Health and wellbeing

• Partnership for Inclusion in Neurodiversity (PINS)

The mental health conditions typically seen are:

• Anxiety disorders
• Depression/low mood
• Psychosis
• Obsessive-compulsive disorders
• Eating disorders
• Self-harm / suicidal thoughts

North Lincolnshire CAMHS provides a range of interventions as identified by the National Institute of Health and Care Excellence guidelines to address the identified needs of each child, young person and family. This could include individual, group therapies, family work, medication where indicated, inpatient care if required, joint working or providing support to other agencies in a consultative manner.

CAMHS runs the THRIVE model of care. This means pathways are split into Getting Advice, Getting Help, Getting More Help and Getting Risk Support.

The team accept referrals from young people, parents/carers and professionals.

This team provides multiple functions:

• Single point of access – responsible for triaging referrals, signposting and guidance, completing onwards referrals, advice and support
• Consultation to professionals including education providers, early help and youth justice to look at what support can be provided outside of CAMHS
• Here and Now Therapy – this model of care is goals focussed and a short-term intervention

If needed Getting Advice can refer care into Getting Help.

Getting Help is the next stage in the THRIVE pathway, though you do not need to have accessed Getting Advice to access Getting Help.

Getting Help is designed to support children and young people whose mental and emotional health needs are considered to be more complex and/or enduring.

Getting Help may complete further, and more in-depth assessment of a young persons needs.

Care may involve:

• 1:1 session with an allocated worker
• Group work sessions with other young people
• Working with other professionals' doctor or therapist.

If needed CAMHS clinicians can collaborate with the psychological therapies team, and this forms our Getting More Help offer of care. This can include access to Cognitive Behavioural Therapy, Interpersonal Psychotherapy and Drama Psychotherapy.

Children and Young People's Mental Health Service – Community Services (Doncaster, North Lincolnshire & Rotherham). Community-based services for children and young people with urgent mental health needs.

Overview

The CAMHS Crisis Team are a specialist trust wide team offering urgent assessments 24 hours a day 7 days a week for three acute sites, Doncaster Hospital, Rotherham Hospital and Scunthorpe General Hospital. The service has a dedicated helpline. Typically, this is a child or young person where there is significant risk to self or others. We work in partnership with families and other agencies involved with the child or young person, to carry out assessments. We accept referrals from children and young people up to the age of 18 years of age (transition to adult services begin at 17 and a half years old). Young people and their families can refer directly to the crisis by contacting the Single Point of Access Service (01302 566999 or 0800 8048999) 24/7. Additionally, through A&E’s, Ambulance services, Police, schools, social care and GPs can also refer directly via SPA (see above)

Children and Young People’s Mental Health Service – Community Services (Doncaster, North Lincolnshire & Rotherham). Community-based services for children and young people with mental health needs

Overview

The Intensive Community Support Services are a specialist trust wide team providing extended assessments trust wide. Typically, this is a child or young person where there is significant risk that the network is struggling to manage in the community. We also provide intensive support to young people at risk of being admitted to Tier 4 hospital settings. This can be flexible from daily visits to twice a week contacts, this is planned with the young people and families. ICST also provide support to young people being discharged from Tier 4 and are involved throughout admissions to facilitate effective transitions back into the community.

We work in partnership with families and other agencies involved with the child or young person. We accept referrals from children and young people up to the age of 18 years of age (transition to adult services begin at 17 and a half years old). We accept referrals form colleagues who are concerned about a young person’s presentation and feel they may need intensive community support or a tier 4 admission as the risks cannot be managed in the community via System 1.

We are a small team within the mainstream North Lincolnshire Child and Adolescent Mental Health Service (CAMHS).

Our team consists of Specialist CAMHS learning disability nurses, psychiatrist, psychologist and a clinical support worker.

Our aim is too support children and young people with a significant intellectual disability who experience challenging behaviour or mental health difficulties.

We work in partnership with families and other agencies involved with the child or young person, to carry out assessments and interventions with individuals, families or groups, or offer consultation to agencies.

The specific services we provide

• Assessment of skills, strengths and specific difficulties
• Psychiatric assessment and medication
• Functional Behaviour Assessments
• Positive Behaviour Support Framework
• Behaviour management advice & interventions
• Counselling for young people and parents
• Psycho-education
• Adapted Cognitive Behavioural Therapy
• Training in Intellectual disabilities and mental health or developmental problems
• Group work
• Family work
• Support in conjunction with Neurodevelopmental pathways such as; Autistic Spectrum Condition (ASD) and Attention Deficit Hyperactivity Disorder (ADHD).
• Emotional Regulation

We may also offer consultation and training to other services and families, including those working with pre-school children, and where appropriate may work jointly with referrer and other services to offer the best package of care.

Our pathway and referral process

Our pathway provides a service to children who have a significant intellectual disability (moderate/ severe/profound). Who have additional complex behaviours or mental health which requires the input of specialist provision.

We work with children and young people aged between 5 and 18 years (transition to adult services begins at 17 years 6 months).

The child or young person must be registered with a local GP in North Lincolnshire.

Anyone involved in a child or young persons life can make a referral if there are significant concerns in relation to behaviour or mental health. We follow the same pathway as CAMHS and a referral form can be found on our CAMHS website.

During the referral process we will gather information on the child or young person assessing their intellectual disability and primary need. This may include visiting the child within their school and home environment. It is important to observe a child or young person in both environments to get a holistic view of what may be causing their behaviour or mental health difficulty.

We are a small team within the mainstream North Lincolnshire Child and Adolescent Mental Health Service, also known as CAMHS made up of Psychologists, Art Psychotherapists, a Mental Health Nurse and an Assistant Psychologist.

