Complex care

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The team and their roles
Continuing care
Personal health budgets

We are a team of highly skilled practitioners with a range of experience in children’s nursing, health visiting, palliative and end of life care, learning and physical disabilities, and mental health.

Children’s Complex Health Team

The Children’s Complex Health Team support children and young people with complex health needs; their families and professionals working with them.

We believe that all children and young people have unique strengths and needs, which require an individualised approach to the planning and delivery of their care. We ensure that children and young people are at the heart of all our work; focusing on outcomes that make a difference to them and their families.

We work closely with a range of professionals across education, health, and social care services to ensure that children and young people have access to a range of opportunities and are cared for effectively at home and their local community. This may include health support through NHS Continuing Care and/or Education, Health and Care plans, as well as providing advice and training.

Designated Clinical Officer – Education, Health and Care Plans

The role of the Designated Clinical Officer (DCO) for Special Educational Needs and Disabilities is to support health, education, and social care colleagues across North East Lincolnshire to ensure that children and young people with SEND have access to the right health support to achieve the best possible outcomes. The role is varied but includes:

Supporting health teams to understand their role in the education, health and care assessment and planning process
Promoting joint working between health, education, and care services
Working with colleagues across education, health, and care services to improve the quality of EHC plans
Providing advice and guidance to colleagues in the local authority, education settings, and care services regarding health needs of children and young people with SEND
Supporting health commissioners with identifying gaps in health services for children and young people with SEND and working to resolve these

The Designated Clinical Officer can be contacted by email: designatedclinicalofficer@nelincs.gov.uk

Hi, my name’s Sarah and I have a dual role as Strategic Lead for Children’s Complex Health and as the Designated Clinical Officer for Special Educational Needs and Disability. I have been a Registered Children’s Nurse since 2000 and have experience in general paediatrics, neurology; neuro-oncology; and child & adolescent mental health.

My role includes the day-to-day management of the children’s complex health team, as well as ensuring that all our health teams who support children and young people with SEND are working with colleagues in education and social care services to coordinate effective packages of support. Where gaps in services are identified I work alongside colleagues in health, education, and social care to address these. I attend lots of meetings, but my favourite part of the role is working with children, young people, and their families to ensure they have access to the support they need to manage their health needs effectively.

I was born in North East Lincolnshire and my passion for working with children and young people with SEND started when I spent time volunteering and undertaking work experience in our local special schools and with local organisation as a teenager, many years ago!

When I’m not working, I love to go for walks and days out around the area with my teenage children and two energetic dogs!!

I’m Chloe and I am a children’s nurse who qualified from Hull University in 2012. After qualifying I worked at Andy’s Children’s Hospice until 2016 when I moved to the Complex Health Team. I have gained lots of experience in complex, palliative and end of life care, developing my clinical skills to meet the needs of the children and young people in our area.

Before being appointed to the Children’s Nurse Educator role I provided specialist nursing support to a local special school. In my current role I deliver training to families, personal assistants, and a variety of professionals who care for children and young people under the continuing health care team. I also deliver training to paid carers who offer respite services in our area.

I am very passionate about personalised care and believe strongly in putting the child and family first, which is a key part of our teams’ vision. I feel honoured to be able to work with the amazing children and families that I do.

When I am not at work, I am always busy with my children and two Labradors, usually getting muddy and exploring!

Hi, I’m Jo my role is Project Manager for SEND. This is a new role, and I am very excited to be supporting the Designated Clinical Officer, picking up projects such as promoting annual health checks, education, health and care plan quality assurance, looking at gaps in services, identifying how we can make improvements as well as supporting our community and finding ways we can work better with our colleagues in health, education and social care across NE Lincs and the wider health and care partnership. I also sit within the Families, Mental Health and Disabilities commissioning team giving me good knowledge of the services available for our children and young people with SEND.

I have always worked within the NHS previously as a specialist dental nurse in the Community Dental Service. I wanted to be the nurse that went in to school when I grew up! I loved being out in the community working with children and families and training other health professionals. I was lead for epidemiology (dental surveys) and later became an oral health promotor. More recently I worked as head of vaccination and testing for NLaG during covid and as programme manager supporting pharmacists in rolling out the vaccine programme.

