paediatrics guidelines07
TRANSCRIPT
7/27/2019 Paediatrics Guidelines07
http://slidepdf.com/reader/full/paediatrics-guidelines07 1/56
2007 Information to guide good practice for
physiotherapists workingwith childrenThe Association of Paediatric
Chartered Physiotherapists
THE CHARTERED SOCIETY OF PHYSIOTHERAPYTHE CHARTERED SOCIETY OF PHYSIOTHERAPY
7/27/2019 Paediatrics Guidelines07
http://slidepdf.com/reader/full/paediatrics-guidelines07 2/56
7/27/2019 Paediatrics Guidelines07
http://slidepdf.com/reader/full/paediatrics-guidelines07 3/56
Foreword
3
All babies, children and young people are important. They each have their own
unique personality and potential. They deserve the best possible care and nurture to
support their health and development.
Physiotherapists who work with children are specialist practitioners who have the
right skills and specific knowledge to deliver appropriate care and educate and to
encourage family involvement.
Paediatric physiotherapists should have an understanding of:
child development
childhood diseases and conditions that may impact on development and wellbeing
therapeutic interventions that enable and optimise development and wellbeing
the need to place the child at the centre of planning
the impact that having a disabled child or a child who is sick has on family life
how to keep children safe
how to ensure that children and young people make choices
how to develop their own skills and practice
how to develop services in line with the Government guidance committed to
improving quality and life chances for children.
Peta Smith
Chair Association of Paediatric Chartered Physiotherapists
November 2007
7/27/2019 Paediatrics Guidelines07
http://slidepdf.com/reader/full/paediatrics-guidelines07 4/56
2007 Information to guide practice for physiotherapists working with children
Table of contentsIntroduction
What is the purpose of this booklet? 5Who is it for? 5
How to use this guide 5
Supporting information 6
Building a business case 6
Section 1 – Physiotherapy as a profession
What is physiotherapy? 7
What is paediatric physiotherapy? 7
Relevant organisations 8
Section 2 – Physiotherapy practice
Legal and ethical framework 9
What is the legal framework that governs physiotherapy? 9
Ethics and consent in paediatrics 10
What are the consent issues for a paediatric physiotherapist involved with 10children and their families?
What is the role of the paediatric physiotherapist in safeguarding children? 13
Checking staff against criminal registers 14
Factors influencing physiotherapy practice 15
What are the factors that support physiotherapy practice? 15
Paediatric competences and standards 15
Workforce development – Continuing Professional Development (CPD) 16
Evidence-based practice 16
Moving and handling 17
Health and wellbeing 21
Public health 21 Locations and settings 22
Supporting practice 24
Section 3 – Providing high quality services for children and their families
What are the key factors that support the delivery of paediatric physiotherapy services? 25
Report writing to support assessment and planning based around the needs of children 28and their families
Legal and tribunal report writing 29
Assistive technology 29
Section 4 – UK Country-specific child-related policy
England 31
Northern Ireland 35
Scotland 37
Wales 39
Section 5 – Useful general information
Sports and leisure 41
Specialist holidays 42
Voluntary agencies and support group 43
Appendix – Resources and references 44
7/27/2019 Paediatrics Guidelines07
http://slidepdf.com/reader/full/paediatrics-guidelines07 5/56
Introduction
What is the purpose of this booklet?
This booklet provides guidance on good
practice for physiotherapists working with
children. It is designed to help address the
breadth of wellbeing of children, especially
those who may be positively affected by
paediatric physiotherapy.
It acts as a signpost to UK government policyand guidance, highlighting those which impact
on paediatric physiotherapy practice and shares
a list of contact details for a wide variety of
information, services and activities that may be
helpful for children and young people.
It is intended that this booklet and the
forthcoming document on ‘Competences
to deliver services for children and youngpeople who require physiotherapy services’
(to be published in 2008) will help and
support clinicians working within paediatric
physiotherapy services as well as those
commissioning, developing and delivering
services for children to ensure that children and
young people receive a high standard of care.
Who is this for?
managers of children’s services
managers and clinical leads for paediatric
therapy services
managers of paediatric physiotherapy services
clinicians working in paediatric
physiotherapy
those commissioning services for children
and young people
parents and carers.
The topics covered and information signposted
will assist in:
Designing and implementing a service that
understands and addresses legislation and
national policy in order to improve
outcomes for children
Commissioning and developing services that
meet the needs of children
Facilitating the use of evidence-based
practice for effective paediatric physiotherapy
Using competence frameworks to
ensure paediatric physiotherapy quality
service provision
Linking to other organisations and services
to help provide individual children and
their families with the best opportunity to
fulfil their potential Service review and redesign, providing a
robust business plan and investing resources
in a new way of working.
How to use this guide
The booklet is divided into five sections:
Each section has a number of headings
relating to its content and identified withthe relevant page numbers. For the most
part, the references are included at the
end, however, for some areas, particularly
around the legal and consent headings,
additional references and reading are
located in the section
Section 4 relates to children’s services
within England, Northern Ireland, Scotland
and Wales. Each country has a dedicated
chapter, which outlines its Children’s
strategy, child legislation, key policy papers,
CSP information papers and
implementation tools
The word ‘children’ relates to babies,
children and young people
The word ‘families’ relates to parents, carers
and members of the extended families.
The content of this guide is current at the time
of going to press, recognising that practice
and legislation evolve. The resource may be
accessed via The Chartered Society of
Physiotherapy’s (CSP) website www.csp.org.uk
linked to the Association of Paediatric
Chartered Physiotherapist’s (APCP) website
www.apcp.org.uk where it will be
updated regularly.
5
7/27/2019 Paediatrics Guidelines07
http://slidepdf.com/reader/full/paediatrics-guidelines07 6/56
The information collated within the booklet
is not exhaustive; it is intended to be used as
a resource and a guide and not as a definitive
document.
Links to relevant websites are included in order
to access current information.
Supporting Information
The booklet is intended to be read and used
in conjunction with additional published
information from the CSP and the APCP,
which is available from the CSP on 020 7306
6666 or www.csp.org/publications, or through
membership to the profession’s clinical interest
group, APCP, at http://www.apcp.org.uk/.
In particular, the guide supports and
references the Health Professions Council (HPC)
Standards of Proficiency(1), the CSP Rules of
Professional Conduct(2), CSP Core Standards of
Physiotherapy Practice(3) and the APCP Good
Practice Guidance(4).
Building a business caseThe CSP publication Making the Business
Case for Physiotherapy(5) provides support
in understanding the modernisation issues
in healthcare, factors influencing what
commissioners need to purchase and
developing the business case in order to win
contracts to provide a physiotherapy service.
Introduction
2007 Information to guide practice for physiotherapists working with children
7/27/2019 Paediatrics Guidelines07
http://slidepdf.com/reader/full/paediatrics-guidelines07 7/56
What is physiotherapy?
What does this mean for children andyoung people?
Children receive appropriate high qualityindividualised intervention and support tohelp them achieve improved outcomes
Children and families are provided with
timely information and advice
Children and young people have accessto professional practice which is based onassessed need and underpinned by robustclinical governance.
Physiotherapy is an allied health care
profession which promotes the health and
wellbeing of all. Physiotherapy is a sciencebased profession, committed to extending,
applying, evaluating and reviewing the
evidence that underpins and informs its
practice and delivery. Physiotherapists are
autonomous practitioners, responsible
for the assessment and interpretation of
investigations to provide expert, holistic
physical rehabilitation to those who require
such intervention because of accident, injury,ageing, disease or disability. They also use their
strong educational skills to teach, empower
and promote physical wellbeing
and independence by maximising
individuals’ potential.
What is paediatric physiotherapy?
Physiotherapists working with childrenand young people bring their generic
skills as physiotherapists. They may have
to cover a wide range of conditions from
respiratory, neurology and musculoskeletal
in differing environments and must be able
to demonstrate competence in all areas in
which they practise. They recognise that
children and young people are not adults and
that as practitioners working in this specialistfield they should have additional skills and
knowledge around:
holistic child development
anatomy, physiology, neurological and
psychological development from new born
to adulthood
the recognition of the ages and stages from
infancy through transitions to adult life
a range of child specific medical conditions
and disability and the impact they have on
participation and wellbeing
the ability to recognise atypicaldevelopment and assess, identify, clinically
diagnose and offer a range of interventions
and options using their clinical judgement
and experience
the understanding of the importance of
working in partnership with the children
and their families to help them gain an
understanding of their situation, teachingand empowering them so that they are
able to maximise their abilities and
life opportunities
the understanding of the possibility for
involvement over a prolonged period if
a child has a long term condition for
which physiotherapy intervention could
be beneficial the ability to provide an advocacy and
educational role in partnership with the
child or young person as they progress
through key stages of development,
engaging with others to ensure consistent
optimum outcomes.
Paediatric physiotherapists have a duty tomaintain their clinical reasoning skills and
up to date knowledge within their specific
area of practice to ensure that interventions
are appropriate and effective. Continuing
professional development (CPD) to increase
specialist knowledge, skill and experience
can be gained through clinical working
with children, attending specialist courses,reviewing the evidence base, reflecting on
practice and undertaking research and is a ‘life
long’ experience for all physiotherapists(3).
Physiotherapy as a profession
7
1.
7/27/2019 Paediatrics Guidelines07
http://slidepdf.com/reader/full/paediatrics-guidelines07 8/56
Developing competence to practise safely helps
to ensure consistent quality standards of care
and delivery of services for babies, children
and young people throughout the United
Kingdom.
Relevant organisations
Chartered Society of Physiotherapy
Tel: 020 7306 6666
www.csp.org.uk
The Chartered Society of Physiotherapy is the
professional, educational and trade union
body for 49,000 chartered physiotherapists,
physiotherapy students and assistants in the
UK. It aims to support its members and
help them provide the highest standards
of patient care.
Rules of professional conduct and standards of
Physiotherapy Practice (2, 3) set high standards
for CSP members’ practice and conduct.
Broader activity around the following supports
members in meeting these:
Qualifying and post-qualifying education
Professionalism and competence
CPD and career development
Research, evidence-based practice and
clinical effectiveness
Professional networking and peer support
(face-to-face and virtual).
The Society is a member-led organisation,
governed by the CSP Council. This is made
up of elected CSP members and is supported
by a system of boards, branches, committees
and groups. The CSP provides a wide range
of member services and is also a campaigning
organisation, raising the profile and lobbying
on behalf of the membership and promoting
the physiotherapy profession.
Health Professions Council – HPC
Tel: 020 7582 0866 www.hpc-uk.org
The HPC is the UK independent regulator
for the allied health professions. It sets
standards of professional training, conduct
and performance for these professionals and
keeps a register of those that meet the above
standards. Action is taken if any registeredprofessionals do not meet the standards of the
HPC. Since 2006, all registrants must engage
in CPD and re-registration with the HPC is
linked to successful compliance with the CPD
standards. The HPC was created by legistration
called the Health Professions Order 2001
and replaced the Council for the Professions
Supplementary to Medicine.
Association of Paediatric Chartered
Physiotherapists APCP www.apcp.org.uk
APCP is the clinical interest group of the CSP
for Chartered Physiotherapists working with
children or an interest in children and their
physiotherapy. APCP has a national committee
which has representatives from the regional
branches. The Association also has affiliated
groups which have a specific interest in certain
areas of Paediatrics.
Affiliated Groups of the APCP
Neonatal Care Group
Critical Care Group
Neuromuscular Group
Paediatric Physiotherapists in Management
Services (PPIMS)
Physiotherapy practice
2007 Information to guide practice for physiotherapists working with children
2.
7/27/2019 Paediatrics Guidelines07
http://slidepdf.com/reader/full/paediatrics-guidelines07 9/56
Legal and ethical framework
What is the legal framework that governs
physiotherapy?
What does this section mean for childrenand young people?
Physiotherapists must understand and
adhere to the law and rules that governtheir profession thereby providing safetreatments in a safe environment forchildren and young people.
Chartered physiotherapists are regulated
healthcare professionals, required to adhere
to the rules and standards of the CSP, the
regulations of the HPC and the legal andpolicy frameworks of the country in which
they work. It is essential that physiotherapists
working with children also have knowledge
and understanding of relevant trust and
local authority policies relating to the care
of children. This is as relevant to private
practitioners who treat children as those
physiotherapists employed within the
public sector.
Sadly, legal frameworks relating to children are
often only reviewed following tragedy, as in
the cases of Victoria Climbié(6), Caleb Ness(7) and
the Kennedy Report(8).
Recent reviews in the UK have driven the
need for organisations to work more closelytogether, putting the child at the centre of
care and using modern technology to improve
communications. Increased movement in the
population has highlighted the need for better
access to information; for example, families
relocating within the UK, children entering the
country as asylum seekers, or during a transfer
to specialist care away from their family and
home locality.
It is essential for physiotherapists to
understand the national and local policy and
legislation which impacts on the way they
work and deliver services. The documents
listed below relate to UK-wide physiotherapy.
The subsections relating to England, Northern
Ireland, Scotland and Wales contain their
relevant documents.
United Nations Convention on the Rights of
the Child 1989 (UNCRC)(9)
The UNCRC was ratified by the United Kingdom
in 1991 and all four governments are committed
to implementing the articles, reporting to the
Committee on the Rights of the Child (one of the
United Nations’ treaty monitoring bodies) every
five years on progress. The Convention provides
a set of minimum standards relating to children
– defined as under 18 years. The standards mostly
address under 16 year-olds and acknowledgethe different needs of the 16-18 year group of
young people.
The CRC is grounded in the Universal Declaration
of Human Rights(10), which states that children
are entitled to special care and assistance as they
often lack the physical and political means to
defend their own rights. Addressing the civil,
political, economic, social and cultural rights of
the child, the standards sit in three categories:
Provision
Protection
Participation.
Children’s right to express their views and
be heard in matters that affect them is now
enshrined in law (Article 12 of the UN Conventionon the Rights of a Child).
Paediatric physiotherapists should have the skills
to work effectively in partnership with children
and young people. These include having the
abilities and qualities to listen, respect and
respond to their views, priorities and wishes.
Disability Discrimination Act (DDA1995 updated 2005) (11, 12). The Disability
Discrimination Act aims to end discrimination
facing many people with disability.
Physiotherapy practice
9
2.
7/27/2019 Paediatrics Guidelines07
http://slidepdf.com/reader/full/paediatrics-guidelines07 10/56
It gives disabled people rights in the area
of employment, access to goods, facilities
and services.
Human Rights Act (HRA 1998)(13)
The Human Rights Act includes the right to
liberty and security, the right to a fair trial,
the right to freedom of thought, conscience
and religion and the right to freedom ofexpression. It also prohibits discrimination. See
also CSP information paper relating to this(14).
The Children Act 2004 (15)
The Children Act (2004) provides the legislative
spine for the wider strategy for improving
children’s lives. This covers the universal
services which every child accesses, and
more targeted services for those withadditional needs.
The overall aim is to:
Encourage integrated planning,
commissioning and delivery of services
Improve multi-disciplinary working and
remove duplication
Increase accountability and improve the
coordination of individual and joint
inspections in local authorities.
The legislation is enabling rather than
prescriptive and provides local authorities with
a considerable amount of flexibility in the
way they implement its provisions. The Act
introduced the role of Children’s commissioner
to actively seek children’s views and championtheir causes.
N.B. Section 12 of the Act allows development
of further secondary legislation and statutory
guidance in setting up databases or indexes
that contain basic information about children
and young people to help professionals in
working together to provide early support to
children, young people and their families.
Data Protection Act 1998(16)
The Data Protection Act gives individuals rights
regarding the personal data organisations
hold about them and gives organisations
responsibilities regarding that data.
Ethics and consent in paediatrics
What are the consent issues for a paediatricphysiotherapist involved with children and
their families?
What does this mean for children andyoung people?
Physiotherapists must understand andadhere to the law and local policy in fullyexplaining and seeking understanding ofthe intervention, and ensure consent isobtained according to guidance.
The position on consent in relation to children
is complex and at times confusing. Therefore,
it is important to be familiar with the extensive
body of literature including statute and case
law, professional guidance, NHS guidance
and scholarly writing on the ethical and legalapproaches to children’s consent. In addition,
since 2001 NHS Trusts and primary care
organisations have developed local consent
policies. Consequently, physiotherapists should
be aware of their contractual obligation to
follow local policy and procedure.
There are both ethical and legal justifications
for obtaining consent. The philosophical basis
of informed consent rests on the principle
of respect for patient autonomy, which is
associated with the notion of involving the
patient in the decision making process(17).
However, the law deals with the issue of
consent in a manner distinct from the
application of ethical concepts. The legal focus
is upon the concept of valid consent which, by
definition, has four elements: voluntariness,
competence, disclosure, and comprehension.
Therefore, for consent to be valid it must be
Physiotherapy practice
2007 Information to guide practice for physiotherapists working with children
2.
