Children with Complex
Needs Protocol
Practice Guidance Notes
January 2002

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Introduction
The aim of the protocol is to ensure all agencies work in partnership to
promote social inclusion and equality. A partnership approach to assessment
and care planning will ensure that children with complex needs receive the
most appropriate service. In order to promote the social inclusion agenda the
Protocol aims to ensure that children are supported at the lowest level of
intervention compatible with meeting their needs. Where children have
reached a high tier of intervention, the aim will be to seek to return them to
progressively lower tiers of intervention, which will enhance their social
inclusion.
These notes should read in conjunction with the Protocol and Panel Referral
forms, see Appendix 1 and Appendix 2 on pages 7 to 12 of this guide.
Before the Panel
These practice guidance notes are intended to give advice on the steps that
need to be taken in order to have a case presented at panel.
The kind of cases that may trigger the process of referral to panel are
illustrated by the following three case studies:
Jack 13 years, severe disabilities, autistic spectrum disorder, severe
challenging behaviour (violent to mother), complex care needs
(feeding, toileting, medication)
Manjit 14 years, mental health problems, attachment disorder,
challenging behaviour, repeated absconding, history of sexual abuse
and neglect
Susan 8 years, profound multiple learning difficulties, hearing loss and
sight impairment.
The criteria that may trigger a referral to the Children with Complex Needs
Panel are:
school placement breakdown – alternative placement cannot be
identified
family approaching breakdown
continuing health care needs unmet.
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Multi-Agency Meeting
If professionals are of the view that a referral needs to be made then a multi-
agency meeting must be held to review all the individual agency assessments.
This meeting should be attended by all professionals working with the child; this
is the primary care team. This meeting should be attended by the parent(s) and
the child where this is appropriate.
The purpose of the meeting is to consider:
what needs are not met by current resources
the views of the child, parent and other family members
objectives for the care package and strategy to promote social inclusion
care package.
More than one meeting may be needed to form a multi-agency assessment of
this agenda.
The multi-agency assessment must conclude whether needs can be met locally
with additional flexibility and/or additional resources at a primary care level, or a
referral to complex needs panel is needed.
Where it is decided that a referral to panel is needed the meeting must decide
the following:
the lead agency and person managing the referral process
the person for all other agencies who will manage the case through
internal eligibility processes. All agencies must be involved in the process
who will be providing the reports required
for health – establish the lead commissioning agency and designated
manager.
Completing the Form
All sections must be completed. The referral form must be accompanied by
assessment reports and current care plans. In the event of this information not
being available, panel will not be able to consider the case.
Section One – The Child or Young Person’s Details
All boxes must be completed. Some information is required for monitoring and
planning purposes. The name of the GP is an essential piece of information as it
identifies the responsible Primary Care Trust.
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Section Two – Parental Details
This section should include everyone known to have parental responsibility.
Section Three – Key Professionals and Provider Agencies Involved
It is essential that all agencies involved with the child/family are identified
and involved in the referral process.
Section Four – Agreement to Referral
The referral form must be agreed by the designated manager in each partner
agency. It is the responsibility of the primary care team member from each
agency to secure the agreement of their designated manager prior to the
referral being made. The referral must be signed by the designated manager
in the lead agency. Designated managers are:
Derby Social Services
Rachel Dickinson
Assistant Director
Derby Education Service
Elizabeth Beswick
Education Officer – Pupil Services
Central Derby Primary Care Trust
Pam Hallam
Clinical Standards Officer
Derbyshire Social Services
Peter Riddle
Assistant Head of Children’s Services
Derbyshire Education Service
Sarah Yearley
Education Officer – Special
Needs
Chesterfield Primary Care Trust
Kathryn Blackshaw
Assistant Director of Planning and
Performance
The referral form does not need to be signed by each designated manager;
the form can be signed off at the panel meeting itself. However, the
designated manager must be made aware and agree to the referral being
made. The designated manager may require the referral to progress through
internal eligibility criteria processes prior to agreeing the referral for panel.
For Social Services this is the Children’s Resource Panel and for Education this
is the SEN Panel.
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Section Five – Detailed Assessment Reports and Current Care Plans
