Health and Social Care

Health care

Care, Education and Treatment Reviews (CETR's)

This is a review that is focused on:

  • Children and young people,
  • Who either have been admitted, or may be about to be admitted to a specialist mental health / learning disability hospital.

A CETR is a meeting that brings together:

  • Your child or young person and your family,
  • People who commission and provide services (for example nurses, social workers, commissioners and other health, education and Social Care professionals),
  • An independent clinical adviser,
  • An expert adviser who will be someone with lived experience of having a learning disability or autism or a family carer.

CETRs are part of the NHS Transforming Care programme but the Local Authority (LA) and education services should be involved. This will help to make sure that the review looks at the care, education and treatment of your child with a learning disability, autism or both and your family.

The CETR should review your child's care, education and treatment. It should be focused on them getting better and being discharged from hospital (or avoiding a hospital admission) and getting the right support to live well in the community.

A CETR seeks to ensure the care, treatment and differing support needs of the person and their families are met, and that barriers to getting support are challenged.

It checks that your child is safe and getting the right care for them, that they have good care plans for the future and that any problems with their health, safety or care get sorted out.

Children and young people with learning disabilities, or autism, may have an Education, Health and Care Plan (EHCP), or receive SEN (Special Educational Needs) support in school.

CETR's should be based on:

  • Human Rights (you take part as a family, in discussions and share decision making, everyone has the same rights. You should feel empowered to know and claim their rights).
  • Person-centered (the review should be focused on your child, all follow the same format, should be clear what is unique about your child and what they need to be safe and well).
  • Co-production (everyone in the meeting should have equal status and their skills, knowledge and experience should be recognised and respected).

Useful links:

Dynamic Support Register (DSR)

When planning to provide care there might be some concerns that are raised about increasing risks of a child or young person not being safe. In these cases they can be reported to the responsible commissioner to ensure they are highlighted within the DSR. This helps young people, parents/carers, and professionals to work together and may include thinking about whether there is a need for a Community CETR. The aim is to report concerns early enough that actions are taken to reduce the risk of children or young people going into hospital.

Informed consent is required for inclusion on the DSR, or a CETR request.

Useful link:

Dynamic registers and dynamic systems (England.NHS.uk)

Health advice

Requirements to provide Health Advice within six weeks (councilfordisabledchildren.org.uk) (PDF)

Securing good quality health advice for EHCP (councilfodisabledchildren.org.uk) (PDF)

What to Do if Your Child's Care Package is Reduced (Cerebra)

Health Care Plan

What is a Health Care Plan?

An Individual Healthcare Plan (IHP) is used in education to detail exactly what sort of care a child needs at school if they have a medical condition. Individual healthcare plans do not have to be created for every child they're only needed for children with complex medical needs. Individual Health Care Plans are developed in partnership between the school, parents, pupils, and the relevant healthcare professional who can advise on a child's case. The aim is to ensure that schools know how to support your child effectively and to provide clarity about what needs to be done, when and by whom.

IHPs are designed for children with both physical and mental health conditions. It details what medical needs a child has and how they should be treated. The Children and Families Act 2014 ensures that children with medical needs are supported to give them the best quality of life at school.

The purpose of an IHP is to help school staff support children with medical conditions, offering them the same opportunities as every other child. Plans should be kept confidential and should be reviewed at a date set by parents and school staff in charge of the child's care plan. It is recommended that plans are reviewed at least once a year, but if deemed necessary they should happen more frequently (depending on the child's specific medical needs).

There is not a strict set of criteria which determines whether or not your child should have an IHP, it is up to the school's Headteacher to decide if they need one. Common medical needs that require an IHP are; asthma, epilepsy, diabetes and allergies, but there are many other conditions where a child may require a plan.

IHPs should be made with the child's best interest in mind. Each child is an individual who copes differently with various medical conditions. One child with the same medical condition as another may require an IHP whereas the other child doesn't.

