Agenda item

Report of Lynn Wilson, and Joanna Clark, Director of Operations, Medicine, Community and Older Person’s Mental Health.

The Committee received a report on the current delivery of therapy services for children in Gateshead, outlining the functions which the three therapeutic services (SALT, Physiotherapy and OT) deliver, the anticipated impact of receiving such a service and the outcome measures collated. Since the SEND inspection, progress has been made on waiting times.

Speech and Language Therapy (SALT)

Within Gateshead Health, there is a team of 24 Speech and Language Therapists who offer support and treatment to children within the Borough. The teams are linked with existing school provision, including special schools and ARMS provision. The impact of high quality, timely intervention can achieve the following outcomes:

·        Provide learning opportunities for the development of skills, confidence and competencies through a range of mechanisms and mediums including coaching, modelling and learning activities.

·        Raise awareness of speech, language, communication and swallowing needs and their impact on an individual's ability to take part in day -to -day activities (especially in the workplace and educational settings) and advocate for children and young people’s rights and needs

·        Provides reassurance, coaching and learning opportunities to enable families to support communication and swallowing development

·        Provides advice, training and support to early years, schools, community and other settings to foster inclusive environments.

·        Develops and delivers evidence based functional interventions in partnership with children and young people, their families and others around them

·        Provide children and young people with access to approaches and resources so they can communicate.

·        Provides training and support to families and other professionals so that they can safely support children with eating, drinking and swallowing 

At present the teams have been focusing on reducing the waiting times for an assessment through collaborative work with Portage, group work, parent support and outreach. The number of children waiting for assessment has reduced by 77% since August 2023 with 4 children waiting over 18 weeks in mid-November. Patients are then appointed for a block of therapy dependent on clinical assessment. Work is ongoing to reduce this further.

Occupational Therapy (OT)

Within Gateshead there is a small team of specialist paediatric OT’s who deliver targeted and specialist interventions to children on referral from universal services.  Many children with the most complex needs require support and equipment to develop more personal independence, OT’s have skills that allow them to do so and without their input children can become socially isolated and marginalised.

OT’s select interventions for children based upon an assessment of the child, whether they are affected by disability and how their environment supports or constrains them in reaching their full potential.

The team is working on reducing the waiting times for Paediatric OT. Full recruitment has now taken place and they have commenced a number of new initiatives, focusing on group work sessions and structured information support, as well as working with colleagues across the region to build on successful programmes such as “Sensational Thinking” which delivers two sessions for patients with sensory challenges to support them and their families to address any issues which they have. These alternatives to traditional ways of service delivery will yield results with ambitious plans to reduce the waiting list significantly by March 2024.

There remains a significant wait for these services, details of which can be found at point 6.

The team collect outcome measures based on the achievement of individual goals set for each child (for example, dressing, holding a pencil).

Physiotherapy

The team within Gateshead work collaboratively to maximise children’s potential.

The physiotherapy team also run regular orthotic clinics supported by an Orthotist. Physiotherapy in school is integrated into the school day.

There is currently a short wait for children’s physiotherapy within Gateshead with children seen promptly.

The team collect a variety of outcome measures including those relating to CPIPS (Cerebral Palsy), GMFCS (Cerebral Palsy), AIMS (Delayed development), Beighton Scale (Hypermobility), Wong Baker Scale (Pain), Two minute walk test (Mobility), Goal Attainment Scale (all children), Modified Ashworth Scale (children with neurological difficulties), Pirani Scale (Talipies), Star Balance Scale (children with neurological difficulties.

The Committee was concerned about the impact of resource shortage on contact time being reduced in therapies.

Significant challenges around selective muteness and potential future cases around motor control were both highlighted as consequences of COVID 19. 

Links have been established in schools to identify difficulties that children may be experiencing, there is also consideration being made of best practice across the region.

The Committee was pleased to hear about the holistic approach and the work done to include schools in therapeutic work.

RESOLVED

       i.          To circulate further information to the Committee on cases of selective muteness.

      ii.          The Committee noted the report.