We work with children and young people age between 5 and 18 years old who have care experience which means children living in foster care and care leavers. We also work with adults caring for younger children.

Sometimes young people may need support with the emotional and mental health past the age of 18 and we then support these young people to transition to adult services if the young person consents to this. Transition means moving from one service to another.

Types of help we offer

The focus of any therapeutic support will be based on what is important to you and helping you to have good mental health. We use a variety of different therapeutic approaches depending on the age of the young person we are working with and what feels right to you and include talking therapies, art or play therapy approaches or a mixture of these.

• Help with regulating different emotions. This means learning about the emotions you experience, understanding them including when these feelings are around, where they happen and who you are with, and how to cope with them.
• We can help with different emotions such as anger, anxiety and worry or feeling sad (sometimes called low mood).
• Help with coping with new situations and new relationships.
• We can help you in thinking about your experiences including loss and trauma (trauma means an upsetting experience that has impacted you).
• We can help with mental health difficulties including: anxiety; low mood; phobias (meaning fear of certain objects, places, situations, animals and/or people); Obsessive Compulsive Disorder (OCD), (this is having upsetting thoughts (obsessions) that lead to behaviours that have to be repeated – compulsions), and psychosis (this is the experience of hearing or seeing things that other people cannot see or hear)
• We can also help with difficulties relating to food and eating.
• We can help you to have positive relationships with others.
• Help for if you self-harm.
• Assessment of mental health and emotional wellbeing. This means we would think together about how you are feeling, what you might be finding difficult at that time, what you might have experienced and how this might be making you feel, as well as what you feel is going OK in life.
• We also provide therapeutic parenting advise to foster cares. Therapeutic parenting is a nurturing way of parenting to help young people to feel safe in their relationships with adults.
• Therapy might be offered with you and your foster carer together. The aim of this kind of therapy, which is sometimes called dyadic (meaning 2 people) is to help with positive relationships, understanding relationships and to help build trust.
• Sometimes CAMHS work with foster carers, social workers and school staff; we call this a network meeting (the word network here means other people who might be involved in supporting you). These meetings are to make sure we are all working together to support you.

Referral Process

As a young person you will need to be registered with a GP (Doctor) in North Lincolnshire. If you are 13 or older you can make a self-referral to CAMHS, this means you can fill out the online form yourself, or you can ask an adult to do this for you, for example this could be your social worker or foster carer. If you are under 13 an adult can fill in the referral for you, the adult will ask if you are consenting to the referral before they do this, consent means they will ask your permission.

Anyone involved in a child or young person’s life can make a referral to CAMHS if they are worried about a young person’s emotional health and well-being or mental health.

The online referral form can be found on the RDaSH website.

Depending on how old you are and what the referral is asking for we will make a telephone call to you and also your social worker (this is called triage which just means collecting information) and will agree a plan with you or with the Network of people supporting you.

Our aim is to support and enable neurodiverse children and young people with social communication and interaction challenges and those on the Autism Spectrum to:

• have equal access to every part of education
• achieve their potential and make a successful transition to the adult world
• be able to assert their individual perspectives and experiences of the world
• benefit from attending schools and settings who understand the impact of social communication and interaction challenges and Autism and work with children and young people to find solutions to identified challenges
• be included in schools and settings who understand neurodiverse needs challenges and ensure reasonable adjustments are used in a strengths-based approach.

We work closely with the Complex Behaviour Team who support and enable parents to support children with complex behaviour presentations linked to social communication and interaction and other neurodivergent needs

Transitions can be tricky for autistic children and young people. The transition from Year 6 to Year 7 can be an exciting challenge with a lot to look forward to.

We have worked with schools and listened to parents to put together transition support to enable a successful move from primary to secondary settings.

Children will be supported on a strengths based, needs led approach ensuring they receive the appropriate support.

Please talk to your primary school if you have any worries . We are in regular contact with all schools.

All Year 6 autistic children’s parents known to ASET will have received a letter outlining transition support.

Please use the resources here to help you talk with your child about the prospective move and help them feel they can manage this confidently.

There are a range of professionals you can contact if you are worried. Who you contact will be dependent on your child’s age:

• Explain your worries to your Health Visitor, Nursery or Childminder. There may be simple changes you can make to support your child’s communication and interaction
• Go to your local Family Hub and ask to talk to someone about your concerns. They will work with you to decide what next steps to take.
• Talk to your child’s pre-school, school or college about your worries. If they are pre-school then support can be requested from the Speech and Language Therapy team (see Therapy pathways). If your child is attending a school/college talk to a member of Staff who knows your child well or ask to speak to the SENCO. They may or may not share your concerns but will listen and together you can develop a plan for next steps.
• You may want to consider asking a professional whether to start an Early Help Assessment. This will enable you to ask advice and be offered support from a with a range of professionals where appropriate.
• It is important you share any concerns with a professional who can then direct you to further support. This may involve liaison with the Autism Spectrum Education Team (ASET) and Education Psychology Service. Where necessary, they will observe/meet with your child, meet with you and other professionals who know your child well.

In North Lincolnshire we have a Multi Agency Pathway for autism and attention deficit hyperactivity disorder.

The Autism Spectrum Education Team (AST), Behaviour Support Team (BST), Education Psychology (EPS) and the North Lincolnshire Neurodevelopmental Service (NDS) work together to ensure that we have a strengths based, needs led process to support children and young people. We have:

• A single Neurodiversity Team offering a single point of access to assessments for autism and adhd
• A graduated approach to completing referrals which gathers a wide range of information
• Greater awareness is given to the support from ASET, BST and EPS as well as information from nurseries, schools and colleges. This is done at the earliest possible stage so that needs-led interventions are put in place based on presenting need regardless of diagnosis.

