Community Paediatric Medical Service (CPMS)

CPMS supports children and young people with neurodevelopmental disorders; provides services for Children in Care including foster care and adoption support and has a dedicated team for child protection.

Our service at a glance:

  • Services for children and young people with neurodevelopmental difficulties or neurodisability.
  • Services for children requiring medical advice and support as part of a wider safeguarding need, for example, child protection medicals and Children in Care health reviews and adoption process support.

  • General Paediatric outpatient clinics (operated in Solent West area).

Contents
  1. Who are we?
  2. How do we work?
  3. What geographical areas do we cover?
  4. Referrals

  5. Education, Health and Care Plans (EHCPs)

  6. Where will my child be seen?

  7. What will happen at the appointment?

  8. How will my child be assessed?

  9. What happens after the assessment?

 
1. Who are we?

Community Paediatricians

A Community Paediatrician is a Doctor who has expertise in working with vulnerable groups of children and young people and their carers; including children and young people with developmental disorders and disabilities, children who are Looked After1,or are in the process of being adopted and children and young people who are at risk of abuse, or are being abused2.

Community Paediatricians work collaboratively with wider multidisciplinary teams including Therapists, Health Visitors, School Nurses, Community Nurses, and in partnership with education and social care.

 

1Children Looked After Team:

We are a specialist team of Doctors and Nurses who deliver care for children and young people who are Looked After working across Portsmouth and Southampton. The team also includes a Doctor who is our Adoption Medical Advisor.

We undertake initial health assessments for children and young people who are new into the care of the Local Authority (we are requested to do this by Social Care and this is statutory in law), as well as review health assessments for those in longer term care. The assessment with the Doctor or Nurse will include reviewing the child’s or young person’s physical and emotional health, dental health, growth and development. 

We work with children and young people and their carers to create a ​​​​​​health care plan to support their health and development whilst they are in care, including recommendations for the future. If the child or young person requires both of our Children Looked After and Neurodevelopmental services, we will aim to combine these appointments.

Our Children Looked After Service is for any child/young person who lives in Southampton or Portsmouth who needs a Child in Care health assessment.

 

2Child Protection Team

We also provide specialist medical assessments for children and young people referred with suspected abuse.

 

 
2. How do we work?

We undertake a specialist assessment to understand what your child or young persons’  strengths and difficulties are, and if further support is needed. This helps us to provide the best quality care and most appropriate support for you and your child or young person.

We always work in partnership with you to ensure you and your child or young person are at the heart of everything we do. We also work closely with other professionals, such as Health Visitors, School Nurses, Therapists and other wider multidisciplinary teams.

The service is available Monday to Friday, 9-5pm, excluding weekends and bank holidays.

 
3. What areas do we cover?

We support children and young people who are registered with a GP in South East Hampshire, South West Hampshire and Southampton and Portsmouth cities.

The Solent CPMS service comprises of two teams who provide medical assessment and advice for children in:

  • Solent East for Portsmouth City and South East Hampshire
  • Solent West for Southampton City and South West Hampshire

 

4. Referrals

We accept referrals from other health professionals, including:

We do not accept self-referral. If you have concerns about your child or young persons’ development, please speak to the health professionals involved in their care, as listed above.

 

Who should be referred

Pre-school (0 - 5 years old)

  • Children with underlying medical causes for disability.
  • Children with neuro-disabling conditions which are known to need medical follow-up e.g. cerebral palsy.
  • Children with chromosomal and syndrome diagnosis causing developmental delay and are known to need medical follow up such as Down’s Syndrome.
  • Children with developmental regression.
  • Children with significant gross motor delay (6 months and older). 
  • Children with significant fine motor delay (under 18 months).
  • Children with where there are concerns about head growth and shape, if there is associated developmental delay.
  • Children with co-ordination difficulties.
  • For Autism referrals - see below.

School Age (5 - 19 years old)

  • Children and young people with known neuro-disabling conditions who are known to need medical follow-up such as Cerebral Palsy.
  • Children and young people with chromosomal and syndrome diagnosis causing developmental delay and are known to need medical follow up such as Down’s Syndrome (0-19 years).
  • Children and young people with developmental regression or confirmed loss of developmental skills.
  • Children and young people with a moderate, or severe learning disability or global developmental delay.
  • Co-ordination difficulties.
  • For Autism referrals - see below.