The referral must be accompanied by assessment reports and current care
plans from all the involved agencies. The panel will not be able to consider
the referral if these are not attached.
Section Six – Description of needs not met by current resources.
A clear description of individual needs that are not met must be provided
together with an indication of where the issues identified can be found in the
assessment reports.
Section Seven – Views of the Child, Parent(s) and Other Family
Members
This should include a description of their difficulties and what they think
should be done to help. In the event of the views of the child and significant
family members not being known the panel will be unable to consider the
referral.
Section Eight – Objectives, Timescale and Strategy to Promote
Social Inclusion
This section must specify clear objectives for the care package which reflects
the unmet needs identified in section 6. The primary care team must have
developed a clear care plan indicating the work that needs to be done and
the time that will be needed.
It is essential that the team has considered how to promote social inclusion.
The most desirable circumstance (and most socially included) for any child is
to be cared for by their family, attend a local school and have health services
provided locally. These circumstances will enable children to be part of their
community and establish peer social relationships and maximise the
opportunity to meet cultural, religious and linguistic needs. Any care plan that
moves a child away from these circumstances must have an accompanying
plan aimed at promoting social inclusion and at optimum level re-establishing
the most desirable circumstances for the child.
Section Nine – Care Package
This section must identify the key components of a care package and why
resources over and above those locally provided are required. The following
may be key components of a care package; domiciliary care, equipment, day
care, additional care staff, flexible outreach support, day/residential
assessment placement, type of school (mainstream, special, residential),
psychological/psychiatric service/placement, forensic treatment placement.
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A brief explanation of why local services cannot meet the needs is required.
For example:
Child J. S has had a formal statutory educational needs assessment,
a full children in need assessment using the Assessment Framework
and a paediatric assessment. The child has severely challenging
behaviour and the family need respite. Existing resources
(Broadway) could provide a placement but are unable to provide
adequate staffing levels to provide a safe placement.
It is critical that when a referral is first made to the Complex Children’s Needs
Panel that the providers of any future services are not identified. The Panel
will:
decide whether the circumstances meet the eligibility criteria for a
complex children’s needs care package
agree the funding partnerships in principle
commission the primary care team to identify service providers.
The case must be re-referred to the Panel when providers have been
identified for approval and confirmation of funding arrangements.
Notice of Panel Decision
For each referral the panel will complete a Notice Of Panel Decision Form.
This form will specify the name and key details of the child, the date of the
Panel meeting, and key workers from each agency. The panel decision with
reasons will be recorded on the form together with the agreed funding
arrangements. A copy of the form will be sent to the identified key worker of
the lead agency. A copy of the form will also be sent to the financial
departments of each agency. The lead agency for each complex care package
will be identified. The lead agency will take responsibility for implementing
the decision of the panel.
The Notice of Decision Form will specify the care package that has been
agreed. Any need to deviate from the agreed package must have panel
approval. The form will also specify the timescale and monitoring
arrangements. These are critical in order to ensure that the care package is
meeting the objectives of the care plan and that everything is being done to
promote social inclusion. All cases will be reviewed at least every six months
and minutes of reviews/reports of statutory reviews will be considered by the
Panel.
January 2002
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Appendix 1
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9

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Document Outline

• CHILDREN WITH COMPLEX NEEDS PROTOCOL - PRACTICE GUIDANCE NOTES
  • Introduction
  • Before the Panel
  • Multi-Agency Meeting
  • Completing the Form
  • Section One - The Child or Young Person's Details
  • Section Two - Parental Details
  • Section Three - Key Professionals and Provider Agencies Involved
  • Section Four - Agreement to Referral
  • Section Five - Detailed Assessment Reports and Current Care Plans
  • Section Six - Description of Needs Not Met by Current Resources
  • Section Seven - Views of the Child, Parent(s) and Other Family Members
  • Section Eight - Objectives, Timescale and Strategy to Promote Social Inclusion
  • Section Nine - Care Package
  • Notice of Panel Decision
• Appendix 1 - Panel Referral
• Appendix 2 - Notice of Panel Decision

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