ASD-ADHD-Pathway [242KB] PDF

Once you receive the diagnosis you will be asked by CAMHS if you would like to have your information shared with the Autism Spectrum Education Team (ASET) This will allow the team to discuss your child with school and also to send you information about our courses for parents of newly diagnosed children. Our courses are delivered in person and run twice a year for 7-8 weeks. See Support provided to children, young people and families section below.

If you have concerns about your child in school, then you should speak to their teacher and SENDCO, they may already be aware and working with your child. One of our Team will be linked with your child’s school to offer advice and support for children and young people both with a diagnosis and those who have social communication and interaction challenges.

Look at our Local Offer pages for other support agencies, for example SENDIASS, Short Breaks, Carers Support Service, and North Lincolnshire Parent Forum.

There are also lots of national organisations which have informative websites for example the National Autistic Society.

Deciding when and how to talk to your child about their diagnosis is an entirely personal decision dependent upon their own level of awareness and understanding.

There are a number of websites and resources available that can help you know what to say and where to begin:

• NHS/RDaSH - Talking together about an autism diagnosis
• Bristol Autism Support – How to tell your child about their autism diagnosis
• West Midlands Autism – Talking to your child about autism.

The following books may help when discussing autism with your child:

• Autism, Identity and Me
• Autism: How to raise a happy child
• The Ice-Cream Sundae Guide to Autism: An Interactive Kids' Book for Understanding Autism
• The abilities in me: Autism
• Can I tell you about Autism?: A guide for friends, family and professionals
• Different Like Me: My Book of Autism Heroes
• Autism and Me: An Empowering Guide with 35 Exercises, Quizzes, and Activities!
• The Secret Life of Rose: Inside An Autistic Head

There is a range of support available including:

• Information about the Autism Spectrum and the impact it can have on the individual
• Support for your child/young person
• Liaison with professionals and agencies to offer advice, support and enable families with a solution focused approach
• SCIP and SPAA course details. One day course with the opportunity to attend specifically focused satellite sessions. Families can attend the sessions that they feel would be most beneficial.

There is a range of support for schools, settings and other agencies including:

• A Toolkit: The Autism Spectrum Education team Support Strategies document helps schools and settings identify needs and put in place simple strategies to help your child. This can be used with children and young people with or without a diagnosis
• Support packages and individual help to develop the communication, social interaction, imaginative and emotional skills of your child at all stages of school and college
• Information about the Autism Spectrum and related difficulties alongside access to a library of resources which can be used to support a young person in explaining their diagnosis. Support in explaining a young person’s diagnosis.
• Training for staff in all aspects of the Autism Spectrum, Social, Communication and Interaction challenges and associated training such as Social Stories and Sensory needs
• Advice to staff on your child’s individual barriers to learning
• Supporting schools in educating their own settings about the Autism Spectrum
• Educating classmates about the Autism Spectrum
• Help for your child with school/setting transitions
• We work closely with other professionals to provide ‘joined up’ approach to support
• We can offer bespoke training for agencies and professionals.

These are the people in our team:

• Tim Mellors, Teacher in Charge
• Clare Noble, Teacher in charge of Primary
• Vicki Turner, Specialist Teacher (Base)
• Julie Dawson, Outreach Practitioner
• Tamara Pullan, Outreach Practitioner
• Wendy Brown, Outreach Practitioner
• Tricia Protheroe Outreach Practitioner
• Donna Ford Outreach Practitioner
• Rebecca Lyons Specialist Teacher

You can view the Autism Toolkit KS1 - KS2 document if you need further information and support.

• To provide support and advice for parents and carers of children with complex needs where behaviour within the home can be challenging to manage.
• To enable identified families to feel empowered to implement behaviour changes that will improve outcomes, build confidence, enable self-help, and contribute to them being safe, well, prosperous and connected.
• Work with other professionals to ensure children/young people with complex needs are kept within their family and communities as appropriate.

All children can behave in ways that are difficult to deal with and are generally linked to a child’s stage of development and communication. For children with Learning Disabilities or Autism, this behaviour can be more challenging, and parents/carers may require specialist advice.

Often, challenging behaviour is a result of frustration or anxiety. Adults may find this a challenge to understand and manage.

We support parents and carers to understand their child’s behaviour. We do this by seeking to identify what the child is trying to communicate through their behaviour and identifying ways to manage these which may involve changing responses and strengthening connections.

We work closely with a range of professionals and services.

The people in our team are:

• Sarah Huddart, Senior Officer
• Myra Seal, Outreach Practitioner
• Angela Hunt, Outreach Practitioner
• Anila Haq, Outreach Practitioner.

In North Lincolnshire we have a Multi Agency Pathway for autism and attention deficit hyperactivity disorder.

The Autism Spectrum Education Team (AST), Behaviour Support Team (BST), Education Psychology (EPS) and the North Lincolnshire Neurodevelopmental Service (NDS) work together to ensure that we have a strengths based, needs led process to support children and young people. We have:

• A single Neurodiversity Team offering a single point of access to assessments for autism and adhd
• A graduated approach to completing referrals which gathers a wide range of information
• Greater awareness is given to the support from ASET, BST and EPS as well as information from nurseries, schools and colleges. This is done at the earliest possible stage so that needs-led interventions are put in place based on presenting need regardless of diagnosis.

View the ASD-ADHD Pathway [242KB] PDF

The North Lincolnshire Family Toolkit is intended to support families of children and young people with communication and interaction differences in the home. It will help you to:

• Have a better understanding of why your child might do what they do
• Identify things to try at home
• Help you give information about your child’s strengths and challenges to others.

