Health Updates July

Commissioners are working with local providers to plan and implement the reintroduction of services, taking all guidelines and local needs into consideration.

As you may appreciate, this means that there are potentially changes on a regular basis and so we would suggest that for the most up to date information on the individual service offers and how to access services then to refer to the following websites.

https://www.nwbh.nhs.uk/st-helens-child-health-services

http://www.sthk.nhs.uk/

https://www.sthelensccg.nhs.uk/local-services/

Shielding Update: Information for Parents/ Carers

On the 8th July 2020 the Government released their latest guidance concerning patients that are currently on the Shielded Patients List (SPL).

In summary, the updated guidance confirms that the majority of children and young people currently considered clinically extremely vulnerable to COVID-19 will be able to be removed from the SPL following consultation with their specialist clinician or GP.

Children who are currently on the shielded patient list (SPL) are advised they should not return to school or nursery before the 31 July but work will be undertaken over the coming weeks to review the SPL ahead of the new school term.

This will mean that all children and young people currently identified as clinically extremely vulnerable should now be reviewed and, where appropriate, removed from the SPL.

Local Health Services have been asked to review all CYP known to them on the SPL and discuss with the child’s parent/ carer.

In line with the guidance, if your child is on the SPL then you can expect to be contacted either by your Specialist Consultant (if you have one) or your GP (if you are not under active care of a Specialist Consultant/ Team) to discuss whether your child is still considered clinically extremely vulnerable. Families, carers and young people do not need to make immediate contact.

Specialists in paediatric medicine have reviewed the evidence on the level of risk posed to children and young people from COVID-19. This latest evidence indicates that the risk of serious illness for most children and young people is low. Only a small group of children who receive specialist care in hospitals are likely to still be considered clinically extremely vulnerable to coronavirus, and potentially advised to shield again in future. For example children and young people receiving cancer care or those at risk of severe infection due to an immunodeficiency.

Most children and young people who were initially identified as being clinically extremely vulnerable, in particular those who are cared for just by their GP, are unlikely to need to remain on the SPL. This includes children with conditions such as asthma, diabetes, epilepsy and kidney disease.

For further information please await contact from your Specialist Consultant/ Team or GP.

However, if your child is on the shielded patients list and you have not received contact ahead of the start of the Summer Term then please contact your GP.

During the lockdown period the service has provided insoles and helmets to all children assessed prior to 23rd March 2020. The service has also provided a footwear drop off service to home addresses (St Helens and Knowsley boroughs) for some children or, if contact details have been available, then parents/guardians have been contacted and arranged for them to collect footwear assessed prior to lockdown from a contactless collect at St Helens Hospital.

The service has also continued to deal with all calls/queries from parents and since the 12th June the service has offered face to face appointments when the problem could not be resolved through phone consultation or Attend Anywhere. 

These face to face appointments have been mainly to fit/supply ankle foot orthoses (AFO’s) or recast if current AFO’s are too small. Those children requiring recasting will be individually risk assessed for any Covid symptoms or underlying health needs as the appointment requires close contact for at least 40 minutes. 

As the service uses private manufacturing companies, in which many of the staff/technicians had been furloughed, this has affected what the service has been able to provide during the lockdown and restart periods. Due to the situation of the service and clinic area on the Hospital site being used for alternative purposes during this period then this too has impacted on what the service has been able to provide for all service users, adult and children. 

If service users have any queries regarding their orthotic needs then parents/ guardians are asked to contact the service directly so that it can be identified if provision will be through telephone consultation, Attend Anywhere or a face to face clinic.

Since the start of the Covid-19 pandemic, Schools and communities have continued to have a Health Visiting and School Nursing offer.  This has consisted of a blend of virtual appointments via the Attend Anywhere platform and face-to-face where it is safe to do so for the client and the nurse.  In particular, three Public Health Nurses have been on site in Mill Green and Lansbury Schools providing a Healthy Child offer to the students who have attended school since March 2020.  The service has committed to support the Respite programme being held at Lansbury School, as part of the continued Covid response. 

The service has worked to develop a suite of resources which are being shared with schools to support key issues such as: Y6 transition, worries, emotional well-being and understanding about the importance of learning bubbles. 

The launch of Attend Anywhere has opened up further possibilities for the service to engage with families and young people and has proved particularly useful in supporting virtual school drop-in’s and bespoke baby clinics.  Young people, have reported that they like the virtual method of accessing the School Nurse, as it is confidential and nobody can see them ‘going into the nurses room’.  During the Covid-19 period, the service has consulted with staff, families and young people about how services can be improved as they move into the recovery phase and consequently, the service is preparing to offer a blend of virtual, text, You Tube, telephone and face-to-face visits/contacts.  The service is committed to ensuring that where face-to-face is best for the family or young person, this will happen. 