An IHP should include:

  • Child's details: name, address, date of birth, class
  • Details about their condition: description, symptoms
  • Daily requirements – what medication they require and dosage, ie asprin, inhaler as well as any dietary needs
  • Who will administer medication – who provides support and care
  • Side effects of medication
  • Family Contact information – names, contact numbers, address, relationship to the child
  • GP and Hospital contact numbers and names
  • Medical emergency – what action to take, who to contact
  • Date of when the plan was created and when it is next reviewed
  • IHPs should aim to provide any necessary information about how to best care for the child and what to do in emergency situations, so no information is bad information.

In some cases, depending on the child, their age and various other attributes some students will manage their own medical needs. Each individual will be assessed and the IHP will document whether the child carries their own medication to administer themselves. If a child does not want this responsibility, then staff should support them until they are able to do so on their own.

A IHP is a document which is drawn up involving people who may be required to contribute to a child's care whilst at school. This could include, but not limited to, child, parent, GP, health professional, head teacher, class teacher, care or support staff or any member of staff who might need to provide medical care or emergency care to the child the plan is in place for.

The plan is intended to set out what sort of support the child needs to participate in school life including physical education and school trips just like other children. Some children with medical conditions may be considered to be disabled under the definition set out in the Equality Act 2010. Where this is the case governing bodies must comply with their duties under that Act.

It's a written document that specifies what sort of help the school can provide for your child – for example, what medicines they can administer, and what to do in a medical emergency. Healthcare plans should be kept confidential, but your child's school will need to share the information with anyone who might need to deal with an emergency involving your child (for example, midday supervisors who monitor the dining hall and playground at lunchtime). The Headteacher should discuss who will need to see the plan with you (and your child, if they are old enough to understand).

Individual healthcare plans are not the same as Education, Health and Care Plans (EHCPs), which set out the support needed by children with special educational needs, although some children may have both types of plan.

Mental health

Mental health crisis support

  • A&E; If your life is at risk and you feel unable to keep yourself safe, you need an emergency service. A&E departments are open 24 hours a day or you can call 999.
  • CYP Haven mental health crisis service for young people aged 10 to 18. 4pm to 8.30pm weekdays, 12pm to 6pm weekends.
  • Extended Hope is for young people aged 11 plus in a mental health crisis. 01483 517898 operates 5pm to 11pm 7 days a week.
  • The Mental Health Crisis helpline (sabp.nhs.uk) is a telephone service offering support to those who are experiencing a mental health crisis. Lines are open 24 hours, seven days a week, call 0800 915 4644 or text 07717 989024.

Mental health support services

Mindworks (CAMHS) Single Point of Access

A single point of contact for referrals to Surrey and Borders Partnership services is called the Mindworks (CAMHS) Single Point of Access.

Referrals can be made by all health, education and social care practitioners, for example GPs and teachers. If a child or young person is already known to a team, please contact them directly on 0300 222 5755. They are open 8am to 8pm, Monday to Friday and then 9am to 12pm on a Saturday. The service is not open on bank holidays or Sundays.

  • Mindworks Community Teams (sabp.nhs.uk) work across Surrey, promoting good mental health and provide assessment and treatment to children and young people up to the age of 18 with mental health concerns.
  • Mindworks Eating Disorders Service (sabp.nhs.uk), a community eating disorder service for children and young people age 0-18.
  • Mindworks STARS (sabp.nhs.uk) is sexual trauma assessment recovery and support for young people who have been affected by sexual abuse.
  • Kooth, a online counselling, self-help and moderated peer support for young people age 10-18.
  • Learning Space (sabp.nhs.uk), early intervention for young people age 5+.
  • Relate, a counselling service for 10-18-year-olds with mild to moderate mental health in West Surrey.
  • B-eat, an eating disorders support service.
  • YoungMinds, children and young people's mental health charity.
  • Childline, providing advice and support about a range of issues.
  • Mind, mental health charity.
  • Papyrus, a charity for the prevention of young suicide.
  • Samaritans work to make sure there is always someone there for anyone who needs someone.
  • SHOUT 85258 is a free, confidential 24/7 text support service.
  • Stem4, a charity that supports positive mental health in teenagers.
  • Dallaglio Rugby Works, supporting young people out of education or in PRU's (UK wide).
  • Heart Heroes, supporting families of children with heart condition both the child and their siblings (England and Wales).