7/27/2019 Paediatrics Guidelines07
http://slidepdf.com/reader/full/paediatrics-guidelines07 11/56
given voluntarily without undue influence,
coercion, or force. In addition, the child giving
the consent must have the necessary mental
capacity or competence to do so at the time
of treatment, which has particular relevance
to children.
The law† recognises broadly three stages of
childhood with respect to consent. First, thereare very young children who lack the capacity
to consent to assessment and treatment. In
such cases it is usual for the person(s) with
parental responsibility‡ to give consent.
Second, there are ‘Gillick competent’ children.
A child under 16 can consent to assessment
and treatment provided he or she is competent
to understand the nature, purpose and
possible consequences of the proposedintervention(18). Finally, there are children over
the age of 16 who can give a valid consent
to any surgical, medical or dental treatment
without consent from the person(s) with
parental responsibility(19).
Up to age 18, where a child lacks capacity,
the person(s) or local authority with parental
responsibility can give consent on behalf ofthe patient.
The other two elements of valid consent,
disclosure and comprehension relate to the
idea that sufficient information must be
provided to the child (and their parents, carers)
so that he/she comprehends in a basic sense
the proposed intervention. Communicating
information in an age and cognitively
appropriate manner is a key element to
this process; e.g. use alternative or
augmentative communication, use of pictures
or photographs and the overall quality of
the child’s health experience.
The following texts are recommended for their
comprehensive discussion and explorationof not only valid consent but various other
important issues relating to the care of
children in health care.
† Refers to England, Wales and Northern Ireland.
There are some exceptions in Scotland; see further
CSP (2005) Core Standards of Physiotherapy Practice
4th ed. London: CSP Standard 2
‡ Parents, guardians or any other persons or
authorities legally entitled to give consent on the
child’s behalf see further the Children Act 1989 and
the Adoption and Children Act 2002
Bibliography
Statutes:
Family Law Reform Act 1969. London:
HMSO; 1969.
Children Act 1989 Elizabeth II. Chapter 41.
London: HMSO; 1989.
Human Rights Act 1998: Elizabeth II. Chapter42. London: HMSO; 1998.
Adults with Incapacity (Scotland) Act 2000 asp
4. Edinburgh: TSO; 2000.
Adoption and Children Act 2002. London:
Stationery Office; 2002.
Mental Capacity Act 2005 Elizabeth II - Chapter
9. London: TSO; 2005.
Cases:
Chatterton v Gerson [1981] QB 432.
Sidaway v Bethlem Royal Hospital Governors
and others [1985]1 ALL ER 643
Gillick v West Norfolk and Wisbech Area
Health Authority and Department of Health
and Social Security [1986] AC 112
Re R (A minor) (Wardship: Medical Treatment)
[1991] 4 All ER 177
Re W (A minor) (Medical Treatment: Court’s
jurisdiction) [1992] 4 All ER 627
Re E (A minor) (Wardship: Medical Treatment)
[1993] 1 FLR 386
Professional Guidance on Consent
in Paediatrics:
British Medical Association. Consent, rights and
Physiotherapy practice
11
2.
7/27/2019 Paediatrics Guidelines07
http://slidepdf.com/reader/full/paediatrics-guidelines07 12/56
choices in health care for children and young
people. London: BMJ Books; 2001.
The Chartered Society of Physiotherapy.
Core standards of physiotherapy practice
4th ed. London: Chartered Society of
Physiotherapy; 2005.
URL: http://www.csp.org.uk/director/
libraryandpublications/publications.cfm
The Chartered Society of Physiotherapy.
Consent. Information paper PA60. London:
Chartered Society of Physiotherapy; 2005.
URL: http://www.csp.org.uk/director/
libraryandpublications/publications.cfm
The Chartered Society of Physiotherapy. Legal
work pack: 2005. London: Chartered Societyof Physiotherapy; 2005. URL: http://www.
csp.org.uk/director/libraryandpublications/
publications.cfm
The Chartered Society of Physiotherapy, North
West Paediatric Physiotherapy Managers
Group. Good practice guideline for obtaining
consent in paediatric physiotherapy . London:
Chartered Society of Physiotherapy; 2004.
The Chartered Society of Physiotherapy.
Human Rights Act 1998 . London: Chartered
Society of Physiotherapy; 2000.
Department of Health. Reference guide to
consent for examination or treatment. London:
Department of Health; 2001.
URL: http://www.dh.gov.uk/publications
Department of Health. Good practice in
consent: implementation guide: consent
to examination or treatment. London:
Department of Health; 2001.
URL: http://www.dh.gov.uk/publications
Department of Health. Seeking consent:working with children. London: Department of
Health; 2001.
URL: http://www.dh.gov.uk/publications
Department of Health. Complex disability
exemplar. National service framework for
children, young people and maternity services.
London: Department of Health; 2005. URL:
http://www.dh.gov.uk/en/Publicationsandstatist
ics/Publications/PublicationsPolicyAndGuidance/
DH_4123814
Department of Health. Consent: what youhave the right to expect – a guide for parents.
London: Department of Health; 2001. URL:
http://www.dh.gov.uk/en/Policyandguidance/
Healthandsocialcaretopics/Consent/Consentgen
eralinformation/index.htm
Department of Health. Consent: what you
have the right to expect – a guide for children
and young people. London: Department ofHealth; 2001. URL: http://www.dh.gov.uk/en/
Policyandguidance/Healthandsocialcaretopics/
Consent/Consentgeneralinformation/index.htm
Further reading:
Brook G. Children’s competency to consent:
a framework for practice. Paediatric Nursing.
2000;12(5):31-5.
Hedley M. Treating children: whose consent
counts? Current Paediatrics. 2002;12(6):458-62.
Vernon B, Welbury J. Consent for the
examination or treatment of teenagers.
Current Paediatrics. 2002;12(6):458-62.
Clayton M. Consent in children: legal and
ethical issues. Journal of Child Health Care.
2000;4(2):78-81.
Spencer GE. Children’s competency to consent:
an ethical dilemma. Journal of Child Health
Care. 2000;4(3):117-22.
Alderson P, Montgomery J. Health care choices:
making decisions with children. London:
Institute of Public Policy Research; 1996.
Alderson P. Young children’s rights: exploringbeliefs, principles and practice. London: Jessica
Kingsley; 2000.
Physiotherapy practice
2007 Information to guide practice for physiotherapists working with children
2.
7/27/2019 Paediatrics Guidelines07
http://slidepdf.com/reader/full/paediatrics-guidelines07 13/56
Dimond BC. Care of children. In: Dimond BC,
editor. Legal aspects of physiotherapy . Oxford:
Blackwell Scientific; 1999. p. 363-84.
General Medical Council. Seeking patient’s
consent: The ethical considerations. London:
General Medical Council; 1998. URL: http://
www.gmc-uk.org/guidance/current/library/
consent.asp
General Medical Council. Confidentially:
Protecting and providing information. London:
General Medical Council; 2004. URL: http://
www.gmc-uk.org/guidance/current/library/
confidentiality.asp
Sim J. Ethical decison-making in therapy
practice. Oxford: Butterworth-Heinemann; 1997.
Smith F, Lyon T. Personal guide to the ChildrenAct 1989 4th ed. Croydon: Children Act
Enterprises Ltd; 2006.
Montgomery J. Care of children. In:
Montgomery J, editor. Health care law. 2nd ed.
Oxford: Oxford University Press; 2003. p.
289-318.
Websites:
Department of Health: http://www.dh.gov.uk/
PolicyAndGuidance/HealthAndSocialCareTopics/
Consent/ConsentGeneralInformation/fs/en
UNICEF: http://www.unicef.org.uk/youthvoice/
rights.asp
Disability Rights Commission:
http://www.drc-gb.org/
What is the role of the paediatric
physiotherapist in safeguarding
children?
What does this mean for children andyoung people?
Paediatric physiotherapists have a dutyof care to work collaboratively with
other services to safeguard children.This may involve sharing informationand liaising with other agencies aboutconcerns in accordance with local policiesand procedures and national guidanceas recommended in the Victoria Climbié
Report(6).
The second joint Chief Inspector’s Report
on arrangements to Safe GuardingChildren(20) states:
All agencies working with children, young
people and their families take all
reasonable measures to ensure that
the risks of harm to children’s welfare
are minimised
Where there are concerns about children
and young people’s welfare, all agenciestake all appropriate actions to address
these concerns, working to agreed local
policies and procedures in full partnership
with other local agencies.
Copies of the report are available from the
website at www.safeguardingchildren.org.uk
Every Local Authority and NHS Trust has aChild Protection (Safe Guarding Children)
Policy which must be adhered if there is any
suspicion through direct contact or information
that a child may be at risk of being harmed. All
physiotherapists must adhere to their
local policy.
There is also non-statutory guidance by
HM Government which provides detailed
information, a child’s version and a flow-chart
to support practitioners through the process.
Physiotherapy practice
13
2.
7/27/2019 Paediatrics Guidelines07
http://slidepdf.com/reader/full/paediatrics-guidelines07 14/56
If a child informs a physiotherapist of a
situation, she or he should explain to the
child that in some cases the physiotherapist
is obliged to take certain actions that may
involve telling other people ‘and I may have to
do this even if you ask me not to’ .
A physiotherapist may wish to consider sharing
the information with the Welfare Servicesof their organisation and ask the Welfare
Services to take the necessary action. If a
decision is reached to take action, then the
professional who received the information
from the child needs to be satisfied that such
action has been taken (either by themselves
or by a third party such as Welfare Services),
and if the professional is not satisfied that
the third party has taken the agreed action,then the professional themselves then
needs to take action. This is, in essence, the
practical application of the first four steps
of the government guidance contained
in ‘What to do if you think a child being
abused’(21). In the summary, the Flow Chart
on page 12 and Appendix 1 on page 17
will be worth reviewing first. Appendix 3 is
very comprehensive offering guidance oninformation sharing and confidentiality issues
in these particular circumstances.
http://www.everychildmatters.gov.uk/resources-
and-practice/IG00182/
Checking staff against criminal registers
It is a criminal offence for people with certain
convictions to apply for and work with childrenand vulnerable adults. It is also an offence to
knowingly offer work to such an individual.
In defining “Working with Children” the
legislation makes no distinction between paid
or unpaid work. The Protection of Children
Act 1999(22), make some checks compulsory
and strongly recommends checks for
other positions.
Commonly known as ‘CRB checks’, this can be
done through the Criminal Records Bureau
(CRB) Disclosure service in England and Wales
and Disclosure Scotland for Scottish employers.
The Protection of Children Northern Ireland
(POC (NI)) and the Protection of Vulnerable
Adults Northern Ireland (POVA (NI)) provide
checks for Northern Ireland employers.
These are agencies set up to help organisations
make safer recruitment decisions. They
provide a service for organisations, checking
police records and, in relevant cases,
additional information held by Health and
the Education Departments.
Two types of CRB checks are available in cases
where an employer is entitled to ask exemptedquestions under the Exceptions Order to the
Rehabilitation of Offenders Act (ROA) 1974(23).
This includes any organisation whose staff or
volunteers work with children or vulnerable
adults. An organisation may apply for a check
to be undertaken. They are issued free to
volunteers. The two levels of check currently
available are called Standard and Enhanced
Disclosures.
Standard Disclosure
This is primarily available to anyone involved
in working with children or vulnerable adults,
as well as certain other occupations. Standard
Disclosures show current and spent convictions,
cautions, reprimands and warnings held on the
Police National Computer. If the post involves
working with children or vulnerable adults, the
following may also be searched:
Protection of Children Act (POCA) List
Protection of Vulnerable Adults (POVA) List
Physiotherapy practice
2007 Information to guide practice for physiotherapists working with children
2.
7/27/2019 Paediatrics Guidelines07
http://slidepdf.com/reader/full/paediatrics-guidelines07 15/56
Enhanced Disclosure
This is the highest level of check available
to anyone involved in regularly caring for,
training, supervising or being in sole charge
of children or vulnerable adults. Enhanced
Disclosures contain the same information as
the Standard Disclosure but with the addition
of any relevant and proportionate information
held by the local police forces.
If requested on the disclosure application
form, the check will also show if someone
applying for a childcare position is on either
of the two government-held lists of people
considered unfit for such work. In this case,
where a person who appears on the list is
applying for a childcare position, it is the
responsibility of the manager to ensure the
police are informed.
This check can be made only for those who
do work that involves regularly caring for,
training, supervising or being in sole charge of
children (under-18s) or vulnerable adults.
The CRB recognises that the Standard andEnhanced Disclosure information can be
extremely sensitive and personal. Therefore
it has published a Code of Practice to ensure
responsible provision of information. An
employer cannot demand disclosure for
existing employees. Retrospective checks may
only be carried out on existing members of
staff if the employee’s contract or conditions
of employment state that a police check canor may be carried out, or the employee has
given written consent. An employer recruiting
staff to work with children must include a
statement to that effect within the application
form, which the prospective employee must
sign, indicating their willingness to provide
a Disclosure. If the prospective employee
then refuses to provide one, the employer
should be within their rights not to proceed
with an application. Furthermore, when the
law requires a Disclosure and a prospective
employee refuses to apply for one, then the
employer would be within their rights not to
take the job application any further.
An individual applying for a Standard or
Enhanced Disclosure has to go through a
Registered Body or Registered Umbrella Body.
A copy of the Standard or Enhanced Disclosure
is sent out to the applicant as well as the
Registered Body.
Criminal Records Bureau Information Line:
0870 9090811
A joint publication from government bodies
has been published to assist in safeguarding
children(24).
Factors influencing physiotherapy
practice
What are the factors that support
physiotherapy practice?
What does this mean for children andyoung people?
Physiotherapists have a duty to continuelearning throughout their professional lifeand demonstrate they are utilising the bestintervention for the child or young person.
Paediatric Competences and Standards
The use of Competences by healthcare workers
has been identified as being important to
the commissioners of health services. APCPis developing a professional competence
framework to ensure providers meet the
standards required, not only under the
statutory frameworks as described below, but
also the standards set by the CSP and APCP.
This supports the delivery of consistent high
quality standards of care for children and
their families.
Competence is not just about knowledge, skills
and abilities or just about being able to
Physiotherapy practice
15
2.
7/27/2019 Paediatrics Guidelines07
http://slidepdf.com/reader/full/paediatrics-guidelines07 16/56
demonstrate technical skill. It is also about
thinking, critical analysis and learning, the
assimilation of new learning with previous
learning, integration of new knowledge, skills
and abilities with pervious knowledge and
application of new learning in practice.
Skills for Health (SfH) is the sector skills
council for the healthcare sector licensed
by the Department for Education and Skills
(DfES); (DfEs has now been superseded by The
Department for Children, Schools and Families)
to develop the health workforce across the UK
(NHS, independent and voluntary). It works
with employers to identify the skills needed to
deliver high quality competent healthcare. The
SfH competence framework, in turn, is linked
to the NHS Knowledge and Skills Framework(KSF). The SfH competences are already
mapped against this framework with each
competence being linked to a relevant KSF
dimension and level.
SfH has developed a suite of National
Occupational Standards (NOS) for Children’s
Services These aim to describe the competences
required by healthcare staff workingwith children. http://www.skillsforhealth.org.
uk/tools/view_framework.php?id=115.
APCP, supported by the CSP, are producing
guidance on workforce competence linking
to HPC and CSP standards, the KSF and
the National Occupational Standards. This
guidance will be specifically linked to SfH
Competences.
The working party looking at this aspect
of paediatric physiotherapy practice will be
producing the guidance which will supplement
this Guide to Good Practice in 2008.
Workforce development – Continuing
Professional Development (CPD)CPD is a systematic, ongoing structured process
of maintaining, developing and enhancing
skills, knowledge and competence both
professionally and personally in order to
improve performance at work.
The CSP expects its qualified, associate and
student members to maintain and develop
their skills, knowledge and competence
through CPD in order to provide safe and
effective practice (25, 26).
There is a strong link between evaluation,
learning and the enhancement of patient care
and quality of service.
Assistants and graduates learn good practice
in a variety of settings; e.g. hospitals, schools,
child development centres through CPD e.g.
formal learning, reflective practice, in-servicetraining and shadowing with a senior member
of staff(27, 28). All assistants and new graduates
should have a senior member of staff who is
responsible for their appraisal and who will
help identify specific areas of learning
required by that individual. There are
courses run specifically for assistants, for new
graduates and advanced practitioners working
in paediatrics(29).
Supervision and appraisal should also be
available to more senior staff to develop their
clinical reasoning skills and broaden practice(30).
See also relevant CSP information papers (31-35).
Evidence-based practiceThe evidence base for paediatric physiotherapy
is growing and practitioners can draw on a
range of resources to support decision-making
about which interventions may be most
appropriate for children and young people.