The service has ensured that School Age immunisations are on track and have adapted the delivery of immunisations in a Covid safe way.  They have worked closely with the schools to invite children into school so as they can receive their vaccination and also complete a welfare check on the child, in association with the school. 

Working with safeguarding colleagues, Early Help and Early Years Teams during the Covid-19 period, the 0-19 Operational Lead worked alongside these services to provide additional resource and support to triage cases and identify 'red' cases to ensure that an appropriate professional was supporting this family at Level 2, 3 and 4.  This work was in addition to the normal safeguarding conversations that take place.  This was recognised as good practice, especially in the Under 5’s and any ‘hidden’ 2 year olds. 

A weekly 0-19 Safeguarding Ops Meeting has been held throughout the period and a multi-agency ‘Working Together’ solution focussed approach has been adopted to ensure that those families most vulnerable are identified, supported and appropriate interventions put in place through a series of contacts.  This activity has been reported to the Safeguarding Unit and the Board to provide reassurance of continued joint working. 

0-19 colleagues have played a key role in the St Helens Track & Trace work stream.  They have flexibly supported frontline NHS staff to manage the pandemic, returning to 0-19 duties where safeguarding need is prioritised.  The school nurses are developing packages of support for schools and pupils, in relation to health protection, hygiene and handwashing, which are all ‘must do’s’ in minimising the transmission of the virus. They are also committed to being part of local response teams to support children, staff and their families within a school setting. Training has started in this area.  NWBH Children’s Service staff are to be invited to access swabbing training, so as they can be part of local swabbing teams in order to contain and control the virus.

TAZ Clinic is now open again on an APPOINTMENT ONLY basis for all 13 to 19 year olds.  Unfortunately we can’t offer a walk-in service at Taz Outreach Team Logothis time, but appointments are currently available from 09.30 to 16.30 Monday to Friday. 

We’re asking young people to contact us in one of the following ways to make an appointment:

Call / WhatsApp or text our dedicated mobile number: 07795452161

Email us at: taz@sthk.nhs.uk 

Further details for young people are on the TAZ webpages and Get It On 

We are aware that clinical services have been reduced for young people over recent weeks and that many young people have felt the need to maintain contact with peer groups, boyfriends and girlfriends, even during the period of ‘lockdown’.  With this in mind, if you have concerns about the sexual health or safety of a young person you know or work with, please advise them that clinic is available again. 

If you have more serious concerns about a young person’s sexual health the TAZ Outreach Team are still available to provide one to one support, via referral. Our referral form is attached.

Please contact the team via the details below for further information. 

TAZ Outreach Team

Fingerpost Park Health Centre

Atlas Street

St. Helens

WA9 1LN 

01744 627692 

www.tazsh.com

 

Follow us:  Instagram  instagram logo   and

TikTok TikTok Logo  @tazsth

The St Helens Neurodevelopmental Pathway has implemented business continuity plans in support of COVID-19, and is working with partners across St Helens Cares to identify recovery and restoration priorities as we move forward in our COVID response. In response to NHS England and NHS Improvement ‘COVID-19 Prioritisation within Community Services’ (19 March; updated 2 April) document, the Trust’s Neurodevelopmental Pathway Services were reduced in line with the guidance, with the aim of keeping children and families and our staff, as safe as possible during COVID. 

The St Helens Neurodevelopmental Pathway are working with partners and families to restore and recover the pathway to support the needs of children and families that we support, in line with NHS England and NHS Improvement’s ‘COVID-19 Restoration of community health services for children and young people: second phase of NHS Response’ (3 June 2020), and as such are increasing the services provided as part of the pathway. 

Multi-Disciplinary Triage Panels - The St Helens Neurodevelopmental Pathway has re-established triage panels on a weekly basis, and have increased the number of children that are reviewed each week.  Children of the highest risk (such as children who are looked after, children in contact with the criminal justice system, and children that are at a key transition age) are prioritised, and all other referrals are reviewed in date of referral received to ensure fair access to the pathway. 

Multi-Disciplinary Decision Panels – From 17 July 2020 St Helens Neurodevelopmental Pathway has re-established multi-disciplinary decision panels on a weekly basis. Children of the highest risk (such as children who are looked after, children in contact with the criminal justice system, and children that are at a key transition age) are prioritised, and all other referrals are reviewed in date of referral received to ensure fair access to the pathway. Feedback appointments will follow once a decision has been made at the panel, and families will be contacted by the Neurodevelopmental Pathway Team in support of this. 

