The Community Paediatric Team

The Community Paediatric team specialise in child development and disability. We provide a diagnostic service for children presenting with features that indicate possible:

  • global developmental delay
  • physical disability
  • autism spectrum disorder
  • ADHD
  • Fetal alcohol spectrum disorders (FASDs)
  • Complex tic disorders

We do not provide the following:

  • on-going behavioural support for Autism or ADHD
  • second opinions
  • investigate, diagnose or manage attachment difficulties
  • investigate, diagnose or manage sleep problems as a lone presenting issue
  • investigate mild learning difficulties or specific learning difficulties such as Dyslexia
  • see children with isolated speech and language delay
  • assess children under the age of 6 years with behavioural needs.
  • provide behavioural support for children presenting with challenging behaviour 

The Roles and Responsibilities of GWH Community Paediatrics Team

The Team have a statutory responsibility which involves the following:

Clinical Team Responsibilities  

  • Undertake medicals for children coming into care and reviews for some children in care.
  • Undertake medicals for children and young people being adopted and meet with adoptive parents to review medical information.
  • Undertake SEND medicals on children and young people who are going through the EHCP assessment process.

Non-Direct Clinical Responsibilities

  • Screen and provide medical advice on adults looking to become foster parents.
  • Screen and provide medical advice on adults looking to become adoptive parents.
  • Provide advice to adoption panels. 

The roles within the Team:

The team has a variety of roles that support the statutory work including:

  • Adoption Medical Advisor Role
  • Designated Doctor, Children Looked After
  • Named Doctor for Children Looked After
  • Designated Medical Officer, SEND
  • Designated Doctor for Safeguarding 

It is important to note that this work must be completed according to statutory guidelines and takes priority.

The team also carry out non-statutory work:

Neurodevelopmental Conditions (NDC) Pathway:

There are three consultants that assess new patients who require a diagnostic assessment through the pathway. 

Follow up patient appointments: 

These are offered by the consultants and can also involve the three Neurodevelopmental Nurse Specialists and one speciality doctor.

What happens when my child is referred for an assessment?

The referral will be triaged by nursing staff to assess whether enough information has been provided. Because all of the conditions we assess for will impact children in some way in different environments it is important that information is provided from at least 2 settings.

In addition, if a child is Electively Home Educated evidence can be submitted from a group attended, a course or observations from other services such as a tutor or another adult (not the parent) involved with them. If they have reports from a previous school attendance these can be submitted also. 

In some instances the Community Paediatrics Team will need to expedite referrals accepted onto the pathway due to the presenting clinical needs of the child. This is discussed and agreed at multidisciplinary meetings (MDT) that take place twice monthly which also provides a second layer of triage to assess who the child would also be best placed to see. This is a small team of professionals, including educational psychology, speech and language (SALT) and key members of the community paediatric team.

Once the referral has been accepted you will be sent a letter confirming that your child has been put on the waitlist to be seen. An information leaflet about the process and local supports available to you whilst on the waitlist will be included.

Consent

The referral and process should be discussed with the child’s parent or carer and they consent to sharing the information detailed. Consent should be obtained from both the parent and young person, if the young person is aged 11 or over and has capacity and can be verbally or written.

Who will see my child?

In our team your child might see a neurodevelopmental paediatrician, a specialist paediatric doctor or other developmental specialist. 

Who they see will depend on their needs and whether they are a new patient or have been seen by us before. We will do our best to make sure you see the same person again if needed.

What happens when my child is seen?

You will be sent a questionnaire with your appointment letter to bring on the day of your first visit to the doctor. The doctor will listen to your concerns. They will ask you questions about your child’s development, medical history and questions about your family history. The doctor will observe and interact with your child and complete a physical examination in most cases. A report will be provided to you and your GP about the outcome of the assessment.

In many cases it is necessary to gather more information from you, your child’s teacher and the young person themselves (if they are old enough). In some cases a referral to another professional for different testing will be needed to complete your child’s assessment.

Once all of the necessary information has been gathered you will meet the doctor to review the outcome. Most children we see will not need to have regular follow ups with our service and will be discharged back to their GP. 

Links

Sometimes Community Paediatricians use melatonin in children with autism to reduce the time it takes to get to sleep. Further important information about Melatonin and how it is used can be found here - Melatonin Information Paediatric

Transition to Adult Care 

Information and advice on Autism and ADHD 

Autism Spectrum Disorder services on the Local Offer 

For more information see the following diagram on the assessment and diagnosis process for neurodevelopmental conditions.

Presentations on the reach and impact of the ELSA project Neurodevelopmental Conditions pathway - designed together-   Facilitated by Health colleagues 

Neurodevelopmental Conditions Pathway Updates

Mental health support for children and young people 

Swindon Educational Psychology Service