The most well used definition of evidence-
based practice is that it is the ‘conscientious,
explicit and judicious use of current best
evidence in making decisions about the careof individual patients.’ (36)
Physiotherapy practice
2007 Information to guide practice for physiotherapists working with children
2.
7/27/2019 Paediatrics Guidelines07
http://slidepdf.com/reader/full/paediatrics-guidelines07 17/56
A more recent definition is:Evidence-Based Practice (EBP) requires that
decisions about health care are based on the
best available, current, valid and relevant
evidence. These decisions should be made by
those receiving care, informed by the tacit and
explicit knowledge of those providing care,
within the context of available resources(37).
Paediatric physiotherapists have a duty to
have an up to date knowledge of their specific
area of practice to ensure that interventions
are appropriate and effective. They also
need clinical reasoning skills to fit the best
intervention for the child, family and social
situation. At times compromises may need to
be made but this needs careful documentation.
Sources of evidence for interventions
Research
Clinical guidelines, effectiveness bulletins
and other summaries of evidence
of effectiveness
Clinical interest and occupational groups
National guidance e.g. National Service
Frameworks, National Institute of Health
and Clinical Excellence guidelines
Local standards and protocols
Information derived from the use
of outcome measures
Audit
Expert opinion.
The use of physiotherapy time, the nature of
intervention and the longer term effects of
practice have become increasingly important
in the cost-benefit analysis within the NHS.
These and other external pressures have added
impetus to the use of outcome measurement
within routine physiotherapy clinical practice
and in physiotherapy research. The value
placed upon accurate, appropriate and timely
outcome measurement is demonstrated in theprofessional body standards and is expected to
be a key attribute of professional practice.
The CSP’s Core Standards(3) statephysiotherapists should select and use quality
outcome measures appropriate to the child.
The physiotherapist is advised to ensure that
the measure used can evaluate change in the
child’s health status and that they should apply
them in a timely manner. Audit guidance and
tools are provided in the CSP Core Standards(3).
Finding and using an appropriate
measurement tool is often a challenge to
physiotherapists, particularly when ensuring
the process remains child and family centred.
The whole process of assessment, goal setting,
management and evaluation must be focused
on ongoing collaboration with children and
their families, other professional groups
and service providers. Therefore, decisionsregarding use of measurement tools cannot
be taken in isolation but must form part of
this continuous process toward meeting the
requirements of these key participants(39, 40).
Moving and handling
What does this section mean for childrenand young people?
Physiotherapists are obliged to undertakefull risk assessments and to ensurethat everyone is trained in moving andhandling techniques necessary in the
care of a child or young person.
Moving and handling is an integral part
of paediatric physiotherapy practice and
paediatric physiotherapists must operate
within the legal framework of health and
safety law. These laws apply to the therapy
carried out by those working with children as
equally as the therapy that is carried out by
those working with adults.
In paediatric practice it is often more aboutthe posture that the therapist or carer has to
assume, or the equipment they have to work
Physiotherapy practice
17
2.
7/27/2019 Paediatrics Guidelines07
http://slidepdf.com/reader/full/paediatrics-guidelines07 18/56
with, when carrying out therapy than the‘load’ they are handling.
All proposed intervention should be assessed
for any potential risks to either the child or
therapist and if a risk is identified and cannot
be avoided during the therapy activity this
risk must be assessed – physiotherapists are
legally bound to formally carry out this risk
assessment and document findings. However,
this is just the beginning – a risk assessment in
itself is not helpful unless action is taken and
control measures implemented to reduce the
identified risk.
The risk assessment is part of a process which
identifies potentially hazardous moving
and handling that may be involved in theproposed therapeutic intervention. There are
four areas to include in a risk assessment:
1. Task
2. Individual (the handler)
3. Load (the child)
4. Environment.
The identified risk is given a grading of high,medium or low dependent on the likelihood
of injury occurring and the consequences
or outcomes for both the therapist and the
child. The risk is managed by the introduction
of control measures and these may include
for example: training, use of equipment or
adaptation of the proposed invention. The
outcome of the risk assessment may mean
that the therapist has to adjust the goals of
treatment to minimise the risks involved in the
therapeutic action.
Risk assessment is an ongoing (iterative) process
and should be reviewed at regular intervals or
when there is any significant change in the child,
therapist, task or environment.
Caring for dependent children may involve
constant repetitive manual handling. The child as
a ‘load’ may be mobile, flexible, precious, possibly
unwell or in pain, sometimes resisting and alwaysunpredictable. Sensory deficit has an impact on
the child’s ability to function. Movement, sensory
processing, perception, communication and the
environment in which handling and therapeutic
activities are taking place are all affected by the
sensory deficit a child may have; and these should
be taken into consideration in the risk assessment
process. Challenging behaviour can also affect
the child’s ability or willingness to move and thus
increase the risks when handling.
Delegation is commonplace within paediatric
physiotherapy practice and paediatric
physiotherapists have a duty of care to
themselves and people they work with be they
colleagues, the child or the carer.
They must assess the risk of injury and cumulative
stress associated with the moving and handling
of the children they are working with and take
all possible steps to reduce the risk. The paediatric
physiotherapist has ultimate responsibility for any
therapeutic activity they delegate to carers.
Documentation is of the utmost importance as
this provides a critical link between assessment,
clinical reasoning and the child’s functional
outcomes or goals.
The fundamental aim must always be to reduce
the risk of injury occurring to the handler as far
as is practicable whilst at the same time ensuring
the best possible outcome for the child.
Physiotherapy practice
2007 Information to guide practice for physiotherapists working with children
2.
7/27/2019 Paediatrics Guidelines07
http://slidepdf.com/reader/full/paediatrics-guidelines07 19/56
Legislation
Health and Safety at Work Act 1974 (41). This
act forms the basis of all health and safety
law. It sets out duties for employers and
employees and covers all aspects of health
and safety in the workplace.
Control of Substances Hazardous to Health
1999 updated 2002(42, 43). Employers must not expose employees to
substances hazardous to health and a
suitable and sufficient risk assessment must
be carried out.
Reporting of Injuries, Diseases and
Dangerous Occurrences Regulations
1995(44)
. Employers must notify the Healthand Safety Executive about accidents which
happen at work resulting in death, personal
injury or sickness where an employee is off
work for more than three days
Management of Health and Safety at Work
Regulations 1999(45). Where an employer
employs five or more employees the
regulations place an obligation on the
employer to actively carry out a risk
assessment of the work place and act
accordingly. The risk assessment is intended
to identify potential health and safety and
fire risks and provide the employees with
a ‘safe system of work’.
Manual Handling Operations Regulations1992 updated 2002(46, 47). The regulations
came into force in January 1993 and are
aimed at preventing injury from manual
handling activities in the workplace. It
sets out a hierarchy of measures to risk
assess potentially hazardous manual
handling procedures. The regulations
apply when loads are moved by hand
or bodily force.
Lifting Operations and Lifting Equipment
Regulations 1998(48). All lifting equipment
must be sufficiently strong, stable and
suitable for the proposed use. Lifting
equipment must be visibly marked with
appropriate information (i.e. weight limits,
size etc) Lifting equipment for lifting
people must be checked at least once every
six months and all lifting operations must
be carried out by competent personnel.
Useful resources
Association of Paediatric Chartered
Physiotherapists. Paediatric manual
handling – guidance for paediatric
physiotherapists. London: Association of
Paediatric Chartered Physiotherapists; 2001.
The Chartered Society of Physiotherapy.
Guidance on manual handling for chartered
physiotherapists London: Chartered Society
of Physiotherapy; 2002.
Dimond BC. Legal aspects of physiotherapy.
Oxford: Blackwell Scientific; 1999.
Mandelstam M. Manual handling in health
and social care: an A-Z of law and practice.London: Jessica Kingsley; 2002.
McAtamney L, Corlett N. Rapid upper limb
assessment (RULA). In: Stanton N, Hedge
A, Brookhuis K, Salas E, Hendrick HW,
editors. Handbook of human factors and
ergonomics methods London: Taylor and
Francis; 2004.
http://ergo.human.cornell.edu/ahRULA.
html Rapid Upper Limb Assessment Guide
http://ergo.human.cornell.edu/ahREBA.
html Rapid Entire body Assessment Guide
www.hse.gov.uk Publications
Physiotherapy practice
19
2.
2007 Information to guide practice for physiotherapists working with children
7/27/2019 Paediatrics Guidelines07
http://slidepdf.com/reader/full/paediatrics-guidelines07 20/56
Transition issues from paediatric toadult services
‘Transition should never be considered a
sprint, a baton pass or simply the event of
transfer between paediatrics and adult care.
Transition is in reality a marathon, starting
on the day of diagnosis. Transition is an age
and developmentally appropriate process,
addressing the psychosocial and educational/ vocational aspects of care in addition to the
traditional medical areas. Transition starts
within paediatrics but continues on into adult
services and is therefore, by definition, a
paediatric and adult concern.’ (49)
Any physiotherapist who encounters young
people in their working practice needs to
ensure they address the important issues raisedduring adolescence. One of the most important
issues raised during this stage of development
is that of transition. Transition can be defined
as ‘the purposeful, planned movement of
adolescents and young adults with chronic
physical and medical conditions from child-
centered to adult oriented health care
systems.’ (50). Transition has been recognised as
an important standard of care in several major
policy documents(51-53). Careful planning and
delivery of treatment is essential to facilitate
a young person’s independence and successful
transition to the adult world. This is best
addressed as part of a multi-disciplinary team,
where the physical, physiological, psychological,
social, educational and vocational needs of a
young person can be met(54). Careful planningand delivery of treatment is essential to
facilitate independence and transition to the
adult world. The key to successful treatment
is empowerment of the young person
thus instilling a sense of responsibility and
ownership of their illness, as well as providing
opportunities for the development of a young
person’s confidence and capacity in dealingwith everyday life. One way this can be
achieved is through co-ordinated transitional
care planning.
Physiotherapists need to recognise therole they can play in assisting with the
development of age and developmentally
appropriate transitional care plans for young
people. The patient/ therapist relationship
allows for ongoing continuity and support
which young people identify as an important
aspect of care(54). Physiotherapists can facilitate
a young person in identifying needs and
potential barriers to ‘growing up and moving
on’ (51) and assist with the development ,
planning and co-ordination of transitional care
packages.
A qualitative study identified transitional care
packages as needing to be:
1) Multidimensional – addressing all
areas of a young person’s life2) Coordinated (multi-disciplinary)
and individualised
3) Supportive – seeing the samehealthcare professional ateach appointment
4) Developmentally appropriate
5) Age appropriate – facilities/information.
Early preparation of young people (especially
those young people with disability and/or
complex or long term conditions) and their
families for transition to adult services is
advantageous, ideally in early adolescence (54,
55). A coordinated, planned and individualised
approach to transition will assist with
identifying those skills that are needed for
independent adult living, as well as aiming to
assist with maximising health outcomes (51, 54).
A key area of transition for physiotherapists
to take a lead in is addressing the exercise
related risk factors of common morbidities
of childhood onset disease; e.g. osteoporosis,
cardiovascular disease and obesity. The latter
are important since adolescence is the time
when adult health promoting andself-management behaviours become
established. Transition planning should also
Physiotherapy practice
2007 Information to guide practice for physiotherapists working with children
2.
7/27/2019 Paediatrics Guidelines07
http://slidepdf.com/reader/full/paediatrics-guidelines07 21/56
provide support for parents/carers throughthe process.
In a Delphi study of transition involving young
people, their parents and rheumatology
professionals, staff knowledgeable in
transitional care were considered best
practice but only currently feasible in a few
UK hospitals(56), and there is a current lack of
formal training opportunities in adolescent
health in the UK(57). This deficit is currently
being addressed by a Department Health
funded intercollegiate e-learning project
in conjunction with the Royal College of
Paediatrics and Child Health(58). Furthermore
a new national multidisciplinary Association
for Young People’s Health is to be launched in
early 2008 which also aims to promote multi-disciplinary training and education in young
people’s health including transition.
Useful webites:
UK
Transition Information Network.
Website: http://www.transitioninfonetwork.
org.uk
DreamTeam website of the Adolescent
Rheumatology Team at Birmingham
Children’s Hospital.
Website: http://www.dreamteam-uk.org
Transition Pathway
Website: http://www.transitionpathway.co.uk/
No Limits.Website: http://www.nolimits.org.uk
Moving on up.
Website: http://www.movingonup.info/
ACT – the Association for Children’s Palliative
Care. (Publishes ‘Transition Care Pathway: A
Framework for the Development of Integrated
Multi-Agency Care Pathways for YoungPeople with Life-threatening and Life-limiting
Conditions’ (2007). Available from ACT online
shop). Website: http://www.act.org.uk/
Youth Health TalkWebsite: http://www.youthhealthtalk.org/
Australia
Royal Children’s Hospital, Melbourne –
Transition to adult services.
Website: http://www.rch.org.au/transition
Canada
Disability Ontario Online Resource for
Transition to Adulthood – D.O.O.R. 2
Adulthood
Website: http://www.door2adulthood.com
SickKids – Good 2 Go Transition Program.
Website: http://www.sickkids.ca/good2go
USA
Health Care Transitions.
Website: http://hctransitions.ichp.edu/
Adolescent Health Transition Project.
Website: http://depts.washington.edu/healthtr/
index.html
Kentucky Cabinet for Health and Family
Services – Transition Resources.Website: http://chfs.ky.gov/ccshcn/
ccshcntransition.htm
Health and wellbeing
Public Health
The health and wellbeing of the people living
in the UK is becoming increasing high in the
profiles for governments. Public Health addresses
the health needs of the population from the
cradle to grave and encompasses education,
prevention of illness, empowering the individual
to make healthy choices and redesigning services
to support this philospohy. The CSP documents
provide the policy background and advice to
support physiotherapists in promoting health
and wellbeing(59-62)
.
For children there is a huge opportunity
for physiotherapists to undertake work to
Physiotherapy practice
21
2.
2007 Information to guide practice for physiotherapists working with children
7/27/2019 Paediatrics Guidelines07
http://slidepdf.com/reader/full/paediatrics-guidelines07 22/56
invest in the ongoing health and wellbeingof the younger population. Major areas
where physiotherapy can become engaged
is in a proactive approach in preventative
and self management of health conditions
and encouraging the family focus to take
full responsibility for the health of all
members of their family. Forecasts of the
health of our future generations is grim.
Strategies are needed to develop and to
address obesity, mental health problems,
smoking and substance misuse in children and
younger people, to address relationships and
prevention of teenage pregnancies and to
promote active life styles amongst the youth.
The CSP has provided information papers on
public health relating to each of the four UKcountries(59-62). This document also references
the policy documents and guidance produced
by the individual countries in relation to public
health. Individual physiotherapists need to
identify local population needs and look at
how to address them, how to link activity
with local government targets, and how to
influence commissioners in demonstrating that
physiotherapy has a prime role to play in thepublic health of the local community.
When addressing public health issues it is
essential to consider not only health but
also social care in the community including
public transport, access to leisure facilities and
schools in assessing how best to input and
influence the wellbeing and the health of
the population.
Locations and settings
Children and their families accessing
paediatric physiotherapy
What does this section mean for childrenand young people?
Paediatric physiotherapists work in a
variety of locations and settings. Theseinclude hospitals, clinics, child developmentcentres, Children Centres, Extended Schoolprovision, Childcare provision and EarlyYears settings, children’s own homes,hospices, social care respite provision,mainstream schools and special schools
Where possible, children should have access
to their physiotherapy in the setting mostappropriate for their assessment, treatment
and on going support and enables them to
achieve their outcomes. Working in a variety of
settings should help improve communication
and collaborative working with others who
are supporting the child. Children may also
respond in different ways in different places and
paediatric physiotherapists should be mindful of
this when they are discussing and deciding on thebest location with the child and family.
The paediatric physiotherapist should ensure
that the locations they work in or the settings
they visit are fit for purpose, providing a
safe environment for children to have their
assessments, interventions and on going support,
and meet the child’s needs and developmental
potential.
In order to support children in various settings,
the paediatric physiotherapist should have the
skills to tailor their intervention, communicate
well with staff and family and share skills and
knowledge so that all involved are holistically and
collaboratively working with each other to help
meet the child’s needs.
Physiotherapy practice
g p p y p g
2.
7/27/2019 Paediatrics Guidelines07
http://slidepdf.com/reader/full/paediatrics-guidelines07 23/56
The paediatric physiotherapist should also takeaccount of their personal safety and adhere to
their local lone working policies when planning
assessments or treatment sessions.
Early Years settings, schools and colleges
Physiotherapists working in Early Years settings,
schools and other educational establishments
should work in partnership with the other early
years practitioners, school and college staff so
that the children and young people benefit from
co-ordinated, integrated support to facilitate
them achieving the best possible outcomes (63).
Paediatric Physiotherapists should adhere to the
SEN Code of Practice and demonstrate good
practice in treatment of children(64, 65).
