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Children’s Community Physiotherapy Service

Occupational Therapy

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GSTT Children’s Community Physiotherapy Service

More information about the Physiotherapy Services offered where support is needed within a school or setting.

The Physiotherapy Service offers the following services when working with a child or young person within a school or setting.

  • Assessment of physical needs and functional ability in the school setting to access curriculum.
  • Development and provision of a physical management and enablement programme and agreement with the school how the programme will be monitored.
  • A training programme for school staff to prepare a school for loco parentis function. This will involve one school based visit where an explanation and demonstration of the programme to all adults working with the child in the class is provided. Physiotherapy staff will clearly identify how often activities recommended are required by the child, taking into account the school setting, and will discuss with staff how best to integrate activities within the school day. How staff chose to best deliver the programme on a day to day basis will be the decision of the teaching staff. The physiotherapist role is to provide advice and guidance.
  • A second visit to support training of the physiotherapy programme and specialist equipment will be provided when a child’s needs are more complex. This will be counted as one of the maximum of 4 sessions per year per child which is the core offer.
  • Assessment and prescription for any specialist physiotherapy equipment required by the child to support access to National Curriculum. Where specialist equipment is required the physiotherapist will make recommendation of this to the school/ SEN for purchase.
  • Setting up equipment when it arrives at the school with a demonstration of how to use the equipment to class based staff and any other school staff identified as requiring training by the school.
  • Liaison with class teacher/ LSA to review physiotherapy input and discuss any concerns (where appropriate).
  • Reviewing physiotherapy recommended school/nursery equipment, purchased by SEN where there are either changing therapy needs of the child/young person, where the child/ young person has grown and requires a larger size of equipment, or where parents/ school report a concern. When there is a physiotherapy recommendation to change equipment due to a changing need this will be discussed with parents and school staff. Sometimes a child/ young person will require the same equipment which they use at home, in the school setting, sometimes the equipment will differ to meet the child’s needs in a school setting. If the child needs to be assessed in the item of equipment and an appointment is required with an equipment company the assessment may take place in either the home or school setting wherever is deemed clinically more appropriate for the needs of the child. Parents will be invited to any assessments which take place in the school. .
  • Being available by telephone throughout the school year for any concerns staff may have regarding the child’s physiotherapy programme or equipment.
  • Review reports for the EHC plan will be written where this is requested by a parent, young person or by the school for a child is on an open caseload known to the physiotherapy service. A single page report giving an update of the physiotherapy needs where they have changed will be provided in time to inform the EHC plan review with copies being given to parents and school.
  • Written contribution where requested to the IEP and annual review if the child is on an active caseload

Interventions are delivered in a maximum of 4 sessions per child per academic year

A session consists of 45 minutes of intervention/advice/training for both the student and the responsible adults working with the child who will be implementing advice. Parents will be informed of the school visits as part of the ongoing physiotherapy of their child and invited to school reviews. At the school visit the therapist will involve the parent/carer in the decisions about the physiotherapy programme. Where a parent has been unable to attend a school visit e.g. when new equipment has been tried, the physiotherapist will communicate with the parent/carer on the outcome and next steps.

If an urgent medical need arises and additional physiotherapy advice/intervention is required e.g. following orthopaedic surgery, the core service will provide additional sessions to meet changed physiotherapy All client related activity such as medical record keeping, production of goal sheet, written advice, written programme or photo programme, arranging equipment representatives, procuring quotes for equipment etc. which has been agreed in liaison with parents will be included within the core service but will be completed outside the delivered individual session at an NHS base. (This is because staffs require access to NHS databases and specialist software.)

Physiotherapy services for Children with Complex Postural Management Needs:

  • Assessment of the child and the environment with recommendations and advice for appropriate equipment
  • Liaison with the wheelchair services and equipment companies , altering / changing equipment as needed
  • Reviewing the child’s postural management needs as required and discussing any changes to the programme with the parent /carer.
  • Demonstrating safe transfers into therapy equipment to school staff.

Physiotherapy services for Children with splinting/ orthotics needs

Children’s splints/ orthotics will be reviewed and altered as required. This will take place in the orthotics clinics based at the child development centres.

Case Examples

1. A session with a child who has a mild physical disability would typically consist of a discussion of school based concerns with staff, assessment of the child in relation to the difficulties, physiotherapy advice and recommendations, training of child and school based staff through demonstration of activities, use of splints if appropriate, discussion about implementation of activities within school day. The written version of this advice will be sent on to the school with a copy also being sent to the carer/ young person/ family after the visit.

2. A session with a child with complex needs would typically consist of a discussion of school based concerns with staff, assessment of child in relation to the difficulties, physiotherapy advice and recommendations, physiotherapy goal setting, assessment of equipment, training staff through demonstration of activities, observation of staff to check competency, discussion about implementation of activities within school day. The written version of this advice / photo programme will be sent on to the school after the visit. An additional copy will be given to the young person/ parent/carer.

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