Families can use the toolkit directly or with support from any involved professional to identify and discuss areas they would like help with.

The North Lincolnshire Family Toolkit [4.94MB] PDF

Deciding when and how to talk to your child about their diagnosis is an entirely personal decision dependent upon their own level of awareness and understanding.

There are a number of websites and resources available that can help you know what to say and where to begin:

• NHS/RDaSH - Talking together about an autism diagnosis
• Bristol Autism Support – How to tell your child about their autism diagnosis

Books that may help support your conversation

• Autism, Identity and Me: A Practical Workbook and Professional Guide to Empower Autistic Children and Young People Aged 10+ by Rebecca Duffus
• Autism: How to raise a happy autistic child by Jessie Hewitson (2018)
• The Ice-Cream Sundae Guide to Autism: An Interactive Kids’ Book for Understanding Autism: Debby Elley & Tori Houghton
• The Abilities in me: autism by Gemma Keir (2019)
• Can I tell you about Autism? A guide for friends, family members and professionals by Jude Welton (2014) (for readers 7 years plus)
• Different Like Me: My Book of Autism Heroes: by Jennifer Elder (2005)
• Autism and Me – Autism Book for Kids Ages 8-12: An Empowering Guide with 35 Exercises, Quizzes, and Activities!: by Katie Cook (2021)
• The Secret Life of Rose: Inside an autistic head by Rose Smitten (2021)

Referrals can be made by any professional working with your child. Parents/carers can also self-refer.

Before making a request for involvement from Portage, it is expected that children will have first accessed support and intervention provided by universal services, such as by a Community Nursery Nurse or Play and Development Groups, or through an early years setting as part of a graduated response.

Referrals for Portage involvement should be accompanied with relevant information about the child’s development, the names of other professionals involved, and an overview of previous support that has been accessed. If the child attends an early years setting then evidence from the setting should also be provided.

The completed referral form must be signed by the referrer and by the parent or person with parental responsibility.

Referrals are discussed fortnightly (during term time) at an Early Years Multi-Agency Meeting. The referrer will be informed of the outcome of the request within 10 working days following the meeting.

If you are unsure whether to make a referral you can contact the Portage Team to discuss on 01724 296679.

Please send the completed Request for Early Years Support Form and supporting information to EYMAT@northlincs.gov.uk.

Once it has been agreed that Portage will work with your child, you will be contacted by letter to inform you that the referral has been accepted. A Portage Practitioner will then be in touch with you to arrange an initial home visit. Sometimes there can be a little wait for this first contact depending on the time of year and capacity of the team.

During the first home visit, the Portage Practitioner will explain to you how they work with families and find out more information about your child. They will then plan further involvement based on the individual needs and circumstances of your child and family.

This can involve further home visits, invitations to individual sessions at a Children’s Centre, attendance at Early Help meetings (if applicable), and visits to see your child in a nursery or preschool (if they attend a setting).

It is the role of Portage Practitioners to:

• Assess your child’s development
• Identify strengths
• Identify areas of development to work on
• Support transition into a nursery, pre-school or a school-based nursery (if they are not already attending an early years education setting).

Our team is skilled in breaking down learning into small achievable steps. We will work with parents/carers and early years settings to demonstrate how this can be achieved with your child to enable them to reach their own individual potential.

If you are either looking for a suitable nursery or pre-school placement, or your child already attends one, we will provide support to ensure they are settled and have supportive access to learning – also supporting any transition.

We work together with other professionals involved with your child. We are also able to support you in further appropriate referrals to additional agencies if required.

Portage Practitioners aim to enhance the understanding, confidence and skills of the parents/carers and adults working with your child.

Portage involvement comes to an end when your child is due to start school (Reception Class), or if their educational needs are being met successfully within an early years setting and there is no longer a role for a Portage Practitioner.

Our Dynamic Support Keyworkers work with autistic people and people with a learning disability aged up to 25 years who are on the Dynamic Support Register rated RED, AMBER, or BLUE (inpatient).

Dynamic Support Keyworkers make sure that people and their families/carers get the right support at the right time. They aim to lower admissions to mental health hospitals and support people leaving hospital.

Our service has been developed as a response to the NHS England long term plan. Full details can be found on NHS England’s Children and Young People Keyworker webpage.

Dynamic Support Keyworkers help by:

Listening

• Listening to your thoughts and feelings.

Acting

• Working with services to try and reduce barriers and achieve change.
• Being the main point of contact for people and their families.
• Making sure care continues once keyworker support is no longer needed.

Doing

• Creating a plan together about what matters to you.
• Supporting you to get the right care.
• Planning for you to live in the community with the right support.

Our service can support you if you are:

• Aged up to 25 years of age. If you are aged 18 or over allocation of a keyworker will focus on the transition between children and adult services.
• On the Dynamic Support Register rated either RED, AMBER, OR BLUE (inpatient). People who are identified as GREEN may receive advice and information.
• Have a GP in North Yorkshire, York, Hull, East Riding, North Lincolnshire, or North-East Lincolnshire.

We are happy to take questions from people, their families or carers, and professionals. We can also arrange an interpreter for you or your family if you need one.

Our service flexible to meet individual needs:

• We can arrange for an interpreter if you or your family need one.
• Let us know if you want or need information in a certain way and we will try to provide this.

Our service is confidential. We will discuss with you who we share your information with. If we are concerned about the safety of a person, we have a duty to report this. We are committed to working with the Safeguarding Children’s Board Guidelines and the Principles of the Children Act 1989.