It may benefit children to have the
involvement of paediatric physiotherapy
to support them achieve their outcomes
within their educational settings. Paediatric
physiotherapy services may tailor the way
they deliver to meet children’s needs.
Children in hospital
Work was undertaken ahead of the fullChildren’s NSF in response to the Kennedy
Report. It addressed the environment of
the child in hospital and the fact that
child-friendly, safe and effective treatment
helps reduce the time spent in hospital and
disruption to the family’s life.
The NSF (52) is divided into three parts and
considers children’s rights and vulnerabilities
in addition to care provision for children and
involvement of parents.
Part one: Child-centred Hospital Services
Secondary care teams should work closely
with community based services for prevention
and treatment, integrating care around
each child’s specific needs and delivering aplanned and co-ordinated care pathway. This
section also encourages asking about a child’s
safety, looking for signs of neglect or abuse,
and taking a multi-agency approach to childprotection if necessary.
Staff should treat children as children and
not mini-adults, pitching services for children
and young people at an appropriate level and
ensuring that play, recreation and education
are built into service provision.
Sharing information with parents, children
and young people in an appropriate manner
is essential, including outcomes and bad news,
and addressing and obtaining consent.
Health care workers should work in
partnership with children, young people and
their parents in both the treatments and
in shaping services, taking into account the
wider lifestyle of each child in treatment,convalescence and prevention of future
deterioration. This encompasses ethnicity,
education and development of the child
towards adulthood and the provision of
transition between services.
Part two: Quality and safety of care provided
Clinical governance provides annual evidence
of child-focused multi-agency service planningand delivery and ensures safe, evidence-based
and audited services by trained workforce for
all children within hospital settings.
Part three: Quality of setting and environment
The treatment of babies, children and young
people should be child-friendly in healthy and
safe settings.
Health promotion should be highlighted in
addition to care provision.
Tertiary Care
Tertiary hospitals predominantly deal with
children with conditions that are rare,
intractable, complex, unusually severe, or
complicated by other disorders, who aretherefore thought to do better if they are
referred to tertiary services for diagnosis
or treatment.
Physiotherapy practice
23
2.
2007 Information to guide practice for physiotherapists working with children
7/27/2019 Paediatrics Guidelines07
http://slidepdf.com/reader/full/paediatrics-guidelines07 24/56
National Institute for Health and ClinicalEffectiveness (NICE) guidelines set the age
limit for access to tertiary paediatric services at
nearer 21/22 years.
Hospices for children
There are over 20,000 children living with life
limiting diseases. Association of Children’s
Hospices (ACH): ‘works together with other
organisations to support the development
of best practice and provision of children’s
hospice services across the UK’. The hospices
provide physical and emotional support in a
home from home atmosphere. The hospices
provide specialist staff and equipment to
support specialised play and laughter as well
as medical care. The role of the hospice
includes care for the child and for the family,including bereavement counselling.
Information on UK based children’s
hospices can be obtained from:
www.childhospice.org.uk
Supporting practice
Interactive CSP – iCSP
The interactiveCSP (iCSP) networks provide
opportunities for physiotherapists to
communicate and share knowledge with
one another. There is a paediatrics network
which covers all aspects of practice and service
delivery and a network dedicated to healthcare
policy on which many of the policies andActs are featured to assist physiotherapists to
understand their impact on practice.
iCSP – is a free, easy-to-use website accessed
via www.interactivecsp.org.uk, enabling
CSP members and APCP members to share
knowledge based on each user’s specific
clinical, professional and workplace interests.
It provides quick access to resources, includingdocuments, news, events and useful websites,
and also to peers through email
and online discussions.
APCP moderates the paediatric network onthis website and manages the content of the
network, under the leadership of APCP public
relations officer.
Physiotherapy practice2.
7/27/2019 Paediatrics Guidelines07
http://slidepdf.com/reader/full/paediatrics-guidelines07 25/56
What are the key factors that supportthe delivery of paediatric physiotherapy
services?
Delivery of high quality services is high on
the government agendas and much of the
policy work focuses on how to improve
and maintain services designed around the
needs of the users. Many of the key factors
that influence the delivery of high qualityservices for children and their families can be
divided into four categories; Clinical Services,
Governance, Quality, including appropriate
use of workforce skills, and the Knowledge
and Skills required to deliver the services. The
four sections have been divided into core,
desirable and extended factors and linked to
the relevant drivers.
Clinical Services:
Core
Skilled assessment by appropriately trained
staff in a location suitable for individual
children’s and family’s needs. This would be
available for children, having a wide variety
of diagnoses(66)
Mutually agreed goals that are reflectiveof the child’s needs (National Workforce
Competency Framework Section 2
(Assessment of Health and Wellbeing)(67)
Formation of a package of care/care
pathway that meets the child’s assessed
clinical need. This will include a 24 hr
postural management programme
when appropriate
Regular communication between therapists
and families, including the copying
to parents of all letters to other
professionals(68, 69)
Liaison with the training of other agencies
involved with the child and their family,
e.g. MDT(70)
Regular use of outcome measures to assess
the effectiveness and cost efficiency ofservice delivery(71)
Clear and transparent discharge from
services at the appropriate time(72).
Desirable
Hydrotherapy availability, ideally in a child
friendly environment
Provision of an orthotics service
Access to rebound therapy
Gait analysis by a trained practitioner
24/7 services delivery (in hospital settings) Involvement in the development of care
pathways for a variety of conditions
Prescribing, including the use of
Botulinum Toxin
Direct access to assistive technology
Access to therapeutic horse riding.
Extended Health promotion activities
Developmental massage
Complementary therapies
Palliative care.
Governance:
In this section all entries are considered core,
as issues of clinical governance arenot optional.
All staff are professionally registered,
where appropriate, and will work to the
standards of their professional body(3)
All staff make user involvement
central to service delivery(73)
All staff are part of an ongoing process
of Professional Review and Development
(PRD) involving the production of
professional portfolios and participation
in ongoing training, both internal and
external
All NHS staff are subject to a KSF,
which will support their professional
development (74)
All staff are CRB checked to an
enhanced level(22)
All staff are expected to use measurable
outcome tools to assess the effectiveness
Providing high quality services for children and their families
25
3.
2007 Information to guide practice for physiotherapists working with children
7/27/2019 Paediatrics Guidelines07
http://slidepdf.com/reader/full/paediatrics-guidelines07 26/56
effectiveness of their practice. These willinclude those recommended by APCP(71)
All staff participate in the appropriate
mandatory training, e.g. Safeguarding
children
All staff partake in some form of supervision,
either formal clinical supervision or some
form of mentorship or peer review.
A regular log of attendance will be keptaccording to local trust policy
All staff are involved in audit of
their practice
All staff are aware of and take part in
risk assessment, in moving and handling
and in other areas of their practice,
according to local trust policy(75)
All staff are aware that it is their
responsibility to deliver services in a costeffective way, which falls within budget.
Quality:
Core
All services are delivered in a timely
fashion. Waiting times will be regularly
audited(76)
All interventions are delivered in a childcentred way at a location appropriate to
that child’s needs(73)
All interventions are based on the best
available evidence(53)
All staff work to APCP, CSP and HPC
standards as well as to local service
standards
The service is constantly reviewedto ensure it continues to utilise the most
appropriate workforce, both in terms of
grade and skill required, in order to deliver
a cost-effective, sustainable service(67)
The service provides regular training to
both families and other agencies to ensure
the delivery of best practice(68)
The service contributes to the
production of educational statements andother statutory documentation(64, 77)
Individual members of the service are
responsible, as autonomous practitioners,in ensuring the quality of the service
they deliver
The service is proactively risk managed
to ensure that it is always fit for purpose
The service liaises with other providers,
both other agencies and the voluntary
sector, to ensure that the needs of the child
remain central to all The service uses the facilities available
to it e.g. IT, accommodation, in the most
cost effective and efficient way, to ensure
the sustainability of service delivery.
Desirable:
Members of staff support the team around
the child approach (TAC) by acting as
Key workers.
The service supports the co-location
of appropriate staff (68)
There is a specialist post, with
research and development at the core
of its purpose
A specialist transition service is in place
The development of income generating
activities is considered, in order tofurther boost activity
The development of a Patient and Public
Involvement Forum (PPI) within the service
supports user involvement(72).
Extended
A consultant physiotherapist post which
spans trusts, promotes and supports
research and development within
the specialty.
Knowledge and Skills:
Core
All paediatric physiotherapists are
registered with the HPC (basic legal
requirement)
All staff participate in an induction processappropriate to their workplace(78)
All staff are experienced in working with
Providing high quality services for children and their families3.
7/27/2019 Paediatrics Guidelines07
http://slidepdf.com/reader/full/paediatrics-guidelines07 27/56
children and have achieved the commoncore of children’s competencies
All staff have achieved the competencies
necessary for their professional body
Individual staff members’ KSF outlines in
the NHS reflects those knowledge and skills
that they need to be part of the children’s
workforce(38)
All staff members participate inpostgraduate training appropriate to
the demands of their job.
Desirable
Further specialisation within the service
to meet specific need, supported by
postgraduate training
Links to academic institutions, particularly
those involved in paediatric physiotherapy
research.
Extended
Specialists in the following areas:
Gait analysis; diagnostics; injection therapy;
neonatology; mental health.
Working in partnership with children,families and other service providers
Working in partnership is one of
the fundamental skills of paediatric
physiotherapists and is a crucial element
of their involvement with children and
their families. For some children and young
people there is an even greater need to work
in partnership with children, young people andtheir families and other service providers.
‘Children and young people who are disabled
or have complex health needs receive co-
ordinated, high quality child and family-
centred services which are based on assessed
needs, which promote social inclusion and,
where possible, enable them and their families
to live ordinary lives.’ (79)
Another example: states:‘Delivering services to disabled children is a
corporate responsibility and improvements
in outcomes for children and their families
can only be achieved by close collaboration
between parents, professionals and agencies
working with children and their families’ .(68)
To support the delivery of these standards,
paediatric physiotherapists should have the
skills and qualities to work in partnership with
children, young people parents and carers,
other professionals and service providers.
The concepts and ethos of multi-disciplinary
working has expanded over the last few years
and working in partnership with children,
families and other service providers is one ofthe key features for the children’s agenda
across the whole of the UK.
Effective inter-agency working is underpinned
by two aspects of the Every Child Matters
integrated working focus and includes
the workforce reform and multi agency
working. The workforce reform includes the
introduction of the Common Core Skills and
Knowledge for the Children’s workforce to
ensure all professionals have the knowledge
and skills to work effectively with children and
families and access to training when relevant.
Multi agency working brings professionals
from different agencies together to meet
the needs of children and families and jointly
agree the delivery of the actions arising from acommon or specialist assessment.
In England, the Common Assessment
Framework and the role of the Lead
Professional are mechanisms to support the
process of multi agency working(80, 81).
‘The Common Assessment Framework for
the children and young people (CAF) is a shared assessment tool used across agencies
in England. It can help practitioners develop
Providing high quality services for children and their families
27
3.
2007 Information to guide practice for physiotherapists working with children
7/27/2019 Paediatrics Guidelines07
http://slidepdf.com/reader/full/paediatrics-guidelines07 28/56
a shared understanding of a child’s needs, sothey can be met more effectively. It will avoid
children and families having to tell and re-
tell their story. The CAF is an important tool
for early intervention. It has been designed
specifically to help practitioners assess needs at
an earlier stage and then work with families,
alongside other practitioners, to meet them’ .(80, 82)
Paediatric physiotherapists in England will
need to have a working knowledge of the
Common Assessment Framework and its
purpose and function. They will need to
know how to complete a CAF pre-assessment
checklist(83) and a CAF and the arrangements
and practice for processing CAF within their
local areas. They will also need to have
an understanding of how their specialistassessments can be supported by the CAF.
Sharing information is an integral part of
agencies working together to support children
and their families. With children, adherence
to the CSP’s Rule 3(84) is essential and the DH
has published guidance to support workers in
understanding their responsibilities(82).
For some children and especially those who
may require long term intervention, a
coordinated approach through interagency
working may be established practice. The team
around the child concept, key worker or lead
professional involvement and child focused,
family centred planning facilitate integrated
working practice as well as enabling children
and young people and their parents to bekey decision makers and central to all
planning (85-88).
Report writing to support assessment
and planning based around the needs
of children and their families
Paediatric physiotherapists are required to
prepare reports for children for a number ofreasons. These include:
Following initial assessment of a child
to inform the referrer Following re-assessment at regular
intervals during the child’s involvement
with physiotherapy
To refer to another professional or service
To support a referral to a tertiary centre
To support a child into an educational
setting
Following a request for an assessmentfor Statement of Special Educational
Need (SEN)
To support an SEN Tribunal dispute
To support a legal case.
All physiotherapy reports should comply with
the CSP Core Standards, the APCP Guide to
Good Practice and the APCP Guidance onSEN (3, 4, 65).
It may be necessary for some reports to be
accompanied by additional information as
listed below. This is especially the situation
if the report has been requested as part of
a legal case or if the child and family are
involved in an SEN Tribunal case.
The following gives some advice as to what
is recommended to be included both in the
report and with the report.
The reason why the physiotherapist is
writing the report including who made
the request
How long the physiotherapist has known
the child and family
Whether the report has been undertaken
in collaboration with the child and family
The liaison and communication between
different physiotherapists and reasons for
not communicating if this is the situation
The physiotherapist’s involvement with the
child and family, including interventions
and within different settings
How much they know about the otherservices involved with the child and family
A developmental history of the child (from
Providing high quality services for children and their families3.
7/27/2019 Paediatrics Guidelines07
http://slidepdf.com/reader/full/paediatrics-guidelines07 29/56
their own observations if known previouslyor from the parents)
The concerns of the child and family
What is reported by families and what
is actually observed or demonstrated
during assessment
Detailed clinical observations
Results from standardised validated
paediatric assessment tools where thisis clinically appropriate
Summary of child’s strengths and difficulties
Physiotherapy intervention necessary
Consideration should be taken when
writing reports to ensure the language is
understandable and accessible to all those
who may wish to read it
All reports prepared for education purposes
should be written with the aim of providing
information to staff in order to support the
child’s inclusion and promote their physical
wellbeing and function within the
educational setting(65)
Consent
Parental copies.
Legal and tribunal report writing
All reports written for solicitors and SEN
tribunals should be accompanied by a
curriculum vitae. The CV should include:
Why the physiotherapist feels they are
competent to write the report, to include
their HPC registration, CSP membership and
specialist group membership
The physiotherapist’s paediatric experienceand whether this has been within acute,
specialist, tertiary or community settings
Their communication with other
professionals involved
If for a tribunal, whether they have worked
with children in mainstream and special
schools settings
Confirmation of whether they haveattended the CSP Expert Witness course
A summary of their CPD Portfolio
A summary of their portfolio ofinvolvement with legal cases or
SEN Tribunals.
Assistive Technology
Assistive technology (AT) is an umbrella
term for a wide range of products. A
commonly accepted definition is “..any
item, piece of equipment or product systemwhether acquired commercially off the
shelf, modified or customized that is used
to increase, maintain or improve functional
capabilities of individuals with disabilities.” (89).
Therefore in terms of devices or equipment
it includes walking sticks to environmental
control systems, or simple dressing aids to
communication aids.
The benefits and purpose of AT are in many
respects self evident(90). When appropriate
equipment is provided in a timely manner
it allows children to move around their
environment, communicate with others and
take part in developmentally appropriate
activities that they would be unable to do
without this technology. It also enables the
family and carers to look after a child in
activities which the child cannot undertake
independently such as personal care, e.g.
hoisting, bathing and toileting.
Physiotherapists are routinely involved in the
assessment and prescription of some AT devices
such as standing supports or orthoses. However
it is important to have an understanding of awider range of AT so that one can understand
the role that AT plays in family life and when it
might be a solution to a problem.
Community equipment services play an
important part in helping people to develop
their full potential and to maintain their
health and independence. A wide range
of equipment and adaptations can now beprovided from 138 services in England with the
majority of items being provided within seven
Providing high quality services for children and their families
29
3.
2007 Information to guide practice for physiotherapists working with children
7/27/2019 Paediatrics Guidelines07
http://slidepdf.com/reader/full/paediatrics-guidelines07 30/56
days of a professional decision being made.Additional resources may be found through
the Foundation for assistive technology
– www.fastuk.org
ICES (Integrating Community Equipment
Services) is a Department of Health funded
initiative across health and social care to
develop community equipment services in
England, remove unnecessary barriers for users
and modernise services(91).
The mission of the ICES Team is ‘To support and
encourage the development and integration
of people centred equipment services for
the enhancement of health, wellbeing and
independence’ . Further information can be
accessed via http://www.icesdoh.org/
Providing high quality services for children and their families3.
