Health

The NHS provides a comprehensive health service to meet the health needs of all the local population. These services reflect core NHS principles of meeting clinical need, collaboration between healthcare professionals and patients and working with other agencies such as education and social care.

Children and young people with Special Educational Needs and Disabilities (SEND) may be more likely to access specific parts of the health service for example, the speech and language therapy service.

In most cases, healthcare support is provided though the services routinely commissioned through the NHS, such as physiotherapy, or paediatric care. For the small number of children and young people with most complex needs, the NHS may also provide direct funding, through continuing care, continuing healthcare or personal health budgets.

Your General Practitioner (GP) provides all primary health services, including immunisations, and will direct you to other specialist services, such as therapy or paediatric services if there seems to be a need. For babies and toddlers, Health Visitors also provide advice, information and support, vaccinations and other early health checks. Read more about keeping healthy.

Find out more about what support is offered, how they are accessed, referral processes and contact details.

In York, health services other than GP are generally provided by:

York and Scarborough Teaching Hospital for example, general paediatrics, therapy services, audiology, ophthalmology (eyes and vision)
Tees Esk and Wear Valleys Trust (TEWV) for mental health care and autism assessments

How any health provision other than your GP is accessed depends on the referral arrangements put in place by each service. These are decided by clinicians following best practice guidelines and will vary from service to service. Therefore, some services may be accessed directly by patients whilst others require referral form for example, GP, clinician, school or social worker. NHS wheelchairs can only be provided on referral from an occupational therapist, and payment is usually made via a personal health budget provided to the patient, for example.

Once young people are aged 13 and upwards, the NHS increasingly acts in accordance with their wishes regarding access to and receipt of treatment or other support. This is called the test of competence, or sometimes the Gillick Test. Children aged 13 to 16 may agree to assessment and provision of support if they are considered able to understand what assessment or treatment is proposed and what are the consequences of accepting or not accepting it. Once young people are 16, then it is assumed that they are able, or competent, to make decisions regarding assessment or care unless there are good evidence that they lack that competence. This is an important point to consider in relation to children and young people in their teenage years.

Adult health services are structured very differently to paediatric services, other than access to GPs. Children and young people who have received paediatric input from services find that the adult specialist service does not accept them, because their threshold of clinical need is much higher than in paediatrics, for example, a young person with stable epilepsy would not expect to be accepted by the adult epilepsy service, their condition would be managed by their GP, who could refer into specialist services if the need presented. The transitions co-ordinator in York Hospital has developed transition pathways for young people from age 16, and the CAMHS service consider whether to transfer young people to adult mental health services at age 17.