What is the Single Point of Access (SPA)?
This service is provided by East Lothian Council, in conjunction with partnership agencies. There is now one process for accessing the following supports through the Single Point of Access:
· Mental Health and Wellbeing Service
· Neurodevelopmental Pathway
· Early Years Education Resource Group
Making a Request for Assistance from the Single Point of Access
Children and Young People access the Single Point of Access by way of a Request for Assistance form (RfA) which is embedded below.
We are encouraging schools to take the lead in making Requests for Assistance, however young people, parents, GPs and Health Visitors are welcome to submit a request provided all correct information is included. The above grid shows what is required for the 3 different services above.
Please note that signed consent is required from the young person, parent or carer. Young people aged 12 years and over can consent themselves but wherever possible it is generally beneficial for their family to be involved and aware of the referral. Where appropriate, consent can be given verbally as long as this is recorded by whom and dated on the Request for Assistance form.
Completed RfA's should be sent to cypspa@eastlothian.gov.uk
We sometimes find that we do not have enough information from parents about their views/ concerns and that there is not enough information about the presentation at home.
For this reason, we are introducing an optional 'Parent ND Additional Information ’ form to be included with the RfA. This consists of questions that parents can complete independently and should be submitted along with the RfA form.
All parents should be given the opportunity to fill this out so their views can be heard.
Where to refer - SPA or CAMHS?
In most situations we would expect that supports via the Single Point of Access should be put into place in the first instance. However, there are some situations where a referral direct to CAMHS will be appropriate. The Single Point of Access is not an emergency or urgent response service and the mailboxes are not checked on a daily basis. Please DO NOT send requests for assistance to the Single Point of Access where there are concerns that a child or young person may be at immediate risk.
A referral should be submitted directly to CAMHS for concerns involving:
Children and young people who have already been well known to CAMHS, or who you think may still be an open case.
Eating disorder.
Concern about risk of suicide or serious self-harm.
Any very unusual or worrying behaviours.
Sexual abuse and other serious trauma
Only requests for neurodevelopmental assessment should be made through the SPA. All other requests to Community Child Health, CAMHS, Speech and Language Therapy or Occupational Therapy should be made through the usual routes.
CAMHS referrals should be made using the same Request for Assistance form as the Single Point of Access. This is helpful because, should the decision from CAMHS be that support through the SPA is more appropriate, it can be passed directly over, without having to come back to you to do this. It may also be the case that in addition to CAMHS support, a service through SPA is also appropriate.
Young People and Families can access information about CAMHS via their website:
If someone is on the waiting list for a ND Assessment, or undergoing a ND assessment or open to CAMHS for prescribing for ADHD they can:
Still be referred to CAMHS or SPA for Mental Health support.
Use the CAMHS Tier 2 consultation line.
If someone is on the waiting list for Mental Health support or open to CAMHS for Mental Health support, or open to CAMHS for Mental Health medication:
It would not be appropriate to also refer to SPA for Mental Health support.
They can still be referred for a ND assessment.
Mental Health and Wellbeing Team
The service aims to provide an additional level of support for children and young people who are experiencing difficulties with their mental health and wellbeing, where their needs cannot be met through universal supports. The Single Point of Access (SPA) is the system by which children and young people are matched with the most appropriate service for them. Services that can be accessed this way include: school counselling, therapeutic interventions for anxiety and low mood, creative therapies, occupational therapy, support from a mental health youth worker and access to a range of third sector supports.
The need for additional support should have been identified through the Child’s Planning Process. The Mental Health and Wellbeing Team comprises a Coordinator, Mental Health Youth Workers and an Occupational Therapist.
Anxiety
Low mood
Self-harm
Suicidal thoughts (where there is no clear planning or active intent)
Peer relationship difficulties
Family issues (such as separation, conflict, domestic abuse, ill health)
Bereavement reaction which appears extreme or long lasting
School issues which are affecting mental wellbeing
Social isolation
When making a referral please ensure that you include the information below. This will allow the team to determine the most suitable course of action, in as timely a manner as possible.
What are the current mental health concerns? Include: the difficulties that the child, young person or family is reporting and what you are noticing about them. What has changed for them?
What has been tried already and with what outcomes?
Include: initial advice given, strategies tried, resources/websites recommended, other services/agencies accesses and what the outcome of these interventions was.
What are the specific outcomes that you are aiming for?
What is the impact of the difficulties described on the young person's day to day functioning across settings?
Include: impact on behaviour at home, socially, school (attendance, academic progress, attitude to school)
Any other relevant information about the young person's circumstances
Include: any triggers for the difficulties emerging, whether the problem is situation specific or more generalised, any relevant history/family history, current family circumstances, particular risk factors, any statutory measures e.g. child protection register
What protective factors are there?
Include: strengths in the family, community supports, young person's strengths.
Is anyone else involved or have other agencies been involved previously?
Are there any current risks that you are concerned about?
Completed RfA's should be sent to cypspa@eastlothian.gov.uk. If you would like to discuss a potential RfA, please contact the Mental Health Youth Worker for your area.