7/27/2019 Paediatrics Guidelines07
http://slidepdf.com/reader/full/paediatrics-guidelines07 31/56
All member countries of the UK have beendeveloping frameworks of care for children
to ensure that they have good quality services
available to them. The section on England
addresses many of the common issues across
the UK. The following sections relate country-
specific work to local policy drivers.
Each country’s framework is summarised in
this section and link to the standards set by
the United Nations Convention on the Rightsof the Child 1989(9). Each country’s section
outlines their Children’s strategy, the national
Child legislation, key policy papers, and
implementation tools. The sections also refer
to relevant CSP information papers.
What does this mean for children andyoung people?
Physiotherapists must be aware of thepolicy drivers and guidance in orderto deliver the high quality servicesfor children and young people set bythe Government.
England
Change for Children is the programme oflocal and national action through which the
whole system of children’s services is being
implemented(92). The changes are described
in Every Child Matters and include revision
of The Children Act, the standards of service
design and the way that services are delivered.
Considerable emphasis is placed on cross-
professional working, involving and centring
services on the child and their family and
raising the quality of services for all children
and young people from birth to age 19(53, 92).
A range of guidance documents has been
produced, including statutory guidance under
the Children Act 2004(15).
The children’s strategy in England is called
Every Child Matters and sits under theDepartment for Children, Schools and Families,
where the most recent developments are sited
and should be viewed in addition tothe Department for Health’s website.
Every Child Matters (September 2003)(53)
Every Child Matters sets out theGovernment’s aim to ensure that everychild has the chance to fulfil their potentialby reducing levels of educational failure,
ill health, substance misuse, teenagepregnancy, abuse and neglect, crime andanti social behavior among children andyoung adults.
Every Child Matters focuses action on four
main areas:
Supporting parents and carers
Early Intervention and effective protection Accountability and integration, locally,
regionally and nationally
Workforce reform.
The key messages from Every Child Matters are
the cornerstone of the Government strategy
and the NSF supports that vision; that every
child should be supported to:
Be healthy
Stay safe
Enjoy and achieve
Make a positive contribution
Achieve economic wellbeing.
The Common Assessment Framework (CAF)
looks at the best way of sharing an initial
assessment amongst professionals that
may be requested by anyone identifying a
child with unmet needs. The common front
sheet of the assessment will be held by a
named service, for access as needed and
updated appropriately by other professionals
engaged in the welfare of that child. Sharing
information and the development of trust
between organisations is crucial in providingquality and seamless services and to prevent
duplication(80, 93).
UK country-specific child-related policy
31
4.
2007 Information to guide practice for physiotherapists working with children
7/27/2019 Paediatrics Guidelines07
http://slidepdf.com/reader/full/paediatrics-guidelines07 32/56
The Framework for the Assessment of Childrenin Need and Their Families addresses the wider
needs of the child and their family(94).
Choosing Health focuses on nine key areas
where people can make healthier life choices.
The policy targets children, especially where
they are unable to make a choice (too young
or passive e.g. passive smoking)(95).
Public Health in England supports
physiotherapy involvement with children in
addressing the issues laid out in the policy(59).
Children’s Trusts – set up in response to Lord
Laming’s report, the government expects
children’s trusts to be introduced to all
areas by 2008 and led by local authorities
and supported by health and voluntary and
community sectors(6).
The trusts work on pooled budgets, joint needs
assessments and use of the CAF, joint training
in common issues and working in teams to
one manager. 35 pathfinder Children’s Trusts
were announced in 2003 to test out the
theory of the Trusts and to help design policy.The Trusts all set up independently of one
another in response to local circumstances
and are therefore running in widely different
manners, but all to the Every Child Matters’
key outcomes.
National Service Framework for
children, young people and maternity
services (2004)(52)
The National Service Framework for Children,
Young People and Maternity Services (NSF
Children) was published in England in October
2004 as part of The Change for Children
programme. It covers health service provision
for children from gestation to adulthood,
extending to 25 years for those living with a
Learning Disability. The CSP has published an
information paper to support implementation
by physiotherapists(96).
The Framework puts into the contextof children the commitments of the
Government reflected in the NHS Plan and
the NHS Improvement Plan, to put the
patient at the centre of service provision, to
encourage partnership working and improve
communication in order to focus the services
around the child and its family. It also
emphasises the driving force behind
the NSFs; to raise standards of care andreduce inequalities of provision across the
country(97, 98).
Implementation of this NSF will challenge
the profession but offers a wide platform of
opportunity to place physiotherapists as key
players in the development and provision of
children’s services.
The Children’s NSF is aimed at everyone who
comes into contact with, or delivers services to
children, young people or pregnant women.
The NSF is divided into three parts:
Standards 1 – 5, described as the Core
Standards, the first five standards address
service provision for all children, young peopleand their families and carers to achieve high
quality service provision for all children and
young people;
Standards 6 – 10, for children covered by the
first five standards, but who have particular
needs; Children and young people who are
ill; Children in hospital; Disabled Children and
Young People and those with Complex Health
Needs; Medicines for Children and YoungPeople;
Standard 11, for mothers and babies, from
pre-pregnancy to three months post-birth,
again in conjunction with the previous
standards as applicable.
There are also seven exemplars, demonstrating
practice using the NSF:
Complex disability
Maternity services
UK country-specific child-related policy4.
7/27/2019 Paediatrics Guidelines07
http://slidepdf.com/reader/full/paediatrics-guidelines07 33/56
Asthma
Autistic spectrum disorders
Chronic Fatigue Syndrome / Myalgic
Encephalopathy (CFS / ME)
Acquired brain injury
Discharge and support of children requiring
long term ventilation in the community.
Supporting documents include:The Information Strategy: which addresses
the key information technology challenges
that need to be met in providing services for
children and their families; challenges that
face national agencies and local organizations
across all care settings(99).
Supporting Local Delivery: produced jointly
(DH & DfES): sets out the national support thatwill be provided to local agencies to support
them in implementing the National Service
Framework for children, young people and
maternity services. It also identifies how the
NSF, and the wider health agenda, fits into
the Every Child Matters - Change for Children
programme, and what this means for health
organisations(100).
The website is regularly updated and the
source of current information: www.dh.gov.uk/
PolicyAndGuidance/HealthAndSocialCareTopics/
ChildrenServices/ChildrenServicesInformation/
fs/en
Removing Barriers to Achievement sets out
the government’s vision for giving childrenwith special educational needs (SEN) and
disabilities the opportunity to succeed; it also
sets out a programme of sustained action and
review over a number of years to support early
years settings, schools and local authorities in
improving provision for children with SEN(63).
It gives government commitment to
partnership working between local authorities,
early years settings, schools, the health service
and the voluntary sector.
It incorporates government strategy forimproving childcare for children with SEN and
disabilities.
Its main focus is on working together to unlock
the potential of the many children who may
have difficulty learning, but for whose life
chances depend on a good education.
There are four key areas:
1. Early Intervention
2. Removing barriers to learning
3. Raising expectations and achievement
4. Delivering improvements in partnership.
Early Support: Helping every child succeed
Early Support, accessed via: www.
earlysupport.org.uk is the central government
recommended mechanism for achieving
better co-ordinated, family-focused services
for young disabled children and their families
across England(101). It stems from government
priorities for restructuring children’s service
in response to Every Child Matters and the
National Service Framework for children. It
builds on existing good practice to integrateservices in partnership with families who use
services and is designed to ensure that the
services provided are well co-ordinated and
responsive.
Early Support puts the needs of families with
young disabled children first. It is designed to
ensure that professionals deliver services which
are well co-ordinated, family centred, timelyand responsive.
The principles and approach of Early Support
are reflected in a set of materials and resources
including:
information booklets for families on
conditions or disabilities
a family pack containing a family held
file, the family service plan and
standardised information about services
which may help the family
UK country-specific child-related policy
33
4.
2007 Information to guide practice for physiotherapists working with children
7/27/2019 Paediatrics Guidelines07
http://slidepdf.com/reader/full/paediatrics-guidelines07 34/56
a monitoring protocol for deaf babiesand children
developmental journals for babies and
children with visual impairment and for
babies and children with Down Syndrome
a service audit tool to help both
practitioners and strategic planners
a professional guidance for those working
with families using the Early Support
approach.
Aiming high for disabled children: supporting
families HM Treasury and Department for
Education and Skills 2007 is a report on the
Government’s Disabled Children Review and
highlights the need to ensure that every
disabled child can have the best possible start
in life, and the support they and their familiesneed to make equality of opportunity a reality,
allowing each and every child to fulfil their
potential(102). It addresses:
Access and empowerment
Responsive services and timely support
Improving service quality and capacity
Next steps.
Sure Start Children Centres
The Sure Start Children’s Centre programme
builds on existing good practice and is based
on the concept that providing integrated
education, care, family support, health services
and support with employment are key factors
in determining good outcomes for children
and their parents.
The Centres are places where children under
five years old and their families can receive
seamless holistic integrated services and
information, and help from multi-disciplinary
teams of professionals. All Sure Start Children’s
Centres will have to provide a minimum range
of services including:
appropriate support and outreach services
to parents/carers and children who havebeen identified as in need of them
information and advice to parents/carers on
a range of subjects, including: localchildcare, looking after babies and young
children, local early years provision
(childcare and early learning) education
services for three and four year olds
support to childminders
drop-in sessions and other activities for
children and carers at the centre
links to Jobcentre Plus services.
Sure Start Children’s Centres in the
most disadvantaged areas will offer the
following services:
good quality early learning combined with
full day care provision for children
(minimum ten hours a day, five days a
week, 48 weeks a year)
good quality teacher input to lead the
development of learning within the centre
child and family health services, including
ante-natal services
parental outreach
family support services
a base for a childminder network
support for children and parents with
special needs, and
effective links with Jobcentre Plus to
support parents/carers who wish to consider
training or employment.
The Government is committed to delivering
a Sure Start Children’s Centre for every
community by 2010 and are expected to use
the Early Support approach and materials todeliver high quality services for families of
young disabled children. The Children’s Centre
Practice Guidance provides support in the
development of Children Centres and Section
17 is dedicated to ‘Working with disabled
children’(103)
Website: http://www.surestart.gov.uk/
Extended Schools
Children succeed best when they are healthy,
self confident and well motivated. Extending
UK country-specific child-related policy4.
7/27/2019 Paediatrics Guidelines07
http://slidepdf.com/reader/full/paediatrics-guidelines07 35/56
the range of services that schools can offer iscrucial to making sure children and families are
given support they need to thrive.
Extended Schools core offer of services
includes:
A varied menu of study support activities
such as homework, sports and music clubs
High quality childcare provided on primary
school sites or through local providers
Parenting support
Identifying children and young people
with particular needs to ensure swift and
easy referral to a wide range of specialist
support services such as speech and
language therapy, child and adolescent
mental health services, family support
services, intensive behaviour support andsexual health services
ICT, sports and arts facilities, and adult
learning for the wider community.
Additional support information may be
obtained from: www.everychildmatters.gov./
uk/ete/extendedschools
Additional useful websites to support childwellbeing:
Choice for Parents, the best start for children:
Ten year strategy for childcare 2004 DfES www.
everychildmatters.gov.uk
Improving the Life Chances of Disabled
People: 2005 PM’s Strategy Unit www.
everychildmatters.gov.uk
Right from the Start 1994 SCOPE: www.rightfromthestart.org.uk
The Lead Professional: Practitioners’
and Managers’ Guides 2006 DfES www.
everychildmatters.gov.uk
Implementation of the Lead Professional Role
2006 DfES www.everychildmatters.gov.uk
Toolkit for Managers of Multi-agency Teams2006 DfES www.everychildmatters.gov.uk
Making It Happen: Working together for
children, young people and families: wwwecm.gov.uk
Services for Disabled Children- a review
of services for disabled children and their
families: 2003 Audit Commission www.audit-
commission.gov.uk
Integrated Approach: Best Practice in Multi
Agency Working: Find out more aboutinformation on structuring teams; advice on
common problems; checklists and toolkits;
glossary; success factors – the strategy and
practices that have worked for other teams;
fact sheet. Available online www.ecm.gov.uk/
multigencyworking
Care Co-ordination Network UK 2004 New
Standards for Key Working: Available www.york.ac.uk/inst/spm/ccnukstandards.htm
Audit Commission 1993: Children First: A
Study of Hospital Services. HMSO, London
Audit Commission 2002: Special Educational
Needs: A Mainstream Issue. Available online
www.audit-commission.gov.uk
Department of Health 1997: The CaldicottCommittee: Report on the review of patient-
identifiable information. HMSO, London
Department of Health 2003: Specialised
Services National Definition Set: 23 Specialised
Services for Children, HMSO, London.
Education Act 1981: HMSO London.
Northern IrelandOur Children and Young People – Our
Pledge is a ten year strategy (2006 – 2016) to
produce improved outcomes for all children
and target services towards those who
need help, to narrow the gap in outcomes
between those who do best and those who
do worst(104). The Government’s vision is
for all children and young people living inNorthern Ireland to thrive and look forward
with confidence to the future.
UK country-specific child-related policy
35
4.
UK ifi hild l d li
2007 Information to guide practice for physiotherapists working with children
4
7/27/2019 Paediatrics Guidelines07
http://slidepdf.com/reader/full/paediatrics-guidelines07 36/56
By 2016, the strategy’s target is for all childrenand young people to be:
Healthy
Enjoying, learning and achieving
Living in safety.
The main emphasis within Northern Ireland
(NI) at present is to develop working together
in multi agency teams, inclusion and improved
collaborative working with Education.
The “Standards and Guidance for Promoting
Collaborative Working to Support Children
with Special Needs” , is a pilot project currently
running in special schools within NI. It gives
guidance on the promotion of collaborative
working between Health and Education
Professions supporting children with specialneeds in special schools, working together
to best meet the needs of children(105). It
endorses joint responsibilities for policy
development, implementation, service delivery,
commissioning and accounting. It outlines
standards to promote collaborative working
at all levels and identifies needs for
partnership agreements.
The Children’s and Young Peoples funding
package (Peter Hain MP) was the allocation of
funding to directly address the most pressing
needs of children and young people. There has
been funding for extended schools, additional
early years provision, more counselling and
therapy support, increased youth provision,
better provision for looked after children and
improving child protection arrangements.
The aim is to reduce under achievementand improve the life chances of childrenand young people.
‘Fit Futures’ is looking at joining health,education and sport in seeking to reduce
obesity in children. The aim is to stop the rise
in childhood obesity by 2010(106)
.
Families Matter: Supporting Families in
Northern Ireland 2007, emphasises the
Government’s determination to improve life
chances for children and young people(107). Its
vision “Our Children and Young People, Our
Pledge” looks at moving parents into a central
position in policy terms and strategic direction.
It aims to empower and assist parents tobe responsible in helping their children
reach their full potential. The drivers for the
document are Every Child Matters: Change
for Children programme, ten-year children’s
strategy and The Child Poverty Review.
The Children’s Strategy is to assist
organisations to work together at alllevels; facilitating better informationsharing, putting together commonstandards and ensuring the focus remainson the child or young person.
Health for all Children, This recommends a
move away from a medical model of screeningfor disorders, with greater emphasis on health
promotion, primary prevention and targeting
effort on active intervention for children and
families at risk). www.dhsspsni.gov.uk/hssmd
15-04.pdf
A Healthier Future is organised around five
themes, investing in health and wellbeing,
involving people – caring communities,responsive combined services, teams which
deliver and improving quality. Targeted groups
are children who need care or extra support
and people with learning disabilities.
The following additional articles address
wellbeing of children in Northern Ireland and
may all be located on; www.dhsspsni.gov.uk
The Children (Northern Ireland) Order 1995
UK country-specific child-related policy4.
UK t ifi hild l t d li4
7/27/2019 Paediatrics Guidelines07
http://slidepdf.com/reader/full/paediatrics-guidelines07 37/56
The Education (Northern Ireland) Order 1996The Special Needs and Disability (Northern
Ireland) Order 2005
The Disability Discrimination Act 1995
Code of Practice on the Identification and
Assessment of Special Educational Needs 1998
Supplement to the Code of Practice on the
Identification and Assessment of Special
Educational Needs 2005
SCIE Report to Managing Risk and Minimising
Mistakes in services to Children and Families
Best Practice – Best Care 2001 A Framework
for Setting Standards, Delivering Services
and Improving Monitoring and Regulation
in the HPSS
A Healthier Future – A Twenty-Year Visionfor Health and Wellbeing in Northern
Ireland 2004
Department of Education Northern Ireland.