Mental health support services for those aged between 18 and 25

Mental health support services for care leavers, looked after children and adoption

Bereavement

  • Jigsaw provides information, advice and guidance to help support bereaved children and young people and those facing death of a loved one.
  • Child Bereavement UK offers support, guidance and information to families when a child or young person is facing bereavement. Call 08000 28840.
  • Winston Wish is a charity that supports children and young people after the death of a family member. Winston's Wish offers freephone support, email service and drop in advice. Call 08088 02002.

Bereavement by suicide

A Surrey and Borders Partnership booklet on Finding Your Way is a directory of suicide bereavement services.

Surrey Suicide bereavement support service is a service for families affected by Suicide.

Social care

EHC needs assessment

Information and advice to be obtained of EHC needs assessments:

6.(1) Where the local authority secures an EHC needs assessment for a child or young person, it must seek the following advice and information, on the needs of the child or young person, and what provision may be required to meet such needs and the outcomes that are intended to be achieved by the child or young person receiving that provision.

(e) advice and information in relation to social care;

(f) advice and information from any other person the local authority thinks is appropriate;

(4) The local authority must not seek any of the advice referred to in paragraphs (1)(b) to (h) if such advice has previously been provided for any purpose and the person providing that advice, the local authority and the child's parent or the young person are satisfied that it is sufficient for the purposes of an EHC needs assessment.

When the LA agrees to assessment following a request for a EHC needs assessment all the paperwork will be sent to the Social Care Assessment Team. As you can see from the piece of Law above this is the correct process.

If your child is already open to social care your allocated worker will be contacted and asked to provide social care advice.

If your child is not open to social care the request will be sent to the Social Care Needs Assessment Team.

The paperwork will be read so they have a clear overview of your family situation, and you will then be contacted by telephone, text and/or email and offered a Social Care Needs (SCN) Assessment.

If you would like to proceed with having an assessment you will be allocated to a Social Worker who will contact you to explain the process, answer any questions and book in a time to visit or complete a virtual call.

With your consent your child will be met as part of the visit. Visits can be completed late in the afternoon to fit around your child's education and your work commitments.

The information gathered during the visit will be recorded on a form. The form will be written up within 10 days of the visit and sent to the Manager to sign off.

Any signposting or referrals will then be made and a completed form will be sent to yourselves and the SEN Team completing the Social Care element of the EHC Needs Assessment. The L-SPA (Learners Single Pint of Access) will have already told the SEN Team that they agreed to assess.

The SEN Team will also receive the social care advice which reflects the information recorded in the above form and you will see this in sections D, H1 and H2 of the finalised EHCP. The electronic recording system called EYES which is used by both social care and education will also be updated.

It is your choice whether you have the Social Care Needs Assessment. There is no obligation and not having one will not affect the Education, Health and Care Needs Assessment or even the decision to issue an EHCP.

The Assessment is offered to assess whether your child has any Social Care needs and whether there is any support or advice or even any services the LA can offer which can be seen as a positive thing. Support, advice and information will be provided at the point you receive a copy of the SCN Assessment. If the SCN Assessment team feel that you would benefit from a referral to another service they will call you to discuss this with you, answer any questions and obtain your consent to make the referral.

During an EHC Needs Assessment the Local Authority must seek advice and information from social care. If this is not done this could lead to inaccurate or inadequate sections of the EHCP which are blank or say "not known to the service" or "no social care needs" when this is not the case. This is the reason why you are being offered a Social Needs Assessment.

The Assessment is short assessment and mainly completed during one visit to your home. It will look at:

  • Physical and mental health
  • Education and interests
  • Emotional and behavioural development
  • Role of extended family and friends
  • Housing, income and employment.

The aim is to identify any Social Care Needs and offer help, advice, guidance, referrals to services or agencies that can support.

If there is any advice given you will see this is Section D, H1 and or H2 of the EHCP when it is in DRAFT Form.

The Tribunal Team will let the team know above and the same process will take place.

Please see the Social care support fact sheet (cerebra.org.uk)