Derby City Council: Early Support Group and Multi-agency Neurodiverse Pathway

Early Support Group (ESG) was delivered by Children’s Centre’s practitioners prior to Family Hubs funding, so is part of our core offer.

In 2022 Derby City received Family Hubs funding and commissioned the Speech and Language Therapy (SALT) service to support the delivery of the Neurodiverse pathway, that surrounds ESG.Derby is a small unitary authority which borders the larger shire county of Derbyshire. The Integrated Care Board and local hospital cover both the city and the county. Delivery of Family Hubs services is only funded at this point in the city. Prior to the family hubs funding the children’s centres in the city developed a good working relationship with the Speech and language service using them for informal consultation for children whose speech and language and social and emotional needs gave them concern.

The development of a multi-agency pathway to support parents/carers of children aged 2- 4 years, whose children are or may be neurodiverse (ASC).

Working in partnership with Family Hubs, SALT, Health Teams and Pediatricians to identify children, offering family support, intervention and potential diagnosis, at the right time in the right place to support the everyday challenges that families experience with a neurodiverse child. Placing the focus on support being the most important factor over diagnosis. Improving the efficiency of the process for both families and professionals by working together.

Prior to 2022 Derby City children and families awaiting specialist support were waiting for up to 2 years for the initial appointment with the Community Pediatrician through Single Point of Access (SPOA) and up to 12 months for an initial assessment with the SALT service (asc specific). There was very little opportunity for working together and information sharing.

The ESG offered the opportunity to “wait well” with access to support in order to meet the individual needs of families during this time.

The challenge was to bring services together that had touch points with identified families along the way, and work together to share information and develop a pathway that would benefit all involved, streamlining service and sharing information with a focus on support for families.

The family hub funding enabled us to fund SALT services within the hubs. The initial work focused on quality assurance of our speech and language pathway and an opportunity was identified to align the ESG within the wider ND partnership in Derby City. This led to the development of a working group and a multi-agency pilot project. 

The development of the ND pathway – which has been piloted and rolled out across the city.

Working group attendees – Leads and change makers for - Family Hubs, SALT, Health Teams, Pediatricians, ASC consultant, Specialist teaching and Psychology service (STePs).

Pathway overview

The working group developed a plan described below, which enabled a streamlined system and clear referral process which promoted a social model rather than a medical model.

The working group developed a plan described below, which enabled a streamlined system and clear referral process which promoted a social model rather than a medical model.

• Clear pathways linking services
• Families accessing support earlier
• Shorter waiting times for assessment
• Skill sharing between professionals
• Families engaging with Family Hubs at an early stage
• Reducing SPOA waiting list
• Quicker access to support and advice
• Opportunity for joint commissioning
• Children are entering school with their needs identified and being school ready

Impact data:

• Waiting time for diagnostic assessment reduced from 2 years to 6 months.
• Waiting times for autism specific speech and language reduced from 12 months to 2 months.
• 120 less children referred to SPOA triage by health team over a 10-month period.
• One assessment appointment with pediatrician – fewer follow ups required.
• Increased engagement with ESG in Family Hubs – with less drop out.
• Families reported high levels of impact and support from the pathway.
• As a result of changes, all professionals are more time efficient – meaning they are able to focus on reducing pressure in other areas of their work streams.

The Pediatrician likened it to “being a chef and having all the ingredients prepared for you”

The time frame was brilliant have been through pathway with my other son about 8 years ago and it was a long process this way helps shorten waiting times whilst being informative on how to help your child whilst waiting.

The waiting time was well shorter than expected. I feel lucky to have been seen and not had to jump  through hoops like most people 

Was amazing so helpful so kind and so caring can’t thank you all enough