Standards and guidance for promoting
collaborative working to support children
with special needs - pilot project. Bangor:
Department of Education Northern Ireland;
2006. URL: http://www.deni.gov.uk/print/
collaborative_working_document.pdf
Children’s and Young Peoples Funding Package
Peter Hain 2006
Fit Futures Implementation Plan 2007
Office of the First Minister and Deputy First
Minister. Our Children and Young People -
Our Pledge. A ten year strategy for children
and young people in northern ireland 2006- 2016. Belfast: Office of the First Minister and
Deputy First Minister; [2006]. URL: http://www.
allchildrenni.gov.uk/tenyearstrategychildren1.pdf
Co-operating to Safe Guard Children (Northern
Ireland) 2003
Understanding the needs of Children in
Northern Ireland 2006
The Disability Discrimination (Code of Practice)(Schools) (Appointed Day) Order (Northern
Ireland) 2006
A Northern Ireland Review of AdvocacyArrangements for Disabled Children and
Young People with Complex Needs 2006
Care Standards for Northern Ireland. http://
www.dhsspsni.gov.uk/index/hss/governance.htm
Clinical Governance and Risk Management:
Achieving safe, effective, patient focused care
and services National Standards 2005.
Scotland
Health and Education are devolved to the
Scottish Parliament.
The approach for children and young
people in Scotland is based on the United
Nations (UN) Convention on the Rights of
the Child (Article 24).
This recognizes the right of the child to
the highest attainable standard of health
and to facilities for the treatment of illness
and rehabilitation of health. No child
should be deprived of the right of access to
health care services.
Scotland’s children need to be safe,
nurtured, active, healthy, achieving,included, respected and responsible in
order to become successful learners,
confident individuals, effective contributors,
and responsible citizens.
There is an emphasis on providing care
locally with effective interagency working.
Where possible, with regard to safety and
quality, hospital care is delivered as locallyas possible.
NHS Reform (Scotland) Act 2004(108)
This Act provides the legislative basis for
the establishment of Community Health
Partnerships (CHPs) which are considered
vital for the modernisation and redesign of
NHS Scotland and of joint services with LocalAuthorities. The priority is working towards
a decentralised but integrated health and
UK country-specific child-related policy
37
4.
UK country specific child related policy
2007 Information to guide practice for physiotherapists working with children
4
7/27/2019 Paediatrics Guidelines07
http://slidepdf.com/reader/full/paediatrics-guidelines07 38/56
social care systems. In particular, CHPs willseek to close the health gap, reducing
health inequalities.
In relation to child health:
Children and young people, their parents and
carers are involved in the design of services.
Areas highlighted include:
More care for children is provided closer
to home Guidelines for the management of common
childhood conditions by primary and
secondary care are agreed and
implemented
Services and initiatives to improve the
health of children are developed further,
for example around the growing
prevalence of obesity in children and
young people
Children with additional needs have shared
assessment by relevant agencies, agreed
coordinated care plans and monitoring
of outcomes
Clear processes are in place to agree
funding arrangements for children with
complex needs
Services for vulnerable families areintegrated with local authority services in
a way that ensures referral access by all
relevant agencies and joint working
amongst health, education and social
work staff.
Education (Additional Support for
Learning) (Scotland) Act 2004(109)
The Act replaces the system for assessment
and recording of children and young people
with special educational needs, including the
Records of Needs process, established by the
Education (Scotland) Act 1980.
Additional Support for Learning legislation
requires agencies such as NHS Boards to
respond to requests for help from educationauthorities within a period of ten weeks,
including services based in the community andmanaged by CHPs.
The process for assessment and recording
educational support needs is detailed in the
publication, Statutory Guidance relating to the
Education (Additional Support for Learning)
(Scotland) Act 2004(110). Agencies must adopt
an integrated approach to assessment,
intervention, planning, provision and review.
There is a duty to help an education authority
unless the help asked for:
is incompatible with the agency’s statutory
or other duties; or
unduly prejudices the agency in its
discharge of its own functions.
A response to a request for assessment should
be made within ten weeks.
Health for All Children(111)
To be implemented throughout the UK this
recommends a move away from a medical
model of screening for disorders, with greater
emphasis on health promotion, primary
prevention and targeting effort on activeintervention for children and families at risk.
Building on Success: Future Directions for
Allied Health professionals 2002(112)
Shaping the future of Allied Health
Professional; key areas includes service design,
clinical governance, research and development,
career pathways, recruitment and retention.
Delivering care, enabling health, Scottish
Executive November 2006(113)
This builds on the national strategy for
nursing and midwifery and the AHP
strategy; Building on Success. It considers the
contribution of Nursing, Midwifery and AHP
services (NMAHP) to health care policy in the
key areas of culture, capability and capacity.Delivering for Health is the policy context
for health care in Scotland. The document
UK country-specific child-related policy4.
UK country specific child related policy4
7/27/2019 Paediatrics Guidelines07
http://slidepdf.com/reader/full/paediatrics-guidelines07 39/56
considers the NMAHP contribution to meetingthe identified need of Scotland’s population.
Enabling is described as being fundamental
to Allied Health professional practice and
services.
Supplementary information relating to
Children’s Services in Scotland can be found
at www.scotland.gov.uk/Publications
The Information Management and
Technology (IM&T) Strategy (2002)(114)
Published by the Scottish Executive Health
Department recommended that all Scottish
NHS Boards implement The Support Needs
System (SNS) by 2004. SNS was established
in 1993, with the aim of enabling early
identification, assessment and monitoring of
children with additional support needs in a
consistent manner across Scotland. Additional
information may be obtained via: http://www.
isdscotland.org/isd/3397.html.
Additional articles address wellbeing of
children in Scotland.
Education (Additional Support for Learning)(Scotland) Act 2004
Emergency Care Framework for Children and
Young People in Scotland http://www.scotland.
gov.uk/Resource/Doc/149108/0039634.pdf
Children’s Cancer Services in Scotland Working
Group: The Future of Cancer Services for
Children and Young People in Scotland
2005 http://www.scotland.gov.uk/Resource/ Doc/77843/0018193.pdf
Delivering for Health 2005 http://www.
scotland.gov.uk/Resource/Doc/76169/0018996.
Joint Inspection of Children’s Services and
Inspection of Social Work Services (Scotland)
Act 2006.
Tertiary Services for Children in ScotlandPlanning the Future Conference – 11 June 2004
http://www.sehd.scot.nhs.uk/cyphsg/documents/ 11June2004.pdf
National Framework for Service Change in
the NHS in Scotland 2005 – Child Healthcare
Services in Scotland http://www.sehd.scot.
nhs.uk/nationalframework/Documents/
ChildHealthcareReport.pdf
Building a Health Service: Fit for the Future:
Scottish Executive 2005 www.scotland.gov.uk
Delivering a Healthy Future: An Action
Framework for Children and Young People’s
Health in Scotland: A draft Consultation 2006
Getting It Right for Every Child: Review of
Children’s Hearings Systems: 2006 Scottish
Executive www.scotland.gov.uk
Getting It Right for Every Child:
Implementation Plan: Scottish Executive 2006www.scotland.gov.uk
The Same As You: A review of Services for
people with Learning Difficulties: Scottish
Executive 2004. www.scotland.gov.uk
Publication-SCLD Bulletin: Scottish Consortium
for Learning Disability: Contact 0141 4185420
www.scld.org.uk
Wales
Designed for Life
‘Building upon the work already begun in
Building for the Future, Improving Health
in Wales and Health Challenge Wales, this
strategy will outline how we will get there. It is
called Designed for Life; this encapsulates our
whole approach. Design needs to be inspired, yet practical, actively planned, modelled and
built by experts. High quality design is durable,
safe and effective – it delivers to people what
they want. In short, it is fit for purpose, and
our purpose here is an improved quality of
life for the people of Wales - adding not just
years to life, but life to years. Much of the
achievement will rely on good partnerships,
especially across the NHS, public health, localgovernment and voluntary organisations.’ (115)
UK country-specific child-related policy
39
4.
UK country-specific child-related policy
2007 Information to guide practice for physiotherapists working with children
4
7/27/2019 Paediatrics Guidelines07
http://slidepdf.com/reader/full/paediatrics-guidelines07 40/56
Over the past few years’ paediatricphysiotherapy services in Wales have engaged
with the health Modernisation agenda set out
by the Welsh Assembly Government. National
strategies such as Designed for Life have been
supported by the development and publication
of Children’s NSF for Wales and by the
Children and Young Peoples Specialist Service
Standards(115-117).
Children’s National Service framework
(Wales)(116)
The overall aim of the Children’s NSF is that “all
children and young people achieve optimum
health and wellbeing and are supported in
achieving their potential” . The scope of the
Children’s NSF includes all children and young
people from pre-conception to 18th birthday,
for whom NHS Wales and local social services
authorities have a responsibility. Special
consideration will be given for transition
management into adult services beyond the18th
birthday for those requiring support services.
The framework contains 21 standards and 203
key actions, which are based on the 42 Articles
of the UN Convention on the Rights of the Childand the Assembly’s seven core aims for children
and young people. A Self-Assessment Audit Tool
has been designed as part of a performance
measurement system for the Children’s NSF
for use by all statutory organisations that
deliver services for children and young people,
including the delivery of maternity services.
Children and Young People Specialist ServiceStandards ( CYPSS)(117):
‘Children are special and some children need
very specialised health services to diagnose and
treat their diseases. There has been considerable
change in the configuration and range of
specialist services available to the children of
Wales in recent years. Many services have been
developed but some have not proved sustainable
because of concerns about continuity of care, or
workload or staffing levels’ .
In 2002 it was agreed that any review of tertiaryservices for children in Wales should:
define in detail what are specialised services
for children
review the incidence and prevalence of
diseases which require specialised care
assess the quantity, quality and costs of the
existing provision
assess how any undesirable variations in
cost, volume and quality of existing
provision can be reduced
propose options for improvement.
Specialist Services under review include:
Neonatal
Paediatric intensive care
Paediatric specialist medicine
Paediatric neurosciences
Paediatric oncology and palliative care
Paediatric specialist anaesthetics and surgery.
For easy to read aide memoirs and synopses of
all the above documents go to the following site:
www.healthcarealliances.com
Therapies for ModernisationIn addition, the publication in 2006 of a specific
Therapies Strategy for Wales has contributed to
the transformation of the delivery of Health and
Social Care in Wales(118).
‘This document sets out important objectives
and key actions applicable across the entire
physical, social and psychological spectrum of
wellbeing, health improvement, accident and
ill health prevention and the management of
illness, injury and disability. It provides a platform
from which therapists and their support staff
should be engaged and employed to support
and deliver service provision, developments and
modernisation across Wales.
Some of this agenda is challenging, but the
potential benefits are considerable. This strategy
provides a framework from which action and
more detailed work will be required at a local
level to fully explore how these benefits will
UK country-specific child-related policy4.
Useful general information5.
7/27/2019 Paediatrics Guidelines07
http://slidepdf.com/reader/full/paediatrics-guidelines07 41/56
be realised. The Government, commissioners, providers, professionals and the public must seize
the opportunities and work together to ensure
that Wales secures the powerful contribution
of the Therapy Services to its health and social
care agenda.’
Sport and leisureFor many of the children and young people
that physiotherapists work with opportunities
to participate fully in sporting and leisure
activities can seem very limited and they may
be asked for advice.
The English Federation for Disability Sports
(EFDS) provides details of local Disability Sports
Development Officers and of their own Regional
representatives. These individuals should be
able to advise on all local sporting activities,
and will possibly be able to work with
physiotharapists to develop new opportunities.
EFDS website provides a vast array on
information ranging from funding
opportunities to information on specific sports.Information relating to disability sporting
events around the country can be found on
EFDS’ website: www.disabilitysport.org.uk
The EFDS also produces a quarterly magazine
‘Inclusive Sport’.
Disability Sports Northern Ireland.
Website: http://www.dsni.co.uk/
NI Gillian McKenna (gillian.
Federation of Disability Sport Wales (FDSW).
Website: http://www.disabilitysportwales.org/
Sport Scotland.
Website: http://www.sportscotland.org.uk/
Other useful websites relating todisability sports include:
British Gymnastics
Website: http://www.british-gymnastics.org/
British Blind Sport.
Website: http://www.britishblindsport.org.uk/
UK Deaf Sport
Website: http://www.ukdeafsport.org.uk/
Mencap Sport.
Website: http://www.mencap.org.uk/html/
mencap_sport/
Useful general information
41
5.
Useful general information
2007 Information to guide practice for physiotherapists working with children
5.
7/27/2019 Paediatrics Guidelines07
http://slidepdf.com/reader/full/paediatrics-guidelines07 42/56
WheelPower – British Wheelchair Sport.Website: http://www.wheelpower.org.uk/
CP Sport England & Wales.
Website: http://www.cpsport.org/
For more specific information on
competing in disability sports at National
and International levels:
British Paralympic Association.
Website: http://www.paralympics.org.uk/
Cerebral Palsy International Sports and
Recreation Association
Website: http://www.cpisra.org/
British Amputee and les Autres Sports
Association (BALASA).
Website: http://www.fastuk.org/atcommunity/
orgview.php?id=2633. Tel: 01204 494308
Sport specific sites of interest include:
The Wheelchair Football Association
Website: http://www.thewfa.org.uk/
National Wheelchair Tennis Association of
Great Britain.
Website: http://www.btf.org.uk/
WheelchairTennis/ Great British Wheelchair Rugby
Website: http://www.gbwr.co.uk/
Great Britain Wheelchair Basketball Association
Website: http://www.gbwba.org.uk/
British Amateur Swimming Association
– Disability Swimming.
Website: http://www.britishswimming.org/vsite/
vnavsite/page/directory/0,10853,5026-142732-159948-nav-list,00.html
Halliwick Association of Swimming Therapy in
the UK.
Website: http://www.halliwick.org.uk/
The Art of Swimming - Shaw Method.
Website: http://www.artofswimming.com/
Swimming and CP.Website: http://www.cerebralpalsysource.com/
Treatment_and_Therapy/swimming/index.html
New Age Kurling.Website: http://www.kurling.co.uk/
International Blind Sports Association – Goal
Ball and other sports
Website: http://www.ibsa.es/eng/
The British Ski Club for the Disabled
Website: http://www.bscd.org.uk/
The British Disabled Angling Association
Website: http://bdaa.co.uk/
British Blind Sports.
Website: http://www.britishblindsport.org.uk/
International Federation of Blind Sports.
Website: http://www.ibsa.es/eng/
The Clavert Trust offers adventurous outdoor
activities for people with disabilities at their
three Centres England – Scottish Posture and
Mobility Network
Website: http://www.calvert-trust.org.uk/
Riding for the Disabled. Provides
comprehensive information relating to
localities and the Association’s activities.
Website: http://www.riding-for-disabled.org.uk/
The Fortune Centre of Riding TherapyWebsite: http://www.fortunecentre.org
The Federation Riding for the Disabled
International
Website: http://www.frdi.net/
MS Trust. Hippotherapy – a new movement
experience: what fun! .
URL: http://www.mstrust.org.uk/publications/
opendoor/0605_10_11.jsp
Revive MS Support. Hippotherapy.
URL: http://www.revivemssupport.org.uk/index.
php?option=com_content&task=view&id=25&It
emid=99999999
Calvert Trust Riding for the Disabled – Exmoor
Equestrian.
Website: http://www.equinetourism.co.uk/
equineestablishments/calverttrust.asp
Royal Association for Disability and
Rehabilitation (RADAR). has a range of
Useful general information5.
Useful general information5.
7/27/2019 Paediatrics Guidelines07
http://slidepdf.com/reader/full/paediatrics-guidelines07 43/56
useful publications including ones relating toaccessible holidays and leisure pursuits
Website: http://www.radar.org.uk/radarwebsite/
The following charities provide
wheelchair training courses for children
and young people:
Whizz Kidz.
Website: http://www.whizz-kidz.org.uk
The Association of Wheelchair Children.
Website: http://www.wheelchairchildren.org.uk/
The Scottish Posture and Mobility Network
Website: http://www.spmn.org.uk/
Specialist holidays
These are some of the national organisations
that provide and support specialist holidays forthe disabled client often incorporating activities
for the family/carers. There may be local
organisations that provide /fund such holidays.
If so, information may be obtained at your
Tourist Information Centre/Local Council.
Calvert Trust Activity Holidays for the Disabled.
Website: http://www.calvert-trust.org.uk/
Royal Blind Society – holidays.
Website: http://www.royalblindsociety.org/
holidays.htm
Enable Holidays
Website: http://www.enableholidays.com
Disability Now – accessible holiday
accommodation.Website: http://www.disabilitynow.org.uk/
directory/adv_accomm.htm
John Grooms Holidays – Provides the highest
quality holidays for the disabled
Website: http://www.johngrooms.org.uk/
landing.asp?id=9
Tall Ships Youth Trust – Supports the personaldevelopment of young people through crewing
tall ships. Website: http://www.tallships.org/
Voluntary agencies and support groupsThere are many easily accessible voluntary
agencies and support groups both nationally
and locally for children, young people and
their families/carers. Below are just a few of
the well known national agencies but it is
worth investigating local voluntary agencies/
support groups.
