Variable implementation of good practice recommendations for the assessment and management of UK children with neurodisability

• Published in: Child : care, health & development Vol. 41; no. 6; pp. 938 - 946
• Main Authors: Gray, L., Gibbs, J., Jolleff, N., Williams, J., McConachie, H., Parr, J. R.
• Format: Journal Article
• Language: English
• Published: England Blackwell Publishing Ltd 01-11-2015
• Subjects: Child; Child development; Child development centres; child development teams; Child Health Services - organization & administration; Child Health Services - standards; children; Children with disabilities; Disability Evaluation; Disabled Children; Disease Management; England; Evaluation; Financing; Health care; Health Care Surveys; Health services; Hotlines; Humans; Medical diagnosis; neurodevelopment; Neurodevelopmental Disorders - diagnosis; Neurodevelopmental Disorders - therapy; neurodisability; Neurological disorders; Patient Care Team - organization & administration; Policy making; Professional associations; services; Teams; Variability; Wales; Workload; England; Scotland; United Kingdom > UK; Northern Ireland; Wales; child development teams; services; neurodevelopment; children; neurodisability
• ISSN: 0305-1862; 1365-2214
• DOI: 10.1111/cch.12272

Objectives
The aims of this study were to determine whether UK child development teams (CDTs) have implemented good practice recommendations for the co‐ordinated assessment and support of children with neurodisability and to explore some of the factors associated with variations in good practice implementation.
Design
Surveys were sent to every UK CDT in 2009/2010. Responses about CDT provision and ways of working were compared with good practice recommendations from national policy documents and professional organizations. The extent to which CDTs in England and Wales met 11 selected good practice recommendations was scored; teams in Scotland and Northern Ireland were given a score out of 9 to reflect the optional use of the common assessment framework and early support materials in these countries.
Results
Responses were received from 225/240 (94%) UK CDTs. Thirty‐seven per cent of CDTs in England and Wales had implemented nine or more of the 11 recommendations. Fifty‐nine per cent of teams in Scotland and 78% of teams in Northern Ireland met between six and nine recommendations of good working practice. Higher levels of implementation of recommendations were found when the CDT had a Child Development Centre base and for teams who had received increased funding in the 5 years preceding the survey.
Conclusions
There was considerable variability in the degree to which CDTs implemented good practice recommendations for the diagnosis and management of children with neurodisability. Evidence about child and parent satisfaction, and the effectiveness of CDT practices and provision, is required, so policymakers, healthcare commissioners and clinicians can provide the most appropriate services to children with neurodisability and their families.