I am a bit of a geek and love to study and have qualifications in radiography, health education, sedation, special care, nutrition and health, health and safety. I also have a degree in health professional studies and post grad courses in education and business administration. One thing I am very passionate about is how we can implement what is happening nationally at a local level, how we can use best practice, develop policy and guidance to support better ways of working and improve services. When I am not working, I enjoy sewing, knitting and anything creative as well as spending time with my family and being a dance mum or taxi! for my daughter.

Our Complex Health Nurses each take a lead on a specific area of support that the team provide.

Cathy

Hello, I am Cathy. I have worked for the NHS for almost 40 years and spent most of this time practicing as a midwife and health visitor. This has provided me with an incredibly varied experience of working with children and families and a great insight into the trials and tribulations of parenting. I have been part of the Complex Care Team for a few years, supporting the Designated Clinical Officer (DCO) to embed the SEND responsibilities for health and work with other SEND partners to help children in our area to achieve their best outcomes.

I have personal experiences of my own children needing Education, Health and Care Plans (EHCP’s) so I understand the stress involved and I am passionate about getting the ‘right support, right place, right time’ for children with special educational needs.

In my free time, I like spending time with friends and family, being outdoors and I am still persevering with the Couch to 5K programme.’

I will soon be moving into a new role in the team with a focus on supporting children and young people with Intellectual Disability and Autism, and their families.

Tina

Hi I’m Tina and I have recently joined the team as a Children’s Complex Health Nurse (Special School Support), based at Humberston Park School. I qualified as a Children’s Nurse in 1999 and I worked in an acute hospital for several years, gaining experience in surgical, medical and oncology nursing. Most of my nursing years have been spent working within a children’s hospice, providing care to children with complex and life-limiting or life-threatening conditions as well as support to their families, both in the hospice setting and in their homes. Before moving into my role in the Complex Health Team, I worked as a Children’s Community Nurse for three years, predominantly in special schools providing nursing care as well as training to teaching assistants and carers. Throughout my career, I have enjoyed studying, and I became a Community Specialist Practitioner (Children’s Community Nursing) in 2010 and a Nurse Prescriber in 2015.

Outside of work, I enjoy home cooking and trying new recipes, spending time walking my dog (she is a spaniel with lots and lots of energy) and practising yoga.

Annette

Hi, my name is Annette and I joined the team as a Children’s Complex Health Nurse at the end of November 2022. My role is to focus primarily on those children with complex health needs who require or may require continuing health care both in their own homes or out in the community setting. I qualified as a Paediatric Nurse in 1999 and initially consolidated my training on the paediatric wards in Hull before moving to Neonatal Intensive Care also in Hull where I worked for 16 years. Following time spent with my own son on the paediatric surgery ward I decided to change roles and it was whilst working here that my passion for working with children with complex health needs was reignited. Many had to have complex orthopaedic, gastrointestinal or neurosurgery and I found caring for this group of children and ensuring all their care needs were met and the family well supported to be so important and very rewarding. I moved to work at St Andrews Hospice and met some amazing children and families consolidating my complex health nursing skills and being privileged enough to provide end of life care for some children.

Since leaving the hospice I have worked out in the community as a paediatric bowel and bladder nurse and supporting children with complex health needs in their own homes. I am extremely passionate about ensuring that children can fulfil their potential and that families receive the support they need to help their child maximise this potential and lead a full and rewarding life.

On a personal level I have 2 grown up children, 3 cats and a dog. I love to be out walking with my dog, I’m a film buff and love cooking and reading. I’m very happy to be in this role and look forward to making a difference wherever I am able.

Carolyn

Hi, I’m Carolyn and I have been with the team for over 10 years, working behind the scenes on the ‘finance’ side of things, to ensure our carers and families have everything they need to care for their child, from gloves to equipment within the home. I also work alongside the payroll company to ensure personal assistants get paid on time.

Sarah

Hi ,my name is Sarah an I joined the team in January 2023. My role is to support with administration, managing the team’s e mail inbox and supporting with coordinating requests for health advice as part of the EHC plan process. I contact health teams to request reports and make sure that EHC plans are attached to health records.

On a personal level I have two grown up children ,a dog, and my daughter has a horse and I enjoy taking her out competing. I also love walking ,holidays and socialising with friends,

I am so happy to be part of a great team and look forward to growing in the role.

