Community Paediatrics in Brent

Hey there! Join us at Barham park community room 660 Harrow road our office on July 3, 2025 at 10:00 AM (for a session on Understanding your priorities in Community Paediatrics. It's a great opportunity to connect with experts and learn more about how to prioritise services

See you there!

What we’re asking for:

The Brent team are too short staffed to do everything that they should do, would like to do, or think it’s right to do. So we need help to decide how to go forwards from here.

We’re going to have to make some hard choices about priorities and decide which types of appointment have to be done first, which could wait, and which might not be done at all.

This isn’t something any of us want to do, but we have to. Of course, the Team is trying to get more resources and more people, but there’s no sign right now that this will happen. So for now, we have to work with what we’ve got.

I hope you can come to the workshop we’re planning where we’ll work on priorities and how much doctor time to give towards each bit of the service. We’ll also be listening for any clever ideas on how to do things differently that might work better. We can’t guarantee we’ll be able to take up every idea, or that the Trust will accept every priority – there’ll have to be some compromises. But please come and have your say.

We are inviting you attend this interactive morning where we hear from Dr Deborah BirdAssociate Medical Director for Children’s Services Named Doctor for Safeguarding ChildrenCentral London Community Healthcare NHS Trust. She will set the scene by telling us about the role Community Paediatrics services in Brent. We will ask you to tell us what is important to you as parents of a child/Young person with SEND which will support commissioners and decision makers to allocate the right resources to the right.

Backgorund

Community Paediatrics in Brent

· The Brent community paediatric team is intended to deliver a range of assessments and appointments – see below.

· The team has been short staffed for many years so they can’t deliver all the things they’re supposed to do. Backlogs and waiting lists have built up. Covid didn’t help either.

· Even if they were fully staffed, they still wouldn’t have enough doctors to do all that they should do, or want to do.

The Brent Community Paediatricians provide the following services:

· Child Protection Medical Assessments

o These are urgent medical checks for children where someone has reported possible abuse, and a doctor needs to check the child to see if they’re well, or if there are injuries that need documenting and treating

o They’re done at the request of social care, and only by senior paediatricians

· Child Looked After Initial Health Assessments:

o There is a legal requirement for all children who comes into Foster Care to have a medical health check within 4 weeks of entering foster care

o This has to be done by a doctor, but in theory could be a paediatrician or GP.

· EHCP needs assessments

o There is a legal requirement for health services to provide information for an EHCP

o This is not intended to be a fully detailed report of all medical needs and input the child has (medical reports like this can be sent in separately). It should be focussed on what health issues impact on the child’s education.

o This doesn’t have to be from a doctor, sometimes a therapists or a nurse knows much more about the child’s needs, but most services try to send some sort of medical report in

· Initial Assessments

o This is the first appointment after a child is referred into the child development team.

o This appointment is to understand what the issues are, get an idea of where the child is functioning either physically or developmentally, and agree a plan.

· Nationally required annual reviews

o Some medical conditions have national guidelines that require annual reviews, in particular, Down Syndrome and Cerebral Palsy.

· Medication reviews

o Some children may be taking medications that are prescribed by their GP, but on the advice of the paediatricians.

o These children may need to have reviews with the paediatric team so that the GPs can keep prescribing.

o ADHD medications and Melatonin both fall into this group.

· Follow up appointments

o These are shorter appointments, 30-45 minutes, to review a child for other reasons – not annual reviews and not medication reviews.

o This is actually most of what we do.

o This might be re-checking a child’s development to see if they’re making progress, or follow up after some tests or scans were taken.

o Most children would only have a few follow up assessments and then be discharged

o Sometimes a paediatrician is the best person for a review, but sometimes they’re not, it depends on what the child’s current issues are

· Autism assessments

o These are long appointments where a doctor will assess a child for autism, which should end with a clear yes or no for the child and parents, advice on what to do next, and then they’re discharged.

o There may be a telephone call as well as a face to face appointment, it varies a bit.

· Village School appointments

o The paediatricians try to review Brent children who go to Village School at least once a year.

o If the children are also seen by SLT or Physio or OT, we try to do joint appointments, but this doesn’t always work out.

o In some places, only children where the therapists, or school nurse, or parents ask for a review are seen, as not all children are medically unwell or need to see doctors

· Other things

o There are always some children and some appointments that don’t fit neatly into a category, so there’s all sorts of other bits and bobs we do, often one-off assessments just to check a child has plugged into the right local health systems, but not usually involving long term follow up.

The doctors also do things that aren’t on the list– we have to do administrative work (eg writing reports, reading reports, scoring questionnaires, talking to social workers), teach the junior doctors (or we won’t have any doctors in the future), keep up to date with their own learning too, supervise the juniors to keep patients safe, engage in annual appraisal, manage the clinical systems and do quality improvement work to keep our services as up to date as they can be. We can’t stop or change this.

There are other areas that community paediatricians wish they could support and would be capable of support with some more resources, things like sleep support, or doing joint clinics for ex-premature babies at high risk of developmental problems, or various other things. But these aren’t usually written into service specifications, so teams are not allowed to do them – a service specification is the document that sets out what a team does, or doesn’t, do, and is set by the Integrated Care Board (ICB). Changing it is possible, but takes a long time and negotiation.

Community Paediatrics in Brent Understanding your priorities !