Emails and Phones – Throughout COVID the service has maintained open communication channels. We receive a large number of calls, emails and messages, and assure you that all of these are responded to at the earliest opportunity by our team. These are being prioritised in order of date received. 

All emails and enquiries are to be sent to 5bp-tr.sthelensneuropathway@nhs.net. Emails are prioritised in date order, and we ask that you please do not send multiple emails to the team as this increases the overall number of messages into the team. 

The Neurodevelopmental Pathway Team can be contacted by phone on 01744 646571. If a member of the team are unable to answer the telephone, there will be an option to leave a voicemail. Please leave a message confirming the name and date of birth of the child that your query relates to, a contact telephone number, and a brief message. Your message will be triaged by our team and we will get back to you as soon as possible. 

We thank you for your support and patience during this time.

Kooth is available for use and is a free, safe and anonymous online mental wellbeing community for young people aged 11-25 in St Helens. Kooth has lots of different features such as blog space to share stories and access self-help resources, forums with other young people to chat about interests and hobbies and confidential 121 counselling and support with qualified counsellors. 

For parents wanting to know more about the Kooth service please email parents@xenzone.com.

 

Kooth - Free, safe and anonymous online support for young people from XenZone on Vimeo.

 

We asked Parents and Carers and Children and Young people on their views of the current SEND Short Breaks offer and what more would they like to see and what could potentially be improved. 41 responses came back from Parents and Carers and 11 from Children and Young People. We realise this is a low representation of our SEND Children and Young People in St Helens.  

Overall the response from the Children and Young People who did complete the survey was positive. 91% got to do fun things with their whole family. 64% said they were happy with the activities on offer, however, 36% said they would like to see more activities for those with SEND.  Some of the suggested activities included, baking, arts and crafts, swimming, singing, relaxation and outdoor activities.  

Parents and Carers survey revealed that only 59% had heard of the St Helens Local Offer website and 90% would prefer to communicate via email. The survey responses have provided us with a wealth of constructive feedback that we are keen to interpret and make improvements. 

The Children’s Community Nursing Team (CCNT ) are currently carrying out priority visits which include line flushes, injections, port flushes, supplies  and essential training such as ventilation and tracheostomy.

They are still accepting new referrals and are able to triage via telephone consultation within 24 hours of receiving a new referral.  Initial assessments are carried out over the telephone via consultation if a clinical intervention is then required this will be planned and co-ordinated with parents and they will be informed along with the child/young person of the PPE they will be required to wear and why.

All telephone consultations where possible are being booked in so families can plan consultations due to their own current needs.

We are still liaising with the local hospitals and are participating in discharge planning meetings remotely via Microsoft teams. The very complex children with packages of care are having weekly coordinated telephone conference calls to ensure that the packages are running smoothly.

Referrals are being accepted as normal and are triaged, parents are then contacted by letter to advise parents/carers to contact the service to accept or decline input. Once the call has been received the patients are placed into a virtual clinic and this is negotiated with parent/carer.

The service is completing visits to those referrals and patients who are fall into the category of urgent or priority patients. Although they are not an Urgent service, those that are categorised as urgent are new referrals in to the community from Alder Hey with patients with a complex health issues or neuropathic bladder and bowels. I.e. spina bifida patients or post op stoma patients,  the service  are picking up these patients to prevent hospital admission. They have continued to offer support for complex patients in school and respite settings.

Staff have been able to complete doorstep visits to offer advice and treatments to patients and deliver equipment (wearing appropriate PPE and or maintaining social distancing).

Staff have been committed to completing virtual clinics and are conducting these via telephone consultations; this is to avoid a delay in assessment and treatment of service users. Prescriptions have been arranged and dropped off in pharmacy for patients to collect by the nurse prescriber or the prescription request has been sent directly to the GP to be processed.

In addition information packs have been sent out to parents and families and regular reviews over the phone have been carried out to advise and plan treatment from this. We have had excellent results with some of the toilet training support packs and medication plans implemented over recent

Staff are continuing to communicate and offer care plans for children in school and have been able to conduct observations of service users whilst maintaining safe distance and or PPE.

Staff are keen and motivated to re-establishing the service and have some new ideas moving forward on how we can improve service delivery, patient engagement and improve patient care experiences.

Children under this service have continued to be reviewed and assessed virtually, and medication continues to be prescribed. We are looking to resetting clinics as soon as it is safe to do so in the next few weeks.

SEND Flag

The purpose of the Local Offer is to enable parents and young people to see more clearly what services are available for children with special educational needs and disabilities in their area, and how to access them.

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