HNY Policy and Pathway Repository - Humber

Initial referral via ERS to children’s community physiotherapy by GPs (and permitted community referrers e.g. HVs and ANPs) and consultants with access to ERS. For those without access to ERS, referrals accepted via email on approved referral form.

For any child presenting with red flag symptoms please refer to acute services. They must first be screened by appropriate medical practitioner (GP or consultant team) prior to referral to physiotherapy

Abnormal neurology to be referred to consultant team for investigation prior to physiotherapy assessment.

Fixed deformities (highlighted on NIPE) to be referred to acute orthopaedic services/HRI physiotherapy

Management guidelines and resources

On your Marks parent booklet

On your Marks Pathway

• Referrals accepted for children between the age of 0-18/19 registered to a GP practice within the NHS Humber and North Yorkshire ICB-02Y area.
• MSK if patient is 5 or under (over 5’s to be referred to ER MSK service via ERS CHCP/Email)
• Under 2 developmental delay with specific issues detailed in referral once ‘On your marks, get set, go’ pathway followed
• Generalised hypermobility with pain and/or functional deficit (will be seen for assessment and universal advice only)
• Oncology – triaged alongside HRI team for assessment of most appropriate provider on a case by case basis
• Post hospital discharge support triaged alongside HRI team for assessment of most appropriate provider on a case by case basis
• Severe developmental delay
• Premature with known medical problems
• Recent CP diagnosis / other genetic / neuro conditions
• Palliative care
• Gait abnormalities / foot posture associated with abnormal tone and movement patterns. (for those without associated abnormal movement patterns or atypical tone, please refer to normal variant clinics at HRI)
• Mild developmental delay with specific issues detailed in referral once ‘On your marks, get set, go’ pathway followed

DO NOT REFER

• Orthotics only (refer to orthotic or podiatry service)
• Development co-ordination disorders / dyspraxia (no NHS commissioned service)
• MSK conditions in those over the age of 5 (refer to CHCP adult MSK physiotherapy services)
• Gait abnormalities / foot posture issues not associated with abnormal tone and movement patterns:  Advise referral to Normal Variant clinics at HRI.

• Children over 18 if not in full time education (refer to adult services)
• Chronic pain referrals/ Chronic fatigue syndrome (signpost to private clinic in York ? Chronic Fatigue Centre - that will take GP referrals)
• Respiratory conditions (respiratory service HRI)
• Deconditioning / strengthening rehab with no underlying neurological cause.
• All Erbs/talipes/DHH referrals/pts go to HUTH - Hull and ER (inc. GP/Health Visitor/Consultant referrals)
• Mild developmental delay. Refer to ‘On your marks, get set, go’ pathway

Triage completed within 3 working days from receipt of referral to decision and booking invite completed. Rejection notification to referrer if appropriate within 3 working days of receipt of referral.

Referral pathway advice

• Referrals to be accepted by ERS via ‘Physiotherapy/neurological’ specialties in ERS. For alternative referral route, email referral form to team email address: Hnf-tr.childrensphysio@nhs.net.
• Triage is aimed to be completed within 5 working days from receipt of referral to decision and booking invite completed. Rejection letter to referrer if appropriate within 5 working days of receipt of referral.
• Guidelines on management to be changed to ‘Management guidelines and resources’ please.
• Ready set go link to be removed and replaced with the ‘On your marks, get set, go’ pathway information and parent booklet attached to this email

Children’s Physiotherapy Team - Connect NHS