Referral guidance

Referral criteria

Referrals we don't accept

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.
  • 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.

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.
  • 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.

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.
  • Referrals for gross motor developmental concerns that are within the normal ranges for age/stage or diagnosis

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.

  • Postural foot issues with no pain or functional concerns – please refer to other appropriate services if required.
  • DCD with no physiotherapy goal


  • 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.
  • Normal variants of gait.
  • Sensory Toe walking, toe walking with no functional impact

Special baby clinic

  • Born at <30+6 and <1500gramms
  • Or neonatal history of asphyxia, intraventricular haemorrhage/ periventricular leukomalacia, cooling

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.
  • Requests for serial casting alone