Archived decisions

REPORT OF THE

HEALTH REVIEW COMMITTEE

PART II

ACCESS TO THERAPY SERVICES FOR CHILDREN IN SCHOOL AND PRE-SCHOOL

1. Under the Chairmanship of Councillor Mrs. McNair Scott the Review Group looked at the Therapy services which included speech and language; occupational and physiotherapy.

2. Speech and language therapy falls into two categories - receptive and expressive. Any child who has problems with understanding language will also have problems with expression, but some children have good receptive skills whilst being unable to formulate their thoughts and feelings into spoken language. Some children will be generally delayed i.e. their development in all areas will be slower than usual. For others development occurs at a generally normal pace with the exception of one or more areas of speech and language.

3. Occupational therapy is concerned with all aspects of a child's life and occupational performance. Children with difficulties such as Development Coordination Disorder (DCD), Autistic Spectrum Disorder and development delays have problems with everyday tasks requiring motor coordination such as handwriting, dressing and learning to ride a bike. DCD can severely limit school performance, self-esteem and age appropriate activities of daily living.

4. Physiotherapy is required for children who have a general delay, disorder of movement, disability or illness that may be improved, controlled or alleviated by physiotherapeutic skills and/or the use of specialised equipment. The aim of the paediatric physiotherapist is to encourage each child to fully develop his/her potential so that maximum function is achieved, deformity is prevented or reduced and the effect of the handicapped minimised.

5. A variety of methods were adopted to inform the review working group and it was apparent from an early stage that the issues surrounding the delivery of therapy services to children were very complex. The methods adopted for the review were:

    · Interviews with staff in each locality area.

    · Interviews with therapy managers centrally.

    · Questionnaires to therapy service representatives.

    · Questionnaires to each Primary and Infant School.

    · Desk research to examine academic work that had been conducted. Meetings with the Strategic Health Authority regarding a planned Health Network

    · Meetings with Social Services for Information of Hampshire's implementation of the Children Bill.

    · A visit to a Special School to discuss issues.

    · Observation of speech and language therapy sessions in a mainstream school.

6. On deliberating all of the evidence collected the review group concluded that the availability of therapy services to children in school and pre-school across Hampshire is inconsistent, lacking in strategic leadership and carries unacceptable waiting times. No one organisation or partnership maintains an overview and many children receive no services at all.

7. The following recommendations were made to and accepted by the Committee:-

    i. The Children's Board becomes the lead agency - The Children's Board has agreed to incorporate the findings of the review into future work that it will be on `integrating children's services'.

    ii. The formation of a Therapy Services Partnership - expanding the existing group of education officers and speech and Language Therapists to include Occupational and Physiotherapists and become the main mechanism for collecting information from the Local Implementation Teams, developing county-wide strategic direction and advising the Children's Board.

    iii. Therapy focus for Local Implementation Teams - these to be Primary Care Trust led multi-agency networks focusing on delivering recommendations from the National Service Framework through managing and monitoring services within their areas.

8. This supports Aims 1, 4 and 5 of the Corporate Strategy.