Continuing Care

Some children and young people may have very complex health needs that cannot be met entirely by the services that are usually offered by GP’s, hospitals, or other services

The Children’s Complex Health Team undertake assessments to determine whether a child or young person (up to their 18^th birthday) may be eligible for additional support through continuing care due to health needs arising from accident, illness, or disability. These children and young people may need additional specialist packages of health support, on top of the care they already receive. These specialist packages are called Continuing Care.

These assessments follow the National Framework for Children and Young People’s Continuing Care. More information can be found on the government website:

Children and young people’s continuing care national framework – GOV.UK (www.gov.uk)

Children and Young People’s Continuing Care – Leaflet

A referral can be made by any professional working with a child or young person who may have complex health needs that can’t be met by existing universal or specialist services alone.

To help decide whether a child or young person may be eligible for continuing care, we ask the professional working with the child/young person to complete a pre assessment. To do this they complete a checklist which involves a discussion with the child/young person, their family, and other professionals involved in their care.

NEL-CYPCC-Pre-Assessment-Checklist Download

This checklist is then sent through to the continuing care team for screening.

Professionals can get help with making the referral by having a look at the ‘Children’s Continuing Care Professionals Guidance’ or by contacting a member of the team.

Guidance-for-Requesting-a-Childrens-Continuing-Care-Assessment Download

Once we have received the completed checklist, we will contact the child/young person’s parent/legal guardian and the referrer to let them know whether we will be offering a full continuing care assessment. We aim to do this within 5 working days of receiving the referral.

Enquiries and referrals for children’s continuing care can be made by contacting the team via email: cchc@nelincs.gov.uk or telephone 01472 323660

Assessments are carried out by an experienced complex health nurse using a nationally agreed assessment process. The nurse will meet with the child/young person and their family at home to discuss their needs and gather a range of reports from health professionals. Sometimes this assessment might be carried out along with another professional who knows the child and family well such as a social worker from the Children’s Disability Service or a Children’s Community Nurse.

The aspirations and views of the child/young person and their family are central to this assessment.

The nurse will share the recommendations from the assessment with the child/young person and/or their parent/carer, before discussing this with a multi-agency panel of representatives from health, education, and social care services.

The process from assessment to receiving a decision should take no longer than 6 weeks. The parent/carer, referrer and other relevant professionals will be informed of the decision within 5 days of the panel discussion.

If it is decided that a child/young person’s needs do not meet the eligibility criteria for continuing care, the nurse will explain why and will ensure that families are supported to access other appropriate services.

Where a child/young person does meet the eligibility criteria, a complex health nurse will work with the child/young person and their family to develop an individual ‘Care and Support Plan’ which details the child/young person’s health and wellbeing needs; what they hope to achieve; the budget available to them; and how they would like this to be used.

Personal Health Budgets

A personal health budget is an amount of money to support a child or young person’s individual health needs which is planned and agreed between the child/family and the local NHS team.

Personal health budgets can improve children and young people’s quality of life and their experience of care by helping them, with the support of their family, to have more choice about how their healthcare needs are met.

A personal health budget can be spent on services to help the child or young person to meet their health and wellbeing goals set out in their care and support plan. Examples include employing a personal assistant, specialist equipment, or leisure/social activities to improve wellbeing. In North East Lincolnshire we offer all children and young people who meet the eligibility criteria for children’s continuing care a personal health budget and offer help and support with this.

This easy read document simplifies Personal Health Budget information with images. Personal Health Budgets Easy Read Version (PDF, 8 MB) .

Personal Health Budgets are a type of Personal Budget. Find more information on the different types of Personal Budgets. NELC SEND Local Offer | What are Personal Budgets? (nelincs.gov.uk)

There are three ways a Personal Health Budget can be managed:

Direct Payments – The budget is transferred directly to you to buy the care and support you and your NHS team agree will meet your needs. You, or your representative, buy and manage services directly yourself. A regular review will take place to ensure that your personal health budget is meeting your needs and goals.

Notional Budget – the NHS will purchase and arrange services on your behalf.

Third Party arrangement – An organisation legally independent of both you and the NHS (for example, an independent user trust or a voluntary organisation) holds the money for you and pays for the care and support agreed in your personalised care and support plan.

The Complex Health Nurse will explain all the options and support with finding the right one for the child and family.

More information about personal health budgets can be found here: NHS England » Personal health budgets for children, young people and families

We are still working on this content and more information is coming soon on Personal Health Budget support in North East Lincolnshire.