The Lead Professional handling the person’s care must make a referral once the person is registered on the Dynamic Support Register (DSR) by filling in a referral form. When referring a person who is aged 13 or over, please seek their consent. If a person is unable to consent themselves, please seek parent/carer consent – Consent form.

If you cannot access either of these forms, please contact us.

If you are unsure whether a person is registered on the Dynamic Support Register (DSR) then please contact your DSR Lead:

• Humber (Hull, East Riding, North Lincolnshire, North East Lincolnshire): hnyicb-ery.admissionvoidancehub@nhs.net
• North Yorkshire and York: hnyicb-ny.dsrrequestsnyy@nhs.net

Your feedback is important to us, we would really like to ask you a few questions based on your experience of our services. To take part in our Friends and Family Test Survey (also available in Easy Read Format) please follow the link and enter the Team Code KS112 when prompted: Friends and Family Test.

Local Support Groups in North Lincolnshire are:

• ASK Autism Support Group
• Magic Moments for Autistic Kids
• North Lincs PIP Forum

To make a complaint about an NHS service

Most NHS care and treatment goes well but sometimes things can go wrong. If you are unhappy with your care or the service you have received, it is important to let the NHS know so they can improve. Take a look at the NHS website for more information.

The Patient Advice and Liaison Service (PALS) offers confidential advice, support and information on health-related matters. They provide a point of contact for patients, their families and their carers.

You can find officers from PALS in your local hospital.

Work to help make services better for people living in North Lincolnshire. They listen to your experiences, comments and concerns around the health & care services you use.

Then ensure your voices are heard by those with the power to make change happen.

If you are not happy with an NHS or Social Care service and you do not want to make a formal complaint, you share your experiences with Healthwatch via a survey. Visit the Healthwatch website for more information.

Your School Nursing Team consists of trained nurses, health care assistants and clerical staff. They are trained to work with children, families and school staff and have a special interest in every school aged child’s health and wellbeing.

The team has links with many other professionals, who also work with children, to support children and young people throughout their school life. They provide a link between education and health.

The team works between Monday to Friday from 9am to 5pm during term time. There is a restricted service during school holidays.

For more information visit North Lincolnshire School Nursing.

Find information on GP surgeries including how to register and book appointments to see a doctor. Use the address search tool to find your local GP surgeries for a local practice near you.

Your pharmacy can provide you with much more than just dispensing medicine. Pharmacists are highly-trained and qualified professionals and they can offer you advice on treating many minor illnesses and ailments, such as coughs and colds, or long-term conditions such as asthma, arthritis or diabetes. They can also give you advice on keeping healthy by eating well, stopping smoking and taking part in exercise.

Pharmacies have longer opening hours than GPs, you don’t need an appointment to see one and most have a consultation area where you can speak privately.

For contact information and opening times for local pharmacies visit the Find Pharmacy Services on the NHS Choices website and type in your postcode to find your local pharmacies.

Find out why regular eye tests are important. Not only will they tell if you need new glasses or a change of prescription, they are also an important eye health check. An eye test can spot many general health problems and early signs of eye conditions before you are aware of any symptoms. You could be entitled to free NHS eye tests or optical vouchers. Search for your nearest opticians.

• Child and Adolescent Mental Health Service (CAMHS)
• Children's Community Nursing
• Children’s Occupational Therapy
• Children's Physiotherapy
• Children's Therapy Team
• Community and Therapy Services – NHS
• Dental Treatment for people with special needs
• Emotional Health and Wellbeing
• End of life care
• Healthwatch
• Health and Wellbeing Service (0-19) (includes school nurses and health visitors)
• Speech and Language Therapy

Therapy Service Pathways

Each Service within the Children’s Therapy Team has a detailed pathway showing the steps that take place following referral as well as the journey your child may take after assessment. Further Information about services can be accessed through the NLaG Trust website.

• Local-Offer-ASD-ADHD-Pathway
• Children's Occupational Therapy Intervention pathway
• PT Intervention pathway

Please note: the documents above may not all be accessible. If you need a document in another format, please contact ais@northlincs.gov.uk

The Children's Therapy Team in North Lincolnshire includes the following paediatric services:

• Speech and Language Therapy
• Occupational Therapy
• Physiotherapy
• Nutrition and Dietetic Service

Services are offered to children and young people 0-16/19 years of age, with specific age criteria for each service area. The team is based in Scunthorpe but works across the North Lincolnshire area. Referrals are received from a range of sources including Consultants, GPs, Health Visitors, schools, early years providers, other professionals (for example Portage, ASET, Education Psychologist) and parents. Please see each services websites above for each teams referral criteria.

Appointments are offered within clinics, schools, and special schools. Home visits are offered to children dependent upon their clinical need, and children will also be seen within a hospital setting as appropriate.

Our main aims are to help children and young people to:

• Develop and make progress at school/nursery to the best of their ability
• Be as independent as possible and make choices for themselves
• Have satisfying relationships at home and at school
• Participate and feel confident
• Be free from discomfort, stay well and be safe

Welcome to our Occupational Therapy Toolkit. Below is a variety of information and advice to help children and young people develop physical skills for learning and life.

Please read the Occupational Therapy Toolkit document so that you can understand the purpose of the Toolkit, an outline of the content, how to use the Toolkit and the referral process.

Occupational Therapy Toolkit [194KB] PDF

"The ability to communicate is an essential life skill for all children and young people in the 21st century. It is at the core of all social interaction. With strong communication skills, children can engage and thrive. Without them children will struggle to learn, achieve, make friends and interact with the world around them." John Bercow MP 2008

Speech and Language Toolkit Introduction [816KB] PDF Speech and Language Toolkit Screens and strategies [1.25MB] PDF Speech and Language Toolkit References and resources [705KB] PDF

Child Development Centre - Occupational Therapy Toolkit - Northern Lincolnshire and Goole NHS Foundation Trust

The child development centre (CDC) is home to some of our children’s therapy teams and a range of services are provided from here including parent and baby/toddler groups, assessments and therapeutic interventions for children under five with additional needs.

