Therapies in Sussex – what changed and how will they work going forward?
Coronavirus lockdown meant significant changes to the way physio, speech and language and occupational therapy have been delivered across Sussex to children and young people with SEND. As lockdown eases, we spoke to therapy teams in Brighton & Hove and East Sussex to get information about how they have been working and what will change going forward.
Brighton & Hove
At the start of the pandemic, there were plans to redeploy staff from Brighton & Hove children’s therapy services to adult services. Thankfully this didn’t happen and instead they were able to continue supporting children and young people and their families – albeit in quite different ways.
Throughout the lockdown, children’s therapy teams and specialist nurses in Brighton have responded to calls and emails from parent carers, ensuring that each service has key contact information available. They were creative around offering support – trialling new and innovative ways of supporting families remotely by telephone and video and developing online resources and training for parent carers. Staff have also been visiting children at home and seeing them at the Child Development Centre when needed. They’ve also been providing and checking equipment, whilst maintaining social distancing at the same time.
Although all teams have missed being able to work with children and families directly, there have been benefits to using video consultations. A Speech and Language Therapist in the team said ‘There have been some unexpected benefits to talking to families in their own homes. We have been able to look at the toys that their child enjoys playing with and explore how to use them to develop communication.’ A physiotherapist found that video calls also led to advantages ‘It’s definitely positive to be able to maintain contact with families. It gives a better understanding of their environment and the equipment available to them making our plans more realistic and creative’. Ratna Sundrum, Medical Lead at Seaside View commented ‘many families have appreciated being able to provide information about their child’s difficulties by video without their child being present in the clinic’.
Services are now gradually returning to the new normal and Lucy Domoney, General Manager of Child Development Services in Brighton & Hove told us how:
“Therapy services will be increasing face to face appointments offered over the summer and we are prioritising children for these. We are adding training videos to the SCFT Youtube channel and are developing further online resources and working on our website. I’m keen to listen to parent carer feedback around what is most useful.
We have carried out environmental risk assessments for Seaside View and other sites to ensure appointments are provided as safely as possible for families and staff, and therapists are liaising with schools and children’s centres around visiting these sites. We are now also focusing on developing Reset Plans to identify learning from the pandemic and longer term plans for services to recover from the impact of Covid.”
Lucy added, “Our therapists have really appreciated how flexible families have been in adapting to phone and video and we are happy to be starting to see more children face to face again.”
Over in East Sussex, the Children’s Integrated Therapy and Equipment Service (CITES) reacted swiftly to the news that schools were closing by setting up ‘Therapy One Point (TOP) which gave all families and referrers a number to call with concerns about their child’s therapy, referrals and assessments. The therapists took turns to work in TOP, Monday to Friday, 9 to 4pm, and they are still managing daily calls from families and referrers. The feedback has been so positive that TOP will remain in place as the service’s single point of access for referral queries and advice and support for parents and professionals about therapies.
During the height of the pandemic, some CITES therapy staff were temporarily redeployed, mainly physiotherapists and occupational therapists, in intensive care or to support the rehabilitation of COVID patients. The service is looking forward to all their staff returning at the end of July.
CITES have continued to provide assessments for all children referred to them, including EHCPs and annual reviews and have been able to continue to provide their specialist equipment service, in partnership with AJMobility, who kept their equipment store open and delivery drivers working throughout the pandemic. Julie Caddock, Clinical Services Manager for CITES explained: “Therapists did home visits to provide urgent equipment and manual handling care to children and young people, in full PPE – trying not to scare any of the children!”
We asked Julie about the successes of lockdown:
“What’s been great is to see our therapists successfully supporting the return to school of a number of anxious children with SEND (after their exhausted families called TOP) and providing support to families who were shielding and unable to access their normal networks. And I’m really proud of how therapy staff and families have adapted so quickly to the new ways of working.”
These new ways of working include video consultations and films, where therapists are producing short video clips to teach parents and professionals how to deliver therapy programmes. They hope to publish all these new digital resources on their website soon. They have also been involved in the purchase of new speech and language therapy and assessment resources for all local authority maintained secondary schools which will be used from September.
Looking to the future, Julie says, “The service is completing risk assessments to ensure that its offices and clinics in Crowborough and Polegate are COVID-secure, and able to provide face to face clinic appointments as appropriate. Sadly we are unable to return to our premises and provide clinic appointments in Ore, as this was converted into a COVID ‘Hot site’, and won’t be available until January 2021. Alternative premises are being actively sought.
“We’re working closely with our paediatricians to reset the ASD diagnostic pathway for children under 11. This is particularly challenging as the Scott Unit in Eastbourne has also been decommissioned to support the COVID response. We are hopeful that ASD diagnostic clinics can start to be provided from Crowborough Memorial Hospital very soon.
“Appointments for urgent orthotic reviews or repairs are still available with John Florence at their clinic in Lewes, until additional COVID secure premises can be identified and reset.
“We’ve also produced a general risk assessment to advise how NHS professionals will work within East Sussex educational settings from September including advice on what face to face contact is appropriate to provide within a nursery/ school or college setting. This advice will be sent out to schools and families through the schools daily COVID bulletin, and directly to the families of children that therapists will be visiting in school.”
A final note from Julie was to encourage any East Sussex family with concerns regarding their child’s transition to a new school, or anxiety over how safe it is for their shielded child to return to school, to contact TOP for advice and support on 0300 123 2652.