Referral criteria
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Referrals we don't accept
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Acute discharges from hospital
- Referrals of this type will be considered on an individual basis, following liaison with the referring therapy team.
- Children must be discharged home safely from hospital, with any equipment needs met, and have a rehabilitation plan in place.
- Referral must include details of any surgical intervention and consultants surgical protocol, contraindications, and rehabilitation aims.
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- Incomplete referrals with non-specific physiotherapy handovers.
- Referrals without equipment needs met on discharge.
- Acute fracture or orthopaedic trauma – this needs to be referred to the Acute service.
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Infant orthopedics
- Positional talipes, over 6 weeks at time of referral
- Torticollis
- Plagiocephaly with concerns regarding functional head turning or head position preference.
- Non-acute management of Erbs Palsy and ongoing support needed for function in community
- Asymmetry of gait: if under 2 years of age and has been screened by the GP / consultant, and relevant investigations already completed.
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- Plagiocephaly with no functional limitation of movement / concerns regarding head circumference with no developmental concerns: please refer to the craniofacial team if family remain concerned about head shape.
- Positional talipes under 6 weeks at time of referral.
- Structural talipes: Please refer onto BCH orthopaedics
- Obstetric Brachial Plexus Injury Erbs Palsy – please refer onto BCH upper limb team urgently.
- Bow leg presentation if under 2 years – please refer onto orthopaedics if concerned.
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Emerging or existing diagnosis
- Concerns with significant delay with achieving gross motor developmental milestones.
- Concerns regarding abnormal movement patterns
- Potential diagnosis or has had a diagnosis affecting gross motor skills; we would accept any referral that stipulates a gross motor developmental concern that is outside of the normally expected development for that diagnosis.
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- Referrals for gross motor developmental concerns that are within the normal ranges for age/stage or diagnosis
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Musculoskeletal (MSK)
- Up to 16 years (over 16yrs to adult community MSK)
- Pain or functional issue
- Gait issues, if pain is the predominant referring factor of symptoms.
- Developmental Coordination Disorder presentation / diagnosis only if significant pain or movement issue
- Back pain. If associated with scoliosis, we request investigations prior to referral to physiotherapy.
Note: Any scans / investigations need to be completed prior to referral as we are unable to request these.
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- Postural foot issues with no pain or functional concerns – please refer to other appropriate services if required.
- DCD with no physiotherapy goal
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Gait
- Concerns about a child’s gait, if 2+ years old
- Must have a clear mobility issue impacting function outside of normal age / stage expectations
- Toe walking: with concerns regarding abnormal calf length or ankle range. Please consider referring to Orthopaedics if significant tightness evident prior to referral to Physiotherapy.
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- Normal variants of gait.
- Sensory Toe walking, toe walking with no functional impact
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Special baby clinic
- Born at <30+6 and <1500gramms
- Or neonatal history of asphyxia, intraventricular haemorrhage/ periventricular leukomalacia, cooling
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Transfer into area/referral with known long-term condition
- Children with a long-term condition, with physiotherapy needs, who have moved into Worcestershire (and meet our other referral criteria).
- Non-acute condition requiring community Physiotherapy input.
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- Requests for serial casting alone
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