NHS Choices - Find information and services to help you manage your health

• NHS website for England - NHS
• Service Finder | LiveWell North Lincolnshire

We have key responsibilities in championing the needs of these children and young people. We are responsible for providing education to children and young people where they are unable to attend school due to ill health. You can read the statutory guidance on the Department for Education website.

The guidance states:

• Pupils at school with medical conditions should be properly supported so that they have full access to education, including school trips and physical education.
• Governing bodies must ensure that arrangements are in place in schools to support pupils at school with medical conditions.
• Governing bodies should ensure that school leaders consult health and social care professionals, pupils and parents to ensure that the needs of children with medical conditions are properly understood and effectively supported.

An Individual Healthcare Plan is a document produced between all parties. It lays out what the child’s medical needs are with appropriate treatments and responses. This should be easily accessible to staff and regularly updated.

Every education setting should have a Medical Needs policy. This gives information about what procedures are in place to support medical needs. This document should be updated regularly. For information about a specific settings Medical Needs policy please contact them directly. An audit of medical needs and policies is produced annually by the Local Authority.

The Health Conditions in School Alliance is an organisation made up of 30 charities to support children with Medical Conditions in schools. Take a look at their website for more information and advice.

The DfE has set out responsibilities for all involved in the care for a child with medical needs:

• The Local Authority
• The Governing Body
• The Headteacher
• Parents
• The child
• School staff
• School Nurses
• Other Medical professionals

• Commission school nurses for maintained schools.
• Promote co-operation between relevant partners.
• The local authorities and Integrated Care Board (ICB) must make joint arrangements for education, health and care provision for children and young people with SEN or disabilities.
• Local authorities should provide support, advice and guidance, including suitable training for school staff, to ensure that the support specified within individual healthcare plans can be delivered effectively.
• Local authorities should work with schools to support pupils with medical conditions to attend full-time.
• Where pupils would not receive a suitable education in a mainstream school because of their health needs, the local authority has a duty to make other arrangements.
• Must make arrangements for children who are off school for more than 15 days.

• Ensure all pupils with medical conditions are supported to enable the fullest participation possible in all aspects of school life.
• They should also ensure that any members of school staff who provide support to pupils with medical conditions are able to access information and other teaching support materials as needed.

• Ensure policy is developed and implemented
• Make sure all staff are aware of policy
• Ensure all staff know about the condition
• Ensure sufficient staff are trained
• Have overall responsibility for the health care plans
• Notify the school nurse of children

• Must provide the school with sufficient and up to date information
• May need to be the ones to tell school about the medical need.
• Should be involved in the development of the plan
• Should carry out any actions they agree (such as providing medication)

• Should be fully involved in discussions about the medical needs
• Should contribute as much as possible.
• Should comply with the care plan.

Other students should be sensitive to medical needs.

• Any member may be asked to help with medical needs including giving medicine but they cannot be required to.
• Should receive appropriate training before taking on responsibility of meeting medical needs.

• Must be responsible for notifying the school where a child has a medical need.
• May support implementing the plan (for example training)
• Liaise with clinicians on appropriate care
• are available for advice from schools

• Health professionals including GPs should let the school nurses know when a child has a medical condition.
• Can provide advice on creating medical care plans
• Specialist local teams can provide support

The Tuition and Medical Needs Education Team (TAMNET) is an education service within North Lincolnshire, located in central Scunthorpe. We support children and young people (aged 4-16) to continue to develop their skills when they are unable to access mainstream or an alternative provision due to medical needs, whether these be associated with physical or mental health. The team was developed to support vulnerable pupils across all key stages.

Our aim is to meet the needs of each individual child or young person through the development of a personalised bespoke offer, drawing on the skillset of our multi-professional team.

A nurturing relational approach is taken to our work, with the whole team using positive communicative strategies to engage, support and move forward the individuals we work with.

Children and young people who are allocated a place at TAMNET will be initially taught either in the home/hospital/ or in a small classroom known as the Tuition Centre. The Tuition Centre is a classroom environment and class work will be completed just as in a mainstream room. A maximum of 10 young people will be taught in the classroom at any one time. Pupils can attend for a maximum of 15 hours per week (3 hours per day).

The aim will be to establish strong work habits that support the child in moving back into mainstream classrooms at their host school or in another school through a managed move process.

If there is a medical need that prevents a young person from attending the classroom, we can offer 1:1 home or virtual tuition. This can be up to 1 hour per day.

We have specialist emotional and social support delivered by our Wellbeing Specialist who, uses a range of therapeutic approaches, such as CBT, Mindfulness, talking therapies and psychodynamic and humanistic approaches to support maintaining and/or improving mental health and wellbeing.

Each session is bespoke depending on the needs of our children and young people and will focus on building positive trusting relationships, managing challenging emotions, self-regulation building skills and will provide strategies to support both acceptance and change. These sessions are confidential however, safeguarding our young people remains our priority.

All pupils requiring support in this area will have a weekly session timetabled in.

Wellbeing support can also be accessed as outreach to schools.

• Felicity Doughty – Service Lead
• Lorna Marvell – Specialist Teacher
• Joanne Wressell – Specialist Teacher
• Shaun Marvell – Specialist Teacher
• Emma Blacklock – Social, Emotional and Mental Health Nurture and Wellbeing Specialist
• Claire Laffey – Tutor
• Magdalena Stefanska – Tutor
• Kate Turner – Tutor
• Mary Ackroyd – Tutor

If you think that your child would benefit from accessing the Tuition and Medical Needs Education Team, please talk to your child’s school so that they can submit a referral. We do not accept referrals from parents/carers.

