Secondary care

Information for families in England and Wales

Your child might be referred to see health professionals or services with more specialist knowledge. These are often referred to as a secondary care, as you are usually referred to the service having first been seen by another professional such as a GP, doctor or nurse.

Secondary care includes hospital services, Child and Adolescent Mental Health services (CAMHS) and child development centres.

If your child is referred to see someone and you are not sure what their role is, do ask the person making the referral - or the specialist when you first meet them. Here is a list of services often accessed by disabled children.

Child and adolescent mental health services (CAMHS)

CAMHS specialise in supporting the psychological and emotional needs of children and young people. Find out more about CAMHS.

Child development team/centre

Child development teams are led by paediatricians working closely with physiotherapists, occupational therapists and speech and language therapists. They assess and review a child's needs and devise treatment programmes to encourage and support their development. They might also require input from psychologists, either as part of the team or from child and adolescent mental health service (CAMHS).

Community nursing

Community children's nurses support disabled children at home and within community settings. This includes those who are technology-dependant, such as children who need tube feeding and gastrostomy care. They also play an important role in making sure a child's health needs are supported safely in nursery or school.

Continence service

The local continence services can see children if there are problems with toilet training. Children can usually be provided with free continence equipment once they reach a certain age - usually around four years old. In some areas health visitors, community nurses and/or learning disability nurses can also prescribe continence equipment and give parents advice on toilet training.

Continuing care - for children with complex needs

NHS continuing care is support provided for children and young people under 18 who need a tailored package of care due to their complex health needs. Professionals working with a child or young person should offer them an assessment if it seems they could have continuing care needs. If you think your child should be assessed for NHS continuing care, talk to a health or social care professional who works with them.

They can arrange a holistic assessment, which may include other services such as education and social services. The assessment process is led by a nominated children and young people's health assessor and reports may be obtained from services already involved with your child. The assessment considers what daily support a child might need with:

  • Behaviour that challenges. 
  • Communication. 
  • Mobility. 
  • Nutrition, food and drink.
  • Continence and elimination. 
  • Skin and tissue viability. 
  • Breathing. 
  • Drug therapies and medicines. 
  • Psychological and emotional issues.
  • Seizures.

You should get a decision about your child's eligibility within 28 working days of them being referred.

If it's decided that the child or young person requires 'continuing care', then provision can be made by health, education and social services.

If you would like more information, please see the NHS Choices website www.nhs.uk/CarersDirect/guide/practicalsupport/Pages/continuing-care-children.aspx

Dietician

A dietician can advise on food, diet and nutrition if a child is reluctant to eat certain foods, or needs to be on a special diet, or has difficulties chewing and/or swallowing.

Educational psychologists

Educational psychologists assess a child's learning and provide advice to parents and education staff on appropriate interventions to support learning and improve behaviour.

Learning disability team

Learning disability teams work with children and adults who have a learning disability and their families.

Occupational therapy

An occupational therapist pays particular attention to hand-eye coordination, perception and manipulative skills. They can advise and provide suitable aids to help with everyday activities such as feeding, dressing, toileting, bathing and play for younger children, plus writing skills for older children.

Paediatrician

A paediatrician is a doctor who specialises in looking after babies, children and young people. A paediatrician can coordinate and liaise with other agencies involved in the management, care and education of the child and family.

Physiotherapy

A physiotherapist helps in the management and development of movement skills. There are a number of ways in which children can be helped. These may include exercises to strengthen weak muscles and games to improve coordination and motor skills.

Speech and language therapy

Speech and language therapists can work with parents to develop communication skills. If a child cannot talk they can help them explore other ways to communicate, such as Makaton signing (a language programme that uses signs and symbols to help people communicate). They can also provide help where there are physical issues with eating, drinking and safe swallowing.

Wheelchair and equipment

Wheelchair and equipment services support the child in home and at school. Wheelchairs for children will need regular reviewing to monitor the child's growth and make sure it is providing good postural support.

Information for families in Northern Ireland and Scotland

We also support Northern Ireland and Scotland. Give our helpline a call on 0808 808 3555 for information and advice on any aspect of raising a disabled child, or call your local contact. Find out our details in the In your area section.