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Care Coordination Service

This is an NHS service for babies and children who present with an identified developing condition or disability which is impacting on or has the potential to significantly impact upon their long-term development.

An appointment will be offered with a Specialist Nurse Advisor and a family service plan will be agreed. In some cases, a care coordinator may be allocated to the child and their family to provide longer term support. This support may include;

  • coordination of care with other professionals and organisations.
  • information on local groups and other agencies
  • support with transition into nursery and/or school
  • team around the child meetings to share information with other professionals involved in the child’s care and put together a family plan
  • referrals onto other agencies /services.

Care Coordinators work with nurseries/schools, GPs, health visitors, doctors, preschools, and other health professionals. They will link in with other agencies involved in the child’s development.

Childrens Therapies Care Coordination

The children can receive time-limited packages of care throughout their time with Children’s Therapies until the age of 12. This may involve being discharged and re-referred to access further support.

Service criteria

Children up to the age of 4 years who have complex needs and require long term intervention from the Children’s Therapies Service.

Children up to the age of 12 years who have previously been open to Care Coordination.

Children up to the age of 12 years with complex needs who have moved into the area and had previously accessed an equivalent service.

Children up to the age of 12 years who have an acquired brain injury that has resulted in significant development delay.

Children up to the age of 12 years with a degenerative condition.

Referral

Children can be referred to the service by their parents, a GP, health visitor, or any other health, social care or educational professionals.

Children who may be eligible for this service will be discussed within the Children’s Therapies triage process.

If a child appears appropriate for assessment, then the specialist nurse advisor may call the parents/carers to offer the service.

Children who have been accepted will be contacted within the 12-week referral to assessment target.

Children will have an agreed support plan in place within two weeks of assessment.

For children living in Ashford, Dover, Deal or Shepway please complete the Children’s Therapies Care Coordination Service referral form.