Paediatrics: Organizations and structures

Organizations and structures

The following agencies are responsible for the organization and delivery of child health services in the community.

Primary health care team

• The general practitioner (GP).

• Practice nurses.

• Midwives

• Health visitor and community nursery nurses

• School nurses for mainstream and special schools

• District nurses.

The local authority

The local authority has responsibilities for the administration and delivery of education and social care.

• The Children Act 2004 requires that local authorities have a director for children’s services and a lead member responsible for children.

• In the UK, central government is responsible for establishing national policies and guidance and overseeing standards via various means of inspection, but local need determines what services are available.

Education

In the UK there are two levels of services:

• Central and administrative level (local authority departments):

•   provide support to schools (includes educational psychology, specialist teachers for learning, behaviour, senses, and educational welfare);

•   responsible for initiation, coordination, and provision of statement of special educational needs according to the 2001 Special Educational Needs and Disability Act.

·Schools and nurseries:

•   are directly managed by their governing body;

•   have a special educational needs co-ordinator (SENCO);

•   are allocated some funds to support children with special needs.

•   have access to specialist educational services;

•   are given extra resources as specified in statements of special educational needs for individual children within the school.

Specialist paediatric services

• Include paediatricians in hospital and community

• Specialist nurses: e.g., diabetes, epilepsy, asthma)

Community paediatric nursing teams: provide nursing care at home and in other settings for children with complex needs