We provide a children’s physiotherapy service to children and young people from 0 – 16 years old or up to 19 years old if attending a special school.
To access the service, children and young people must be resident, have a GP or attend a school in the Wigan borough.
Referrals to children’s physiotherapy are accepted from health and medical professionals. Referrals are through a letter or referral form with consent from the family. Families can request any relevant professional to refer on their behalf.
Referrals are triaged and prioritised on receipt and families are asked to opt in to the service. If parents/carers do not respond within 10 working days to our letter, the child is discharged from the service.
All children are seen within an 18 week timeframe from the date of the referral.
There is no cost for the children’s physiotherapy service.
Location of Services
The team is based at Platt Bridge Health Centre and covers the whole of the Ashton, Leigh and Wigan area.
We also have access to Leigh Health Centre and are able to offer some appointments at this site.
In negotiation with families, we can also gain access to other health locations across the borough.
Physiotherapy services are sometimes offered in children’s homes and education settings as this may be a more appropriate environment to ensure that the child’s needs are best met.
Our team are skilled in the assessment and analysis of physical movement and development and make recommendations to support children and young people to maximise their physical and functional ability.
The children’s physiotherapy service will offer:
- Specialist Assessment of a child’s needs and identification of outcomes and goals for the child
- Advice and Intervention on the basis of assessment of clinical need
- An individual management plan developed and agreed with the young person, parents and carers as appropriate
- Evaluation of outcomes and future plans
- Advice on Transition and Discharge.
The children’s physiotherapy team work with children presenting with a range of physical and developmental conditions, complex needs and functional difficulties
Children, young people and their families can access expert knowledge in the following areas:
- Developmental delay
- Neurological conditions
- Degenerative conditions
- Respiratory conditions
- Cystic Fibrosis
- Gait anomolies
- Musculoskeletal (MSK)
- Motor Co-ordination Difficulties and Developmental Coordination Disorder (DCD)
- Neuromuscular conditions
- Rehabilitation for children and young people following injury/accident.
Once an initial appointment has been agreed, a physiotherapist will complete the assessment of the child’s needs.
This initial assessment will be with the child and the parents, in order to ascertain the child’s needs. This will usually be in the clinic setting. Please inform the service at the time of booking the appointment if this would not be appropriate for the child.
The physiotherapist will use a number of tools for assessment. This may include standardised tests and assessments and non-standardised observations and assessment.
Further assessment may be required and this may occur over a number of sessions, in the clinic, home or educational setting.
Liaison with other professionals and agencies also forms part of the assessment process.
The physiotherapist may also provide assessment and follow up as part of a multi-disciplinary approach with other professionals around a specific need.
We currently provide physiotherapy input into the Tone Management Clinic at Platt Bridge Health Centre and the Cystic Fibrosis Clinic at Thomas Linacre Centre, alongside our colleagues in Wrightington, Wigan and Leigh NHS Foundation Trust.
The outcome of the physiotherapy assessment and any recommendations will be explained by the physiotherapist.
As part of the assessment process, the physiotherapist may complete an assessment and recommendation of equipment to meet a child’s mobility and postural needs. This may include mobility aids and standing frames.
A recommendation for any equipment will be based on clinical need.
Equipment identified as required to meet the child’s need by the physiotherapy service is provided by Bridgewater Community NHS Foundation Trust.
This equipment remains the property of the trust and we will ensure that it is adequately maintained and serviced.
Following assessment of the child/young person’s clinical needs, there may be a recommendation for implementation of some intervention for the child.
To support the child, there are a range of different interventions that may be offered from the physiotherapy service.
This decision will be based on the assessed clinical need, the identified goals from the child and parents and based on specific clinical pathways and NICE guidance.
Outcomes and goals of intervention will be agreed and negotiated between the physiotherapist, the child and parents.
The main forms of intervention fall into three categories:
Individual direct intervention focusing upon the child/young person’s needs, delivered by a physiotherapist or therapy assistant.
Direct intervention in a group, with children presenting with similar needs.
Provision of equipment to promote mobility and postural management.
Coaching sessions to parents, working with the child and a physiotherapist or therapy assistant.
Coaching sessions to education staff, working with the child and a physiotherapist or therapy assistant.
The frequency of direct therapy will be according to the child’s assessed clinical needs and may be in a short block, with a review period at the end.
An individual programme of strategies and advice for parents to implement with the child.
An individual programme of strategies and advice for education staff to implement with the child.
Liaison and attendance at meetings with parents and professionals to address a child’s needs.
Referrals and signposting to other services and agencies.
Following assessment and any intervention, goals and outcomes will be evaluated and any further recommendations will be made at this point.
Information will be collated and shared in a report format with parents.
With the relevant consent, any reports and information will also be shared with health, education and social care colleagues.
Information from a physiotherapist may be used to help inform diagnosis by the paediatrician.
Physiotherapist’s may also be requested to contribute to Education, Health and Care (EHC) Plans and annual reviews for children and young people with additional needs. Once a request is received for contribution to an EHC Plan, the physiotherapist will work within legal timeframes to collate this information, in collaboration with the parents.
This report will be shared with parents, the Local Authoity SEND team and the child’s educational setting.
Moving on – transitions and discharge
Once the child or young person’s physiotherapy needs are met then a child will be discharged from the service. This may be for reasons including:
- Skills are at an optimum level.
- Parents and other professionals working with the child are able to implement the advice and strategies to maintain the physical and functional skills of the child.
- Difficulties no longer have significant impact upon the child’s development.
- Resolution of difficulties with no ongoing needs.
- Child moves out of area in terms of home address, GP and school.
- A child or family declines input from the service at this time.
The decision to discharge will always be discussed and agreed with the child or young person, their family and other relevant professionals.
A re-referral to the service will be accepted should further physiotherapy needs be identified in the future.
If a young person reaches the maximum criteria age within the service and there are still ongoing physiotherapy needs then a referral to the appropriate adult physiotherapy service will be made.
Collaboration and joint appointments where appropriate will be facilitated in order to facilitate the transition to adult services.
Working with Other Professionals
Evidence shows that the best results are achieved when we work with those in daily contact with the child and young person.
This enables those around the child to promote skills to their full potential in a variety of meaningful environments.
For the physiotherapy service this means working with a variety of settings and with a variety of other people including parents and professionals.
The aim is to form a partnership with families and professionals to support others to maximise their child’s potential.
Parents are a significant member of the team who hold a unique insight into their child and whose contribution we value.
Physiotherapists work closely with other health colleagues to provide an integrated approach to management.
This includes other health services across Bridgewater:
- Children’s Physiotherapy Service
- Children’s Speech and Language Therapy Service
- Children’s Early Years Assessment
- Children’s Community Nursing Team
- Children’s Occupational Therapy Service
- Wheelchair Service
- Health Visiting Service
- School Nursing Service
The physiotherapist’s will also work closely with any other health colleagues who are involved in the child’s care, such as the child’s Paediatrician, GP and professionals within the local and tertiary centres.
Close working with partners from education, including nurseries and schools are advocated within the service, in order that we are able to provide the best support and approaches in developing the child’s skills and functioning in their education setting.
We also work alongside colleagues in the local authority and social care.