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Health

Health services are arranged by Greenwich Clinical Commissioning Group which are part of the National Health Service. Clinical Commissioning Groups are made up of GPs from the local area and at least one registered nurse and one secondary (hospital) care specialist doctor. CCGs plan and buy healthcare services for the residents of their area.

CCGs work in partnership with the Royal Borough of Greenwich to help improve children and young people's health and wellbeing. The Greenwich Clinical Commissioning Group aims to improve the health and quality of life for people by arranging health and social care services delivered closer to your home and where everyone providing them is working together with you.

I am worried about my child's health and development

All children are individual and will develop at different rates. However, to get a general idea ‘milestones’ are used to help track your child’s development and to give an indication as to whether they are progressing at a ‘typical’ rate.

This page contains responses to the most commonly asked questions in relation to child development as well as useful links to information and services.

As a general rule, if you are worried about your child's development, your GP, Health Visitor or child's education setting will be best placed to offer you advice and support.

 

Is my child developing at the expected rate?

View the interactive guide to child development from birth to five years old, including videos and advice to help parents along the way.

The information here will give you an indication as to whether your child is developing at the expected rate: www.nhs.uk/Tools/Pages/birthtofive

 

Who can I talk to if I am concerned about my child’s development?

My child is under 5yrs old

Speak to your Health Visitor or GP (Doctor). They may share your concerns and make a referral to a child specialist i.e. a community paediatrician for further investigation.

If your child is in an education setting you should speak to their key person or the SENCO (Special Educational Needs Coordinator). They may share your concerns and suggest that you request a referral from your GP to a specialist or decide to monitor progress more closely.

My child is over 5yrs old

Speak to your child or young person’s class teacher or SENCO (Special Educational Needs Coordinator). They may share your concerns and recommend that you speak to your GP about a referral to a specialist for further investigation.

You should ask about the additional support that the education setting can put in place to support your child’s development. Further information about the support that schools must put in place for pupils with SEND can be found on our Education Offer.

Who can I talk to if I feel my concerns are not being listened to?

If your school is not concerned about your child but you still are, you might want to contact the Royal Greenwich Special Educational Needs Information, Advice and Support Service SENDIASS – this service offers free confidential and impartial advice and support to Royal Greenwich parents and carers who have children and young people (up to the age of 25) with SEND (Special Educational Needs and Disability).

You can call SENDIASS on 020 8921 8042.

 

Receiving a diagnosis

Finding out that your child has a special educational need or disability can be a confusing and emotional time for parents. While some may receive a specific diagnosis, others may be told their child has an additional need or global developmental delay. In some cases you may never receive a specific diagnosis at all.

As well as dealing with your own emotions and concerns for the future, you may also need to offer support and advice to other family members such as partners, children and grandparents. You will come into contact with a number of different professionals during this time, and at some stage will want to find out more about your child's difficulties.

One of the biggest challenges is coming to terms with the fact your child's future will be different from the way you imagined it. Getting in touch with national and local organisations, support groups and other families can help you to deal with a diagnosis, and can be a valuable source of support and advice. It is also important to remember that, with time, your emotions will become easier to manage – many parents report that after a diagnosis they discovered qualities of strength, determination and positivity that they didn't even know they had.

 

Support after receiving a diagnosis

During this time, parents will need time to talk about their feelings and any decisions they are going to make. Close family and friends can be a good emotional support, although talking to a GP, health worker or counsellor may be easier for some people at this stage.

During and after a diagnosis you may come into contact with a number of different health care workers, including GPs, obstetricians, paediatricians, occupational therapists, health visitors and portage workers.

Services within the SEND Outreach Service, Clinical Psychologists and Child Psychotherapists are specifically designed or trained to provide support to parents after receiving a diagnosis.

You’re likely to feel overwhelmed with information, whilst trying to manage your emotions. Don’t be afraid to ask questions, for professionals to repeat themselves or to explain things more clearly.

If you’d like to talk to someone who has first-hand experience of a child/young person with SEND you can contact Greenwich Parent Voice who can offer both emotional and practical support for parent carer - info@greenwichparentvoice.com.

For information, Advice and Support on any element of your child/young person’s SEND you can contact Royal Greenwich SENDIASS (Special Educational Needs and Disability Information, Advice and Support Service) by calling 020 8921 8402.

 

These NHS pages contain useful information on receiving a diagnosis:

What is a learning disability?

Children with a learning disability - Coping with diagnosis

Profound intellectual and multiple disabilities

Health Services

What health services are available in Royal Greenwich?

Some children will need to see one health professional only such as a speech and language therapist, occupational therapist or physiotherapist through hospitals, children's centres and schools. Our health professionals work closely together with you to ensure that joint assessments are carried out when your child needs to see more than one health professional.