Contact a FamilyWebsite: http://www.cafamily.org.uk/
Scope UK.
Website: http://www.scope.org.uk/
High/Scope UK.
Website: http://www.high-scope.org.uk/
HemiHelp.
Website: http://www.hemihelp.org.uk/
Erb’s Palsy Group.
Website: http://www.erbspalsygroup.co.uk/
BLISS – the premature baby charity
Website: http://www.bliss.org.uk/
National Association of Toy & Leisure Libraries.
Website: http://www.natll.org.uk/
The Variety Club Children’s Charity.Website: http://www.varietyclub.org.uk/
Cerebra: for Brain Injured Children and Young
People.
Website: http://www.cerebra.org.uk
Whizz Kidz.
Website: http://www.whizz-kidz.co.uk
YoungMinds. Young people and mental healthissues including advice and information sheets
on eating disorders and self harm
Website: http://www.youngminds.org.uk/
g
43
Appendix – Resources and references
2007 Information to guide practice for physiotherapists working with children
7/27/2019 Paediatrics Guidelines07
http://slidepdf.com/reader/full/paediatrics-guidelines07 44/56
Other relevant Clinical Interest Groupsand Occupational Groups (CI/OGs)
There are nearly 40 CI/OGs recognised by
the CSP and new ones continue to develop.
Interest groups represent a distinct field of
physiotherapy clinical practice that may be
specific to a client group, a clinical area or
a specific treatment approach or modality.
The occupational groups all represent
physiotherapists working in a specific
occupational area.
The following recognised CI/OGS link to
paediatrics:
Acupuncture Association of Chartered
Physiotherapists: AACP www.aacp.uk.com
Association of Chartered Physiotherapists in
Cystic Fibrosis: ACPCF
Association of Chartered Physiotherapists in
Energy Medicine: ACPEM
www.energymedphysio.org.uk
Association of Chartered Physiotherapists in
Electrotherapy: ACPIE
Association of Chartered Physiotherapists in
Independent Hospitals and Charities: ACPIHC
Association of Chartered Physiotherapist
Interested in Neurology: ACPIN www.acpin.net
Association of Chartered Physiotherapists in
Reflex Therapy: ACPIRT
Association of Chartered Physiotherapists
in Management: ACPMwww.physiomanagers.org.uk
Association of Chartered Physiotherapists in
Occupational Health and Ergonomics: ACPOHE
www.acpohe.co.uk
Association of Chartered Physiotherapists in
Orthopaedic Medicine and Injection Therapy:
ACPOM www.acpom.org.uk
Association of Chartered Physiotherapists in
Oncology and Palliative Care: ACPOPC
www.acpopc.org.uk
Association of Chartered Physiotherapists forPeople with Learning Difficulties: ACPPLD
www.acppld.org.uk
Association of Chartered Physiotherapists in
Respiratory Care: ACPRC www.acprc.org.uk
Association of Chartered Physiotherapists in
Sports Medicine: ACPSM www.acpsm.org
Association of Chartered Physiotherapists inTherapeutic Riding: ACPTR
British Association of Bobath Trained
Physiotherapists: BABBT www.bobath.org.uk
British Association of Chartered
Physiotherapists in Amputee Rehabilitation:
BACPAR www.bacpar.org.uk
British Association of Hand Therapists: BAHTwww.hand-therapy.co.uk
Chartered Physiotherapists Interested in
Massage and Soft Tissue Therapies: CPMaSTT
Chartered Physiotherapists in Mental Health:
CPMH www.cpmh.org.uk
Chartered Physiotherapists Promoting
Continence: CPPC
Craniosacral Therapy Association of Chartered
Physiotherapists: CTACP
Chartered Physiotherapists Working as
Extended Scope Practitioners: ESP
Hydrotherapy Association of Chartered
Physiotherapists: HACP
Haemophilia Chartered Physiotherapists’
Association: HCPA
International Support Group for Chartered
Physiotherapists: ISC4CP
Medico-legal Association of Chartered
Physiotherapists: MLACP
Organisation of Chartered Physiotherapists inPrivate Practice: OCPPP www.physiofirst.org.uk
pp
Appendix – Resources and references
7/27/2019 Paediatrics Guidelines07
http://slidepdf.com/reader/full/paediatrics-guidelines07 45/56
Physiotherapy Pain Association: PPA.Physiotherapy Research Society:
PRS www.prs-uk.org
The following CI/OGs are not formally
recognised by the CSP but also address
children within the specialty:
Association of Chartered Physiotherapists
working with Acquired Brain InjuryRenal
Burns
Paediatric Physiotherapists in Management
Service
NB Those CI/OGs without a website may be
contacted by logging onto the CSP website;
www.csp.org.uk/specialist group section.
Working Party Lead Project Officer: Leonie Dawson, CSP
Clinical Policy Officer
Project officer: Mary Harrison
Sarah Crombie
Felicity Dickson
Linda Fisher
Carol Mackay
Terry Pountney
Diane Rogers
Peta Smith
Lorna Stybelska
Laura Wiggins
Also acknowledgement for their
contributions:
Fiona Down
Julia GrahamGeraldine Hastings
Stephanie C Phillips
Dr Janet E McDonagh
References:1. Health Professions Council. Standards of
proficiency - physiotherapists. London: Health
Professions Council; 2005. URL: http://www.hpc-
uk.org/publications/index.asp?id=49
2. The Chartered Society of Physiotherapy.
Rules of professional conduct 2nd ed. 2nd
ed. London: Chartered Society of
Physiotherapy; 2002.
3. The Chartered Society of Physiotherapy. Core
standards of physiotherapy practice 4th ed.
London: Chartered Society of Physiotherapy;
2005. URL: http://www.csp.org.uk/director/
libraryandpublications/publications.cfm
4. Association of Paediatric Chartered
Physiotherapists. Paediatric physiotherapy
guidance for good practice. London:
Association of Paediatric Chartered
Physiotherapists; 2002.
5. The Chartered Society of Physiotherapy.
Making the business case. London:
Chartered Society of Physiotherapy; 2007.URL: http://www.csp.org.uk/director/
libraryandpublications/publications.cfm
6. The Victoria Climbié inquiry: report of an
inquiry. Report of an inquiry by Lord Laming;
presented to Parliament by the Secretary of
State for Health and the Secretary of State for
the Home Department by Command of Her
Majesty. London: The Stationery Office; 2003.
URL: http://www.victoria-climbie-inquiry.org.uk/
7. O’Brien S, Hammond H, McKinnon M. Report
of the Caleb Ness inquiry. Edinburgh: Edinburgh
and the Lothian’s Child Protection Committee;
2003. URL: http://www.nhslothian.scot.nhs.uk/
news/annual_reports/publichealth/2005/ar2003/
caleb/cnr.pdf
45
Appendix – Resources and references
2007 Information to guide practice for physiotherapists working with children
7/27/2019 Paediatrics Guidelines07
http://slidepdf.com/reader/full/paediatrics-guidelines07 46/56
8. Bristol Royal Infirmary Inquiry Chairman IanKennedy. Learning from Bristol; the report of
the public inquiry into children’s heart surgery
at the Bristol Royal Infirmary 1984-1995.
London: The Stationery Office; 2001. URL: http://
www.bristol-inquiry.org.uk/final%5Freport/
rpt%5Fprint.htm
9. United Nations International Children’s
Emergency Fund (UNICEF). Convention on theRights of the Child. New York: UNICEF; 1989.
Section 12. URL: http://www.unhchr.ch/html/
menu3/b/k2crc.htm
10. United Nations General Assembly. Universal
declaration of human rights. New York: United
Nations; 1948.
11. Disability Discrimination Act 1995 Elizabeth
II. Chapter 50. . London: HMSO; 1995. URL:
http://www.opsi.gov.uk/acts/acts1995/1995050.
htm
12. Disability Discrimination Act 2005 Elizabeth
II - Chapter 13. London: The Stationery Office;
2005. URL: http://www.opsi.gov.uk/acts/
acts2005/20050013.htm
13. Human Rights Act 1998: Elizabeth II. Chapter
42. London: HMSO; 1998. URL: http://www.opsi.
gov.uk/acts/acts1998/19980042.htm
14. The Chartered Society of Physiotherapy.
Human Rights Act 1998. London: Chartered
Society of Physiotherapy; 2000.
15. Children Act 2004: Elizabeth II. Chapter 31.
London: The Stationery Office; 2004. URL: http://
www.opsi.gov.uk/acts/acts2004/20040031.htm
16. Data Protection Act 1998. Elizaeth II Chapter
29. London: The Stationery Office; 1998. URL:
http://www.opsi.gov.uk/acts/acts1998/19980029.htm
17. Alderson P, Montgomery J. Health carechoices: making decisions with children.
London: Institute of Public Policy Research;
1996.
18. Jayadevappa R, Johnson JC, Bloom BS, et
al. Effectiveness of transcendental meditation
on functional capacity and quality of life of
African Americans with congestive heart failure:
a randomized control study. Ethn Dis. 2007Winter;17(1):72-7.
19. Family Law Reform Act 1969 c. 46 London:
HMSO; 1969.
20. Commission for Social Care Inspection.
Safeguarding children. The second joint
Chief Inspectors’ report on arrangements tosafeguard children. Newcastle: Commission for
Social Care Inspection; 2005. URL: http://www.
hmica.gov.uk/files/safeguards_fullprint.pdf
21. Department for Education and Skills. What
to do if you’re worried a child is being abused.
Nottingham: Department for Education and
Skills; 2006. URL: http://www.everychildmatters.
gov.uk/resources-and-practice/IG00182/
22. Protection of Children Act 1999 Elizabeth
II. Chapter 14. . London: The Stationery Office;
1999. URL: http://www.opsi.gov.uk/acts/acts1999/
ukpga_19990014_en_2
23. The Rehabilitation of Offenders Act 1974
(Exceptions) (Amendment) (England andWales) Order 2007. SI 2007 No. 2149. London
TSO; 2007. URL: http://www.opsi.gov.uk/si/
si2007/20072149.htm
24. Department of Health. Working together
to safeguard children: a guide to inter-agency
working to safeguard and promote the
welfare of children. London: The StationeryOffice; 1999.
Appendix – Resources and references
7/27/2019 Paediatrics Guidelines07
http://slidepdf.com/reader/full/paediatrics-guidelines07 47/56
25. The Chartered Society of Physiotherapy.Physiotherapy assistants code of conduct.
London: Chartered Society of Physiotherapy;
2002. URL: http://www.csp.org.uk/director/
libraryandpublications/publications.cfm
26. The Chartered Society of Physiotherapy.
Policy statement on continuing professional
development (CPD) (Revised). London: Chartered
Society of Physiotherapy; 2007. URL: http://www.csp.org.uk/director/libraryandpublications/
publications.cfm
27. The Chartered Society of Physiotherapy.
Delegation of tasks to assistants. Information
paper PA 6. London: Chartered Society of
Physiotherapy; 2004.
28. The Chartered Society of Physiotherapy.
Guidelines for in-service training for
physiotherapy assistants. Information paper
CPD16. London: The Chartered Society of
Physiotherapy 2002.
29. The Chartered Society of Physiotherapy.
Lifelong learning and physiotherapy assistants:
new approaches to assistant education
and development. Information paper
CPD 33. London: Chartered Society of
Physiotherapy; 2001.
30. Smith P, Fisher L. Paediatric physiotherapy:
report for the workforce review. Association of
Paediatric Chartered Physiotherapists. 2007;June.
31. The Chartered Society of Physiotherapy.
Workplace learning: evidencing through
reflection and evaluation (CPD31). London:
Chartered Society of Physiotherapy; 2005.
URL: http://www.csp.org.uk/director/
libraryandpublications/publications.cfm
32. The Chartered Society of Physiotherapy.The personal development plan (PDP) as part
of the development review process (CPD 28).
London: Chartered Society of Physiotherapy;2005. URL: http://www.csp.org.uk/director/
libraryandpublications/publications.cfm
33. The Chartered Society of Physiotherapy.
Resources for continuing professional
development (CPD) (CPD 11). London:
Chartered Society of Physiotherapy; 2005.
URL: http://www.csp.org.uk/director/
libraryandpublications/publications.cfm
34. The Chartered Society of Physiotherapy.
Keeping a CPD portfolio - using your
CD ROM: guidance to students.(STU 12).
London: Chartered Society of Physiotherapy;
2005. URL: http://www.csp.org.uk/director/
libraryandpublications/publications.cfm
35. The Chartered Society of Physiotherapy.Support worker education and development:
learning opportunities London: The
Chartered Society of Physiotherapy; 2007.
URL: http://www.csp.org.uk/director/
libraryandpublications/publications.cfm
36. Sackett DL, Rosenberg WM, Gray JA, et al.
Evidence based medicine: what it is and what
it isn’t. BMJ. 1996 Jan 13;312(7023):71-2.
URL: http://www.bmj.com/cgi/content/
full/312/7023/71
37. Dawes M, Summerskill W, Glasziou P, et al.
Sicily statement on evidence-based practice.
BMC Med Educ. 2005 Jan 5;5(1):1.
URL: http://www.pubmedcentral.nih.gov/
articlerender.fcgi?tool=pubmed&pubmedid=15634359
38. The Chartered Society of Physiotherapy.
Rules of professional conduct 2nd ed. - rule 1.
London: Chartered Society of Physiotherapy;
2002.
39. McKay C, Smith L, PaediatricPhysiotherapists in Management Support
(PPIMS). Paediatric outcome measurement.
47
Appendix – Resources and references
2007 Information to guide practice for physiotherapists working with children
7/27/2019 Paediatrics Guidelines07
http://slidepdf.com/reader/full/paediatrics-guidelines07 48/56
London: Association of Paediatric CharteredPhysiotherapists (ACPC); 2005.
40. Pountney T. Physiotherapy for children.
Oxford: Butterworth Heinemann; 2007.
41. Health and Safety at Work, etc. Act 1974
Elizabeth II. Chapter 37. . London: HMSO; 1974.
URL: http://www.hse.gov.uk/legislation/hswa.
42. The control of substances hazardous to
health regulations 1999. SI 1999 No. 437.
London: Stationery Office; 1999. URL: http://
www.opsi.gov.uk/si/si1999/19990437.htm
43. The control of substances hazardous to
health regulations 2002. SI 2002 No 2677.
London: TSO; 2002. URL: http://www.opsi.gov.
uk/si/si2002/uksi_20022677_en.pdf
44. Reporting of Injuries, Diseases and
Dangerous Occurrence Regulations (RIDDOR)
1995. SI 1995 No. 3163. . London: HMSO; 1995.
45. The Management of Health and Safety at
Work Regulations 1999 SI 1999 3242 Lonodn:
The Stationery Office; 2000. URL: http://www.
opsi.gov.uk/si/si1999/uksi_19993242_en.pdf
46. Manual Handling Operations Regulations
1992 SI 1992 2793. . London: HMSO; 1992.
URL: http://www.opsi.gov.uk/si/si1992/uksi_
19922793_en_1.htm
47. Manual handling operations regulations
2002 SI 2002 No. 2174. London: TSO; 2002. URL:http://www.opsi.gov.uk/SI/si2002/20022174.htm
48. The Lifting Operations and Lifting
Equipment Regulations 1998 SI 1998 2307.
London: The Stationery Office; 1998. URL:
http://www.opsi.gov.uk/si/si1998/19982307.htm
49. McDonagh JE. Transition of care from
paediatric to adult rheumatology. Arch DisChild. 2007 Sep;92(9):802-7.
50. Blum RW, Garell D, Hodgman CH, et al.Transition from child-centered to adult health-
care systems for adolescents with chronic
conditions. A position paper of the Society for
Adolescent Medicine. J Adolesc Health. 1993
Nov;14(7):570-6.
51. Department of Health. Getting the right
start: National service framework for children,
young people and maternity services: Standardfor hospital services. London: Department of
Health; 2003.
52. Department of Health, Department
for Education and Skills. National service
framework for children, young people and
maternity services: Core standards. London:
Department of Health; 2004.
53. Department for Education and Skills.
Every child matters: change for children.
Nottingham: Department for Education
and Skills; 2004. URL: http://www.
everychildmatters.gov.uk/publications/
54. Shaw KL, Southwood TR, McDonagh JE.
User perspectives of transitional care for
adolescents with juvenile idiopathic arthritis.
Rheumatology (Oxford). 2004 Jun;43(6):770-8.
55. McDonagh JE, Southwood TR, Shaw KL.
The impact of a coordinated transitional care
programme on adolescents with juvenile
idiopathic arthritis. Rheumatology (Oxford).
2007 Jan;46(1):161-8.
56. Shaw KL, Southwood TR, McDonagh
JE. Transitional care for adolescents with
juvenile idiopathic arthritis: a Delphi study.
Rheumatology (Oxford). 2004 Aug;43(8):1000-6.