 

Co-ordination Difficulties and Autism Referrals
  • Developmental Coordination Disorder/ Dyspraxia

Mild and moderate co-ordination difficulties should be managed in education settings. Occupational Therapy services (OTs) have put training into schools for this purpose. Children who have not made progress with school input can be referred directly to Occupational Therapy by schools.

Guidelines for teachers about what to put in place and when to refer, can be found on the Solent NHS Trust website  (https://www.solent.nhs.uk/our-services/services-listings/childrens-therapy-service/)

 

  • Social communication difficulties including concerns about Autistic Spectrum Disorder

CPMS will provide a diagnostic service under the age of 6 for those with a Portsmouth GP and under the age of 5 for those with a Southampton GP, South East or South Western Hampshire GP. Children and young people over this age will be seen by the relevant CAMHS service.

In general, we see pre-school children with social communication difficulties along with developmental delay. For example, children who have significant speech and language difficulties before the age 3 years who also have social communication difficulties. These children would usually have been referred to a Speech and Language Therapist and have had an audiology assessment before being referred.

 

5. Education, Health and Care Plans (EHCPs)

CPMS health professionals are required to contribute to EHCPs where a child or young person is known to them.

The Local Authority notifies Solent NHS Paediatric Department of children and young people being assessed for an EHCP.

For children and young people not already known to the service each request is reviewed and a decision made about whether the child or young person needs to be seen by a Neurodevelopmental Paediatrician (such as children under the age of 7 years, or if there are likely to be significant learning or developmental difficulties that have not already been medically investigated). If the child or young person is known to other medical health professionals, they will be asked to provide a report instead.

 

6. Where will my child be seen?

We operate in the community and we will aim to see you in a clinic most convenient to where you live.

Your child or young persons’ first appointment may take place at one of the following places:

CPMS East Clinical Sites

  • Battenburg Child Development Centre (BCDC) Portsmouth
  • Oak Park Havant
  • Fareham Community Hospital
  • Gosport Community Hospital
  • Special Schools – Rachel Madocks, Mary Rose, St Francis, Heathfield

CPMS West Clinical Sites

  • Child Development Centre (CDC) William Macleod Way, Southampton
  • Royal South Hants Hospital (RSH)
  • Thornhill Centre for Healthy Living
  • Hythe Hospital
  • New Milton
  • Special Schools – Rosewood, Cedar, Springwell, Great Oaks, Forest Park, Hill House, Southlands

 

7. What will happen at the appointment?
  • Your first appointment will usually be 60 minutes long, with follow-up appointments being 45 minutes.
  • The Paediatrician or Specialist Nurse will discuss and write down your concerns and find out more about your child or young person and the difficulties they are having.
  • We will ask for some background information including birth details, health issues, and talk about your child or young persons’ general progress and family history.
  • There will be opportunities for your child or young person to play while you chat to the Doctor. Older children may be involved in discussions if they wish.
  • After discussions, the Paediatrician will need to assess your child or young person in more detail with a physical examination to find out their specific needs and to see if further support is needed.
  • You will have an opportunity to ask questions. You may like to write any questions down so that they can be discussed away from your child. 
8. How will my child be assessed?

The Paediatrician or Specialist Nurse may use one or more of the following ways to assess your child:

  • Watching your child or young person playing and looking / listening to what they can do.
  • Playing with your child or young person to informally check their skills.
  • Undertake formal assessments or tests which will give more information about their skills.
  • Perform a physical examination.
  • Referral for bloods and investigations at local hospitals.
  • The Paediatrician may also need to talk to your child or young persons’ Nursery/playgroup or school to get more information about their strengths and difficulties.

 

9. What happens after the assessment?
  • The Paediatrician or Specialist Nurse will talk to you about their findings and decide if further support is needed.
  • You will have the opportunity to ask any other questions you may have.
  • All recommendations and findings will be clearly explained to you.
  • At the end of the appointment your Paediatrician will talk to you about what happens next and what the arrangements for this will be.
  • A report will be written and, with your consent, will be shared with other professionals, for example, GP, Health Visitors, Pre-school staff, so that everyone is aware of what the plan of care will be.