healthcare funding may include those with needs arising from:

disability
illness or life limiting conditions
accident
palliative care

Continuing care can be considered only if the needs of the child or young person can not be met from existing universal and specialist services.

Personal health budgets in your area

Further information about personal health budgets in your local area can be found as follows:

North Yorkshire

Via the North Yorkshire ICB website.

For more information about personal health budgets, contact your NHS continuing care team on 0300 303 8294.

Hospice care

Children's hospices

Children's hospices provide specialist respite and terminal care for children suffering from life limiting conditions in a home-to-home environment.

More information on hospice care can be found on our hospice care for children page.

Integrated Care Systems in North Yorkshire

Integrated Care Systems are partnerships of organisations that come together to plan and deliver joined up health and care services, and to improve the lives of people who live and work in their area.

The following place-based partnerships operate within the North Yorkshire and Craven area:

National health websites

Keyworker service

The NHS Long Term Plan includes a commitment that ‘by 2023/24 children and young people with a learning disability and/or who are autistic with the most complex needs will have a designated keyworker, implementing the recommendation made by Dame Christine Lenehan in the Council for Disabled Children review 'These are our children'.

Initially, keyworker support will be provided to children and young people with a learning disability and/or who are autistic who are inpatients in, or at risk of being admitted to, a mental health hospital. Keyworker support will then be extended to the most vulnerable children with a learning disability and/or who are autistic, including people who face multiple vulnerabilities such as looked after and adopted children, and children and young people in transition between services.’

Keyworkers will make sure that these children, young people and families get the right support at the right time. They will make sure that local systems are responsive to fully meeting the young people’s needs in a joined up way and that whenever it is possible to provide care and treatment in the community with the right support this becomes the norm.

A keyworker will work with children and young people with the most complex needs and their families and carers to make sure families are fully involved in their plans, feel listened to and informed, plans are personalised, and they have the support they need at the right time, in a co-ordinated way. Keyworking should help families experience a reduction in stress and uncertainty and an increase in stability. More information about children and young people keyworkers is available on the NHS website.

Who can have a keyworker?

To access a keyworker the child or young person must:

have a diagnosis of a learning disability, autism or both
be 0 to 25 years of age, although our primary focus is under 18s
have a potential risk of inpatient admission or are currently in hospital
be on the Dynamic Support Register - priority referrals are with those at Red and Amber and at crisis point -those at Green currently do not receive an allocated keyworker, however, may receive signposting or consultation
live in the geographical area of Humber and North Yorkshire which includes Hull, East Riding, North Lincolnshire, North East Lincolnshire, York, and North Yorkshire

Our service flexible to meet individual needs:

we can arrange for an interpreter if you or your family need one
let us know if want or need information in a certain way and we will try to provide

Our service is confidential. We will discuss with you who we share your information with. If we are concerned about the safety of a child or young person we have a duty to report this. We are committed to working with the Safeguarding Children’s Board Guidelines and the Principles of the Children Act 1989 (updated 2004).

Humber and North Yorkshire Dynamic Support Keyworker Service

Our Dynamic Support keyworkers work with autistic people and people with a learning disability aged up to 25 years who are on the Dynamic Support Register rated red, amber or blue (inpatient).

The Dynamic Support Register is to identify people at risk or may become at risk of admission to a mental health hospital without support.

For further information visit the keyworker service page on the Humber and North Yorkshire website.