We have a number of specialist services that support children’s centres, nurseries and schools to meet the health needs of children with special educational needs and disability:

Neonatal intensive care unit (NICU) – helps newborn babies with disabilities

Health visiting - universal services that support all children under school age

Community children’s nursing service– supports children in schools and at home with complex medical needs

School nursing service - School based nurses who support children in schools

Community nutrition and dietetics service - helps children who have problems with food.

Community Paediatricians – specialist children’s doctors

Speech and language therapy service – helps children learn to speak and understand

Children’s 2nd tier audiology (hearing) service - is a service that assesses and treats children and young people's hearing

Occupational therapy service – helps children with disabilities in managing all the tasks of everyday life – eating, dressing, self-care

Community equipment service for children with disabilities – provides equipment that children may need to help improve of maintain their health and independence

Children’s physiotherapy – works with the child or young person to improve movement and normal body function

Greenwich child and adolescent mental health service – helps children and young people who have problems with for example, behaviour or self-esteem or depression

Continence - Bladder and Bowel Service - help for disabled children and young people to help manage their continence.

My child's special education need / disability

There are many different types of SEN and disabilities.

We have put together information sheets on a range of special educational needs and disabilities. You can see these by looking at the Related Links to the right.

Furthermore, Contact a Family offer a comprehensive guide on a vast range of disabilities which includes information on causes, diagnosis, and additional support that may be available to you and your child. For further information please see the Contact a family website.

 

There is also a lot of information avaliable through the NHS Choices website.

Receiving a diagnosis

Finding out that your child has a special educational need or disability can be a confusing and emotional time for parents. While some may receive a specific diagnosis, others may be told their child has an additional need or global developmental delay. In some cases you may never receive a specific diagnosis at all.

As well as dealing with your own emotions and concerns for the future, you may also need to offer support and advice to other family members such as partners, children and grandparents. You will come into contact with a number of different professionals during this time, and at some stage will want to find out more about your child's condition and learning disability itself.

One of the biggest challenges is coming to terms with the fact your child's future will be different from the way you imagined it. Getting in touch with national and local organisations, support groups and other families can help you to deal with a diagnosis, and can be a valuable source of support and advice. It is also important to remember that, with time, your emotions will become easier to manage – many parents report that after a diagnosis they discovered qualities of strength, determination and positivity that they didn't even know they had.

Pre-birth diagnosis

In some cases, a disability may develop before birth. This could be due to:

  • the baby suffering damage to the brain or spinal cord
  • the mother having an accident or illness during pregnancy
  • a genetic problem developing during pregnancy

As well as regular antenatal checkups and ultrasounds, some women will be offered other tests during their pregnancy if there are concerns about their baby's development.

Amniocentesis

Amniocentesis is a test that takes place during pregnancy to check on a baby's progress, and to see whether there is a chance of developing one of a number of genetic conditions. The test is usually recommended for women over 35 who are at an increased risk during pregnancy because of their age. It may also be recommended for women who have already had a child with a disability, or who have a family history that indicates a problem is more likely to occur.

Chorionic Villus Sampling (CVS)

CVS is another diagnostic test which can detect certain genetic disorders. It is an alternative to amniocentesis and can be carried out at an earlier stage of pregnancy.

All tests carried out during pregnancy have risks, so it is important to consult carefully with your doctor when deciding whether or not to go ahead. Not all women will decide to have antenatal testing. If tests are taken and a problem is discovered, there may be the possibility of early treatment while the baby is still in the womb. If the problem is serious, parents will then have the choice whether to continue with the pregnancy or to have a termination.

Diagnosis afrer birth

Some parents will receive a diagnosis after their child's birth. This could be due to:

  • a problem that developed before birth
  • a problem during birth, for example if the baby did not get enough oxygen, or was born too early
  • a childhood illness or physical accident during early childhood

Although some conditions are easy to diagnose, other parents may never receive a diagnosis, or may be told their child has an additional need or global developmental delay. This is a difficult term to make sense of, but it indicates that a child will take more time to reach milestones in some or many areas of their development.

Whilst a lot of children’s additional needs are identified in early childhood, some children and young people can receive a diagnosis much later.

Support after receiving a diagnosis

During this time, parents will need time to talk about their feelings and any decisions they are going to make. Close family and friends can be a good emotional support, although talking to a GP, health worker or counsellor may be easier for some people at this stage.

During and after a diagnosis you may come into contact with a number of different health care workers, including GPs, obstetricians, paediatricians, occupational therapists, health visitors and portage workers.

You’re likely to feel overwhelmed with information, whilst trying to manage your emotions. Don’t be afraid to ask questions, for professionals to repeat themselves or to explain things more clearly.

If you’d like to talk to someone who has first-hand experience of a child/young person with SEND you can contact Greenwich Parent Voice who can offer both emotional and practical support for parent carers.

For information, Advice and Support on any element of your child/young person’s SEND you can contact Greenwich SENDIASS (Special Educational Needs and Disability Information, Advice and Support Service) on 020 8921 8402 or or Email: sendiass@royalgreenwich.gov.uk.

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