Identification
The Pathway is developed for the use for children meeting the assessment criteria as described below, however our aim is to evolve the document into a Pathway that can support the wider group of children with complex needs. These are the assessment criteria used to identify Children with Exceptional Healthcare Needs:
The six impairment categories used for assessing the children and young people are:
- learning and mental functions
- communication
- motor skills
- self care
- hearing
- vision
A child or young person (up to the age of 19) is defined as having exceptional healthcare needs if they:
- Have severe impairment recorded in at least 4 categories together with enteral/ parenteral feeding OR
- Have severe impairment recorded in at least 2 categories and require ventilation/CPAP
AND the impairments are sustained, lasting for more than 6 months and ongoing.
Children will be identified in a number of ways. They may have a congenital severe health problem or an acute neonatal problem and have complex needs from birth. They may suffer a severe onset condition such as a road traffic accident or a severe infection. They may have a neurodegenerative disorder with gradual decline in health where they then meet the CEN criteria. Ideally children would be assessed using the disability criteria on the national Support Needs System. If the children are assessed using this methodology, the children will automatically be 'flagged up' in the data base and the clinician will be prompted to follow the Pathway. In those areas where the SNS is not in place the health assessment tool can still be used but the children will have to be identified by the clinician as having CEN needs using the defined criteria. Once a child has been identified as being in the CEN criteria an initial planning discussion should take place with a lead professional or key worker identified to do this. Within the hospital this may be the responsible consultant or a senior nurse on the ward or the discharge planning nurse. In each area it is critical that there is a clearly identified person to lead the meetings.
Useful web sites:
Useful documents: