St Helens Neurodevelopmental

Pathway

Introductions

• Garry Joyce – Senior Integrated Children’s Commissioning Manager

• Julie Hoodless - DCO

• Sara Dolan – Parent Carer Forum

SEND Inspection Letter Comments

Joint commissioning is a strength of the local area. The development of the neurodevelopmental pathway demonstrates the commitment of senior leaders and managers to work collaboratively. Arrangements for working together are strong, from senior managers through to frontline staff.

Co-production with Listen4Change has been key to success in developing the neurodevelopmental pathways. The learning from this work is now paying dividends with the development of the new local offer, occupational therapy (OT) services as well as improving EHC planning processes.

The innovative neurodevelopmental pathway has transformed the accessibility, timeliness and coordination of specialist services for children, young people and their families. Parents and carers agree that referrals are dealt with efficiently and appropriately.

Families awaiting assessment as part of the neurodevelopmental pathway are able to access a range of training and support. This helps them better understand their children’s conditions and associated behaviours. Parents told inspectors about the positive impact of the range of training programmes offered. For example, some parents and carers reported that their child required no further support or help following the completion of these programmes.

Children and young people who are looked after have their needs identified and assessed quickly. For example, those referred into the neurodevelopmental pathway are routinely prioritised for assessment by individual services. This means that they are assessed within six weeks of referral so they receive the support and help they need quickly

The parent carer forum, ‘Listen4Change’, co-produced the neurodevelopmental pathway from its earliest consideration to its implementation.

Context

• Autism coordination established 2012/13• Challenges from the beginning – long waits,

inconsistent service involvement, complaints• Challenges from parents and local parent carer

forum• Services re-designed 2014 – 2015 SLT and

Community Paediatrics• Introduction of additional support services –

2015-16 • New NDP coordination function established 2017

Governance Arrangements

• Agreed establishment of Multi-Agency stakeholder group was crucial

• Involvement of CAMHS from start of pathway process for children with SEMH conditions

• Bi-monthly Meetings over 2 year period

• Within project plan, each phase was approved by the stakeholder group

Multi –Agency Stakeholder Group• Local Authority Assistant Director• Education Psychology• Specialist Teachers• Behaviour Improvement Team• SENCO• Head Teacher • Speech and Language Therapy• Occupational therapy• Community Paediatrics• CAMHS• Commissioners• ADDvanced Solutions• Parent Carer Forum• Healthwatch

Parent Carer Forum View

• Background

• Identifying St Helens Issues

• Feedback to Parent Carer Forum Members

• Now and the Future

Implementation Phase• Coordination team delivered by North West

Boroughs NHS Foundation Trust established• Coordination team consist of Clinical Lead,

Pathway Coordinator, Administrator• Establishment of electronic database for Early

Years and School Age Pathways • Focus on reducing backlog via additional

assessment panels and feedback sessions• Investment in ADOS training, Hanen ‘More Than

Words’ training• Documentation

Implementation Phase (cont)• Transforming pathway from Autism to wider ND remit

• Introduction of weekly multi-agency triage sessions involving pathway clinical lead, SLT, Specialist Nurse, OT and Consultant Psychiatrist (as required)

• Consideration of multiple potential diagnoses for Autism, ADHD, General Development Delay, Attachment Difficulty, Developmental Language Disorder, Social Communication Disorder through a single, coordinated assessment process

• On-going Monthly panels for Early Years and School Age, with increased capacity

• Feedback sessions to parents normally within a fortnight of the panel decision

How Does the Model Work• Referral – triage• Redirection to specific services eg. DLD• Coordinated assessment • Ongoing communication• Ongoing support throughout pathway process • Opportunity for ADOS, as required• Annually planned monthly multi-agency panels

for Early Years and School Age• Multiple diagnoses considered eg. Autism, ADHD,

GLD, DLD, Attachment, DCD etc.• Prompt face-to-face feedback sessions

Pathway Oversight Group

• Smooth transition at launch from stakeholder group to oversight group as per NICE guidance

• Ensure continual governance

Oversight Group Functions

• Current performance

• Issues arising and solutions

• Ongoing development of the pathway

What Have We Achieved

• Early identification of needs• Early and ongoing access to support services• A shorter journey for children with complex

needs from referral to diagnosis decision• Current average waiting time from referral to

panel decision is 26 weeks• Pathway discharge letters which confirm

diagnoses other that Autism eg. ADHD, General Development Delay, Attachment Disorder, Developmental Language Disorder, Social Communication Disorder.

Feedback from the latest Parent Carer Forum

Meeting that was held on 1st November 2018