For further information, please contact us.

For more information please refer to the document below.

TAMNET Leaflet [1.81MB] PDF - Print only

Preparing for adulthood should be an ongoing process rather than a single event. And it should be tailored to your needs.

The term “Transitions” describes how we support young people with SEND to move from:

• Children’s Services to
• Services offering support when you turn 18

Young people and their families can feel confused when moving from Children’s Services to adult support. For example:

• There may not be a single equivalent service to support you after making the change from Children’s Services.
• You will be seen as an independent adult capable of making decisions, consenting to services and sharing information about yourself with other people. Planning and preparing early will help make it a more positive experience. And it will also help build confidence and independence for moving into adulthood.
• This change can be difficult to adjust to.

The North Lincolnshire Preparing for Adulthood Protocol aims to ensure that professionals across education, health and social care are consistent in their approach to providing a seamless and safe transition from adolescent to adulthood, enabling young adults to achieve the best possible outcomes in employment, independent living, positive relationships, community inclusion and good health.

The Learning Disability and Sensory Team – works in partnership with young people (with a range of disabilities/complex health needs) and their families to start the planning for this change from year 9 (age 13 or 14) and more intensively from Year 11 (age 16).

For many young people, transition plans will be part of their Education, Health and Care plan (EHCP).

This procedure is based on a ‘person centred’ approach. The person centred approach means that we focus on your needs at every stage of moving from Children’s Services. Your choices and preferences lead planning as much as possible.

Each of the Preparing for Adult outcomes will be considered when supporting you to plan and set your goals: These outcomes are set out in law and are as follows:

• Education and employment
• Being part of the community and having relationships
• Health and wellbeing
• Independent living and housing options

We will review and update your “person centred” plan every year. A meeting will take place with you and your family / circle of support. We can meet you in person or by telephone.

North Lincolnshire Council must assess:

• a young person
• young carer, or
• an adult caring for a child

if they have needs when they, or the child they care for, turns 18.

The council will assess you if there is a significant benefit to you. This is regardless of whether you currently receive any services.

A young person’s eligibility for adult and community wellbeing support should be established when they are 16 years old, and no later than 17 and a half. This depends on the level and complexity of need and planning required.

A young person is eligible if they are disabled and has an Education Health and Care Plan, and has been assessed as having severe learning difficulties and/or autism, a physical or sensory impairment, or a mental health problem or is “Looked After” and has an Education Health and Care Plan identifying them as having learning difficulties, physical disability or sensory impairments which would mean that they would be deemed to be vulnerable as young adults or is a care leaver and whose continuing needs will require referral on to Adult and Community Wellbeing or receives support from Children and Families function.

If you are an adult living with a learning, physical or sensory disability you can be referred to the team for advice, information and support.

You could also be a young person preparing for adulthood. It may be you, your family or someone you know, for example your teacher or doctor (GP). If you do not have a named worker to support you with this referral please contact Adult and Community Wellbeing Access team on 01724 297000.

Someone from Adult and Community Wellbeing will contact you to discuss your request. This will be over the telephone or at your home or somewhere else, like work, college or our office. We will always provide information, support and advice to access further services, including how to get support.

For more information about young carers, please read the Wellbeing and young carers teams section.

• Anyone aged 14 or over who’s on their GP’s learning disability register can have a free annual health check once a year.
• You can ask to go on this register if you think you have a learning disability.
• The learning disability register is different from the register of social care needs managed by local councils.
• Check with your GP practice if you or the person you care for is on the register.

• You’ll get to know your GP better, which will help if you ever do get ill.
• Most health problems are simple to treat once you know about them.
• Your GP can help stop you getting a serious health condition. This is better than waiting until you’re ill.
• You can ask your GP questions about your health, how you’re feeling, your care or any medicines you take.
• Your GP can give you information you need in a way that will help you.

Adults and young people aged 14 or over with a learning disability who are on the GP practice learning disability register should be invited by their GP practice to come for an annual health check.

Most GP surgeries offer annual health checks to people with a learning disability. However, GP surgeries don’t have to offer this service.

If your GP surgery hasn’t offered you an annual health check, you can ask them if they could provide one. If they say no, ask your local community learning disability team for advice. They should be able to help you access an annual health check.

Find local learning disability services.

During the health check, the GP or practice nurse will:

• do a physical check-up, including weight, heart rate, blood pressure and taking blood and urine samples
• talk to you about staying well and if you need any help with this
• ask about things that are more common if you have a learning disability, such as epilepsy, constipation or problems with swallowing
• talk to you about your medicines
• if you have a health problem such as asthma or diabetes, the GP or nurse will check how it’s going
• check to see if you have any other health appointments, such as physiotherapy or speech therapy
• ask if family and/or carers are getting the support they need
• help make sure that things go well when children move to adult services at the age of 18

If your learning disability has a specific cause, the GP or practice nurse will often carry out additional tests if there are any other health risks.

For people with Down’s syndrome, for example, they may do a test to see if the thyroid gland is working properly.

You’ll be asked for your consent (permission) to share information with other services that provide your care. This will help you get the right support if you go to a hospital, for example.

The GP or practice nurse will also give you health information, such as advice on healthy eating, exercise, contraception or stopping smoking.