57. McDonagh JE, Minnaar G, Kelly K, et
al. Unmet education and training needs in
adolescent health of health professionals in
a UK children’s hospital. Acta Paediatr. 2006Jun;95(6):715-9.
Appendix – Resources and references
7/27/2019 Paediatrics Guidelines07
http://slidepdf.com/reader/full/paediatrics-guidelines07 49/56
58. The Royal College of Paediatrics and Child
Health. Adolescent Health Project
Website: http://www.rcpch.ac.uk/Education/
Adolescent-Health-Project
59. The Chartered Society of Physiotherapy.
Public health in England: a guide to the public
health agenda. London: Chartered Society of
Physiotherapy; 2005. URL: http://www.csp.org.
uk/director/libraryandpublications/publications.cfm
60. The Chartered Society of Physiotherapy.
Public health in Northern Ireland: a guide
to the public health agenda. London:
Chartered Society of Physiotherapy; 2007.
URL: http://www.csp.org.uk/director/
libraryandpublications/publications.cfm
61. The Chartered Society of Physiotherapy.
Public health in Scotland: a guide to the public
health agenda. London: Chartered Society of
Physiotherapy; 2005. URL: http://www.csp.org.
uk/director/libraryandpublications/publications.
cfm
62. The Chartered Society of Physiotherapy.
Public health in Wales: a guide to the public
health agenda. London: Chartered Society of
Physiotherapy; 2006. URL: http://www.csp.org.
uk/director/libraryandpublications/publications.
cfm
63. Department for Education and Skills.
Removing barriers to achievement: The
government’s strategy for SEN. London:Department of Education and Skills; 2004.
64. Department for Education and
Skills. Special Educational Needs
(SEN) Code of Practice 2001. London:
Department of Education and
Skills; 2001. URL: http://publications.
teachernet.gov.uk/eOrderingDownload/
DfES%200581%20200MIG2228.pdf
65. Association of Paediatric Chartered
Physiotherapists. Special educational needs
code of practice 2001. Guidance for paediatric
physiotherapists. London: Association of
Paediatric Chartered Physiotherapists (APCP);
2003.
66. Department of Health. National service
framework for children, young people and
maternity services: Core standards 1,6 & 8.London: Department of Health; 2004. URL:
http://www.dh.gov.uk/en/Publicationsandstatist
ics/Publications/PublicationsPolicyAndGuidance/
DH_4089099
67. Skills for Health. National workforce
competence framework for children and young
people. Skills for Health 2005.
Website: http://s153550741.websitehome.co.uk/ candc/dev/sfhcyp/competences/2_1_cs2.doc
68. Department for Education and Skills,
Department of Health. Together from the start:
practical guidance for professionals working
with disabled children (birth to third birthday)
and their families. London: Department for
Education and Skills; 2003. URL: http://www.
dh.gov.uk/en/Publicationsandstatistics/
Publications/PublicationsPolicyAndGuidance/
DH_4007526
69. Department of Health. Complex disability
exemplar. National service framework for
children, young people and maternity services.
London: Department of Health; 2005. URL:
http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/
DH_4123814
70. Department of Health. National service
framework for children, young people and
maternity services: Core standard 3. London:
Department of Health; 2004. URL: http://
www.dh.gov.uk/en/Publicationsandstatistics/
Publications/PublicationsPolicyAndGuidance/ DH_4089099
49
Appendix – Resources and references
2007 Information to guide practice for physiotherapists working with children
7/27/2019 Paediatrics Guidelines07
http://slidepdf.com/reader/full/paediatrics-guidelines07 50/56
71. The Chartered Society of Physiotherapy.
Core standards of physiotherapy practice 4th
ed. Standard 6. London: Chartered Society of
Physiotherapy; 2005. URL: http://www.csp.org.
uk/director/libraryandpublications/publications.
cfm
72. Department of Health. National service
framework for children, young people and
maternity services: Core standard 4. London:Department of Health 2004. URL: http://
www.dh.gov.uk/en/Publicationsandstatistics/
Publications/PublicationsPolicyAndGuidance/
DH_4089099
73. Department of Health. National service
framework for children, young people and
maternity services: Core standards 3 & 8.
London: Department of Health; 2004. URL:http://www.dh.gov.uk/en/Publicationsandstatist
ics/Publications/PublicationsPolicyAndGuidance/
DH_4089099
74. Clark DM, Ehlers A, Hackmann A, et al.
Cognitive therapy versus exposure and applied
relaxation in social phobia: A randomized
controlled trial. J Consult Clin Psychol. 2006
Jun;74(3):568-78.
75. The Chartered Society of Physiotherapy.
Core standards of physiotherapy practice 4th
ed. Standards 16-18. London: Chartered Society
of Physiotherapy; 2005. URL: http://www.
csp.org.uk/director/libraryandpublications/
publications.cfm
76. Department of Health. National service
framework for children, young people and
maternity services: Core standard 7. London:
Department of Health 2004. URL: http://
www.dh.gov.uk/en/Publicationsandstatistics/
Publications/PublicationsPolicyAndGuidance/
DH_4089099
77. Education Act 1996 Elizabeth II. Chapter56. London: HMSO; 1996. URL: http://www.
opsi.gov.uk/acts/acts1996/1996056.htm
78. Penzien DB, Rains JC, Lipchik GL, et al.
Behavioral interventions for tension-type
headache: overview of current therapies and
recommendation for a self-management
model for chronic headache. Curr Pain
Headache Rep. 2004 Dec;8(6):489-99.
79. Department of Health. National service
framework for children, young people andmaternity services: Core standard 8. London:
Department of Health 2004. URL: http://
www.dh.gov.uk/en/Publicationsandstatistics/
Publications/PublicationsPolicyAndGuidance/
DH_4089099
80. The common assessment framework for
children and young people: practitioners’
guide: integrated working to improveoutcomes for children and young people.
London: Department for Education and
Skills; 2006.
81. Every Child Matters. The lead
professional: managers’ guide: integrated
working to improve outcomes for
children and young people. . Nottingham:
Department for Education and Skills; 2006.
URL: http://www.everychildmatters.gov.uk/_
files/338C2F15F85E6496FD62296172CC865F.
82. Information sharing: practitioners’ guide:
Integrated working to improve outcomes
for children and young people. London:
Department of Education and Skills; 2006.URL: http://www.everychildmatters.gov.uk/
informationsharing/
83. The common assessment framework
for children and young people (CAF) pre-
assessment checklist. London: Department of
Education and Skills; 2006. URL: http://www.
everychildmatters.gov.uk/_files/C02087097EA27
155915396EB0FBE8710.doc
50
Appendix – Resources and references
7/27/2019 Paediatrics Guidelines07
http://slidepdf.com/reader/full/paediatrics-guidelines07 51/56
84. The Chartered Society of Physiotherapy.
Rules of professional conduct 2nd ed. - rule 3.
London: Chartered Society of Physiotherapy;
2002.
85. Limbrick P. The team around the child:
multi-agency service co-ordination for
children with complex needs and their
families: a manual for service development.
Worcester: Interconnections; 2001.
86. Limbrick P. Early support for children
with complex needs: team around the
child and the multi-agency keyworker: a
manual for service development Worcester:
Interconnections; 2004.
87. Limbrick P. Working in partnership
through Early Support: distance learning text:Team around the child. London: Early Support;
2007. URL: http://training.earlysupport.org.
uk/Portals/5/Team_around_child.pdf
88. Davies H, Meltzer L. Working in
partnership through early support distance
learning text: Working with parents in
partnership. London: Early Support; 2007.
URL: http://training.earlysupport.org.uk/
Portals/5/Working_with_parents_partnership.
89. U.S. The Technology-Related Assistance for
Individuals with Disabilities Act of 1988 (PL
100-407) Section 3. 1988.
90. Cowan D, Wintergold A. Assistivetechnology In: Pountney T, editor.
Physiotherapy for children. Edinburgh:
Butterworth-Heinemann Ltd 2007.
91. Audit Commission. Fully equipped 2002:
assisting independence London: Audit
Commission; 2002. URL: http://www.audit-
commission.gov.uk/reports/AC-REPORT.asp?C
atID=english%5EHEALTH&ProdID=2103ACC1-7512-46a0-B74C-3D28724585FE
92. Lang AJ. Treating generalized anxiety
disorder with cognitive-behavioral therapy. J
Clin Psychiatry. 2004;65 Suppl 13:14-9.
93. The common assessment framework for
children and young people: managers’ guide.
Integrated working to improve outcomes
for children and young people. London:
Department of Education and Skills; 2006.
94. Department of Health. Framework for
the assessment of children in need and their
families. . London: Stationery Office; 2000.
URL: http://www.dh.gov.uk/en/Publicationsand
statistics/Publications/PublicationsPolicyAndGu
idance/DH_4003256
95. Department of Health. Choosing health:
making healthy choices easier. London: TheStationery Office; 2004. URL: http://www.
dh.gov.uk/en/Publicationsandstatistics/
Publications/PublicationsPolicyAndGuidance/
DH_4094550
96. The Chartered Society of Physiotherapy.
The national service framework for
children, young people and maternity
services: a briefing paper PA 67. London:
Chartered Society of Physiotherapy; 2006.
URL: http://www.csp.org.uk/director/
libraryandpublications/publications.cfm
97. Department of Health. The NHS plan:
a plan for investment; a plan for reform.
London: The Stationery Office; 2000. URL:
http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidanc
e/DH_4002960
98. Department of Health. The NHS
improvement plan: putting people at the heart
of public services. London: The Stationery
Office; 2004. URL: http://www.dh.gov.uk/en/
Publicationsandstatistics/Publications/Publicatio
nsPolicyAndGuidance/DH_4084476
51
Appendix – Resources and references
2007 Information to guide practice for physiotherapists working with children
7/27/2019 Paediatrics Guidelines07
http://slidepdf.com/reader/full/paediatrics-guidelines07 52/56
99. Department of Health. Children’s and
maternity services information strategy:
Supporting the National services framework
for children, young people and maternity
services. London: Department of Health; 2004.
URL: http://www.dh.gov.uk/en/Publicationsands
tatistics/Publications/PublicationsPolicyAndGuid
ance/DH_4089202
100. Department of Health, Department forEducation and Skills. Supporting local delivery:
national service framework for children, young
people and maternity services. Nottingham:
Department for Education and Skills; 2004.
URL: http://www.dh.gov.uk/en/Publicationsands
tatistics/Publications/PublicationsPolicyAndGuid
ance/DH_4098299
101. Department for Education and Skills.Early support : helping every child succeed.
Professional guidance. Nottingham:
Department for Education and Skills; 2004.
URL: http://publications.teachernet.gov.uk/
default.aspx?PageFunction=productdetails&Pa
geMode=publications&ProductId=ESPP33&
102. HM Treasury, Department for Education
and Skills. Aiming high for children: supporting
families. London: HM Treasury; 2007. URL:
http://www.hm-treasury.gov.uk/media/9/9/cyp_
supportingfamilies290307.pdf
103. Sure Start. Sure Start children’s centres
practice guidance. Revised version. London:
Sure Start; [2006]. URL: http://www.surestart.
gov.uk/publications/?Document=1854
104. Office of the First Minister and Deputy
First Minister. Our Children and Young People
– Our Pledge. A ten year strategy for children
and young people in northern ireland 2006
- 2016. Belfast: Office of the First Minister and
Deputy First Minister; [2006]. URL: http://www.
allchildrenni.gov.uk/tenyearstrategychildren1.
105. Department of Education Northern
Ireland. Standards and guidance for promoting
collaborative working to support children
with special needs - pilot project. Bangor:
Department of Education Northern Ireland;
2006. URL: http://www.deni.gov.uk/print/
collaborative_working_document.pdf
106. Fit futures: focus on food, activity and
young people. Belfast: Department of Health,
Social Services & Public Safety; 2005. URL:http://www.investingforhealthni.gov.uk/
fitfutures.asp
107. Department of Health Social Security
and Public Safety. Families matter: supporting
families in Northern Ireland [Consultation].
Belfast: Department of Health, Social Security
and Public Safety; 2007. URL: http://www.
dhsspsni.gov.uk/showconsultations?txtid=22152
108. Lutgendorf SK, Logan H, Costanzo E,
et al. Effects of acute stress, relaxation, and
a neurogenic inflammatory stimulus on
interleukin-6 in humans. Brain Behav Immun.
2004 Jan;18(1):55-64.
109. Education (Additional Support for
Learning) (Scotland) Act 2004 asp 4 Edinburgh:
TSO; 2004. URL: http://www.opsi.gov.uk/
legislation/scotland/acts2004/20040004.htm
110. Statutory guidance relating to the
Education (Additional Support for Learning)
(Scotland) Act 2004.; 2005. URL: http://www.
scotland.gov.uk/Publications/2005/08/15105817
/58187
111. Campbell H, Hill J. Health for all children
(HALL 4) 2004. Website: http://www.dhsspsni.
gov.uk/hssmd15-04.pdf
112. Scottish Executive. Building on success:
future directions for the allied health
professions in Scotland. Edinburgh: The
Stationery Office; 2002. URL: http://www.scotland.gov.uk/Resource/Doc/46729/0013995.
52
Appendix – Resources and references
7/27/2019 Paediatrics Guidelines07
http://slidepdf.com/reader/full/paediatrics-guidelines07 53/56
53
113. Scottish Executive. Delivering care,
enabling health. Harnessing the nursing,
midwifery and allied health professions’
contribution to implementing Delivering
for Health in Scotland. Edinburgh: Scottish
Executive; 2006. URL: http://www.scotland.gov.
uk/Resource/Doc/152499/0041001.pdf
114. The Scottish Executive Health Department.
Information management and technology(IM&T) strategy Edinburgh: The Scottish
Executive; 2002.
115. Welsh Assembly Government. Designed
for life: creating world class health and social
care for Wales in the 21st century. Cardiff:
Welsh Assembly Government; 2005. URL: http://
www.wales.nhs.uk/documents/designed-for-
life-e.pdf
116. Welsh Assembly Government. National
service framework for children, young people
and maternity services in Wales. Cardiff: Welsh
Assembly Government; 2005. URL: http://www.
wales.nhs.uk/sites3/home.cfm?OrgID=441
117. Welsh Assembly Government. Children
and young people’s specialist services -
standards. 2005 -.
Website: http://www.wales.nhs.uk/sites3/page.
cfm?orgid=355&pid=13958
118. Welsh Assembly Government. A therapy
strategy for Wales: the contribution of
therapy services to transforming the delivery
of health and social care in Wales. Cardiff:NHS Wales; 2006. URL: http://new.wales.gov.
uk/docrepos/40382/dhss/403821215/Therapy_
Strategy_Final_Engl1.pdf?lang=en
2007 Information to guide good practice for physiotherapists working with children
Notes
7/27/2019 Paediatrics Guidelines07
http://slidepdf.com/reader/full/paediatrics-guidelines07 54/56
7/27/2019 Paediatrics Guidelines07
http://slidepdf.com/reader/full/paediatrics-guidelines07 55/56
ENVIRONMENTAL
STATEMENT:
This document is fully
recyclable and made
from elemental
chlorine-free pulps
sourced from
sustainable forests.
The paper mill operates
an environmental
management system
to internationally
recognised ISO 14001
standard. When you
have finished, pleasepass this document
to another user or
recycle responsibly.
7/27/2019 Paediatrics Guidelines07
http://slidepdf.com/reader/full/paediatrics-guidelines07 56/56
CSP Headquarters
14 Bedford Row
London WC1R 4ED
Tel: 020 7306 6666
Fax: 020 7306 6611
Email: [email protected]
CSP Northern Ireland
Merrion Business Centre
58 Howard Street
Belfast BT1 6PJTel: 028 9050 1803
Fax: 028 9050 1804
Email: [email protected]
CSP Scotland
21 Queen Street
Edinburgh EH2 1JX
Tel: 0131 226 1441
Fax: 0131 226 1551
Email: [email protected]
CSP Wales
Cymdeithas Siartredig Ffisiotherapi
1 Heol Yr Eglwys Gadeiriol
Caerdydd CF11 9SD
1 Cathedral Road
Cardiff CF11 9SD
Tel: 029 2038 2429Fax: 029 2038 2428
Email: [email protected]
This document is available in a format forpeople with sight problems. Please call020 7306 6666 or visit www.csp.org.uk
C o n t e n t a n d d e s i g n c o p y r i g h t © T
h e C h a r t e r e d S o c i e t y o f P h y s i o t h e r a p y 2 0 0 7 .
CSP members £7
Non-members £20ISBN no: 978-1-904400-22-6
The Chartered Society of Physiotherapy is the professional,
educational and trade union body for the UK’s charteredphysiotherapists, physiotherapy students and assistants.
We support our members at work, and through services
such as our publications, courses and enquiries unit. We
play a key role in fostering professional learning and
innovation, and in championing physiotherapy’s role in
modern healthcare.