Variations in working practices and clinical services: findings from the 2009 survey of UK child development teams

Aims To survey team structures, working practices and service pressures experienced by clinicians working in UK child development teams (CDTs). To evaluate the extent to which services available to children with neurodisability and their families have changed over the last decade. Methods Relevant teams were identified from the British Academy of Childhood Disability9s directory of 170 CDTs. In July 2009 the contact member for each CDT received a questionnaire about the services offered by their CDT and the mode of working; reminders were sent regularly to non-respondents. Results To date, 119/170 (70%) questionnaires have been returned. The membership of the multidisciplinary team (MDT) varied considerably between CDTs. Most services provided a service to children of all ages; some continue to only support preschool children and their families. National initiatives for early years support in recent years were reflected in the altered working patterns and practices of some teams, some of which had undergone restructuring. The referral and assessment procedures utilised by teams varied widely. Many CDTs offered specific clinics for the assessment of children with particular diagnoses and have moved towards using standardised assessments for diagnosis. There was wide variation in practice for supporting children in the transition from paediatric to adult medical services. Funding for CDTs most frequently came from block contracts with Primary Care Trusts; however, many clinicians see assessment tariffs as an opportunity to improve funding of services. Despite the general increase in funding for early years support, surprisingly a number of teams had been under financial pressure. Changes in service provision and methods of working between 1999 and 2009 will be presented and discussed. Conclusions CDTs continue to vary significantly in their structure and working practices. CDTs are experiencing some financial pressures, but data indicated how CDTs might develop these over the coming decade.