A reasonable adjustment is when somebody changes how they do things to make it better for you. People with a learning disability have a legal right for reasonable adjustments to be made so they can get the same benefits from healthcare services as everyone else.Ask your GP if you need any reasonable adjustments, such as:

• using pictures, large print or simpler words to say what’s happening
• booking longer appointments
• putting an appointment at the beginning or end of the day, if you find it hard to be in a busy waiting room

The reasonable adjustments you need should be written down in a health profile or health action plan that the GP or nurse can use.

No. All parts of the health check are voluntary.

Anyone who’s having the health check, or their carer, can ask the GP or practice nurse for more information about the process.

The person can then give their consent before any tests or procedures are carried out.

No. The NHS Health Check programme is for all adults aged 40 to 74.

It assesses their risk of heart disease, stroke, kidney disease, diabetes and dementia every 5 years.

Find out more about the NHS Health Check.

In 2016-17, about 53% of people with a learning disability who are on their GP’s learning disability register had a health check. This means just under half of people who are on the register did not have a health check.

However, not everyone with a learning disability is on their GP register, so even more people who could benefit from the free annual health check are missing out.

This information is covered by the Open Government Licence

We provide an assessment and care and support planning service for adults who live with a learning and/or physical disability. This includes adults who live with a sensory impairment.

We also support young people from 14 -18 who are preparing for and entering into adulthood, who have additional needs and are eligible for support from Adult and Community Wellbeing. We work closely with education, health and children’s service to make this transition from school or college as smooth as possible.

If you are an adult living with a learning, physical or sensory disability you can be referred to the team for advice, information and support. You could also be a young person preparing for adulthood. It may be you, your family or someone you know, for example your teacher or doctor (GP). If you do not have a named worker to support you with this referral please contact Adult and Community Wellbeing Access team on 01724 298000.

Someone from Adult and Community Wellbeing will contact you to discuss your request. This will be over the telephone or at your home or somewhere else, like work, college or our office. We will always provide information, support and advice to access further services, including how to get support.

• Information, advice and signposting to other support
• Assessment and reviews – know your needs and achieve your planned outcomes
• Relationships and lifestyle
• Crisis Intervention and safeguarding adults
• Support with specialist housing needs
• Community access
• Low level equipment for sensory impairment
• Disability registration

Disabled children have the same rights as any other child to be protected and cared for properly.

Sometimes, however, due to the nature of their disability, disabled children can be more vulnerable to harm or abuse.

This can be because they might:

• have difficulties in communicating or telling someone about the harm
• have multiple carers (sometimes providing personal care for them)
• be less likely to openly complain than other children, or
• may not have the cognitive ability to know that something is wrong.

Children can suffer harm or abuse in a number of ways. Either through:

• their care being neglected
• suffering sexual abuse
• being physically hurt
• or being emotionally harmed

Most of us worry more about strangers abusing our children. But unfortunately, when children are abused, it is usually by someone they know.

As parents, you know your child best and you will usually be the first to notice if something seems wrong.

Things to look out for

• changes in your child’s behaviour, becoming upset for no reason etc
• unusual marks or bruises without good reason or explanation
• your child seeming wary, anxious, or unusually withdrawn
• signs that routine basic care has not been provided
• or sexualised behaviour unusual for your child or beyond the child’s knowledge

It is difficult to provide a full list. Therefore, it is best for you to rely on your instincts as a parent and note any changes that seem particularly worrying.

If you suspect your child has been harmed

If you suspect that your child has been harmed, try to stay calm and try to communicate with your child in a calm manner.

• Try to find out how they are and if they have any fears or worries.
• If a specific injury has occurred, find out if anything has happened to them that they are unhappy with.
• Try not to ask leading questions or make assumptions.
• You may want to get support from a trusted friend or relative but you should always tell your child’s Social Worker. The Social Worker will make an assessment of the situation and take further steps if necessary.
• If your child does not have a Social Worker you should still tell a Social Worker by telephoning Children’s Services on 01724 296500. Ask to be put through to a duty Social Worker. The Social Worker will always listen carefully to you and will take your concerns seriously.

Children at immediate risk

If it is an emergency and your child is at immediate risk then you should contact the Police by dialling 999.

If the Social Worker assesses that your child may have suffered or is suffering significant harm, then they will discuss the matter with the Police and investigate it. This may involve talking to your child by Social Workers and Police Officers whom are trained in communicating with children and young people.

Your child will always be supported through the process. All referrals relating to a child being harmed or abused will result in a Children’s Services Assessment being undertaken. This assessment is about your child’s needs, and your needs as a parent.

If the allegations are about someone who works with children, then there are special procedures for dealing with this that include considering the safety of other children.

North Lincolnshire Council is committed to delivering excellent customer service. Listening to our customers and learning from customer feedback enables the council to improve its services and meet the needs of customers more effectively.

We want to make it as easy as possible for customers to let us know their views, including how to make a complaint. Have a look at the document Your Right to Complain

North Lincolnshire’s complaints policy sets out how customers can make a complaint about council services, and how we will respond to and learn from complaints received. You can read the Policy here

Service specific complaints should be made to the Customer Contact and Relationship Manager.

Further details on ‘How to make a complaint’ as well as the facility to make an on-line complaint about council services are available on the council website.

If you feel that discussions have not addressed your concerns you can contact Community Accord for mediation. This is an independent service available to help sort out SEN disagreements in Yorkshire and Humberside. The people involved in the dispute work together to reach an acceptable solution with the help of a mediator. Using the mediation service does not affect your right of appeal to the First-tier Tribunal (Special Educational Needs and Disability). You can use mediation at any time during a disagreement.

Parents and young people can appeal to The First Tier Tribunal (SEN and Disability) about EHC needs assessments and EHC plans, following contact with a mediation adviser in most cases.

Advice on making SEND appeals to the Tribunal is available from gov.uk.