Team Coordinator: John Watters-Marr (jmarr@eastlothian.gov.uk)
Tranent: Gemma Burns (gburns@eastlothian.gov.uk)
Prestonpans: Carla Byrne (cbyrne@eastlothian.gov.uk)
Dunbar: Joy Burton (jburton1@eastlothian.gov.uk)
North Berwick: Michael Cleary(mcleary1@eastlothian.gov.uk)
Musselburgh Grammar and Feeder Primaries: Danni Spencer (dspencer@eastlothian.gov.uk)
Rosehill Highschool and Feeder Primaries: Martin Lahiffe (mlahiffe@eastlothian.gov.uk)
Haddington: Martin Lahiffe (mlahiffe@eastlothian.gov.uk) and Michael Cleary(mcleary1@eastlothian.gov.uk)
Neurodevelopmental Assessment Pathway
What is it?
In East Lothian, the process for identifying Neurodevelopmental Conditions such as; Autism, ADHD, Learning/ Intellectual Disability, Developmental Coordination Disorder, FASD and Developmental Language Disorder is through the Neurodevelopmental Pathway. All referrals for these Neurodevelopmental Conditions need to come through the Single Point of Access. The Pilot Phase finished in March 2024.
Once you have submitted your Request for Assistance (RfA), you should receive an email receipt acknowledging your request. All the paperwork is then automatically forwarded to the NHS ND Pathway Team. Any queries following this should be directed to loth.eastndreferrals@nhslothian.scot.nhs.uk
The documents below are aimed to support the process.
Where is my child on the waiting list?
The Neurodevelopmental (ND) Pathway is coordinated by the NHS. Unfortunately, due to the review of the consent process by Caldicott, the NHS ND pathway team are unable to email parents directly in response to queries.
For this reason, the preferred route for parental queries needs to be through the referrer (school/ GP/ Health Visitor etc).
All enquiries regarding the pathway should now be directed to loth.eastndreferrals@nhslothian.scot.nhs.uk
How long is the waiting list?
Please do not email to ask where your child/ young person is on the waiting list. Education does not have access to information about waiting lists.
As of October 2024, the waiting time for an assessment is approximately 3 years. Pre-schoolers are being seen quicker. However, demand exceeds capacity so the waiting times can be expected to go up.
We know that this is unacceptable, and we are working hard to improve this. Along with the screening meeting outcome you will receive guidance about supports and strategies available, whilst your child/ young person is on the waiting list. If you have not received this, please email loth.eastndreferrals@nhslothian.scot.nhs.uk to receive a copy of this.
I haven’t received any communication at all following the RfA. Should I have done?
Yes, the referrer should receive confirmation of receipt of the paperwork. Screening meetings occur weekly.
The referrer will always receive a letter explaining the outcome of the screening. If you have not heard anything at all, since putting in the RfA, then please contact loth.eastndreferrals@nhslothian.scot.nhs.uk . Otherwise, you can expect to hear from the assessment team, approximately 6 months before the child/ young person is allocated.
At this point you will receive the Teacher Questionnaire.
Things have deteriorated since the initial RfA. What should I do? How can I provide an update?
If you have been accepted onto the ND pathway and you have new information, please email it to loth.eastndreferrals@nhslothian.scot.nhs.uk
There is very rarely a need for an urgent decision about whether a young person has a neurodevelopmental condition. We know that most parents and carers are anxious to have assessments completed quickly. However, all neurodevelopmental strategies should be available without a diagnosis and use of relevant strategies should be encouraged.
Who can refer to the ND Pathway?
I don’t live in East Lothian, but my child/ young person goes to school in East Lothian?
What if my young person is within 3 months of being 18?
Who can sign consent?
What if my child isn’t in nursery or school yet?
My child attends an independent school, but we live in East Lothian. Which pathway do we use?
My child ‘holds it together’ in school so they don’t think there’s an issue. How do I refer?
Does my child need to get a certain score on the Dimensions Tool to be referred?
My GP has information about my child that I have not shared with school. How can this information be shared with the assessment team?
My child already has a diagnosis of autism, but I think they may also have a learning disability. Do I need to go through the pathway?
My child is already being seen by CAMHS for anxiety. Do I need to go through the Pathway and who refers?
Do I have to wait for completion of an ND assessment before melatonin can be prescribed?
My child has a private diagnosis of ADHD. Is this accepted? I can’t afford to continue to pay for private medication – can my GP prescribe it?
Is it possible to prioritise assessments?
Do you diagnose ASD in pre-schoolers?
Who identifies dyslexia or dyscalculia?
Do you diagnose Learning/ Intellectual Disability in pre-schoolers?
Do you diagnose ADHD in pre-schoolers?
Do you diagnose Auditory Processing Disorder, Pathological Demand Avoidance (PDA) or Dysgraphia?
Is the Dimensions Tool compulsory?
Are the ASQ & ASQ:SE compulsory for children under 3 who are not in an educational placement?
Do I need a formal diagnosis of an Intellectual/ Learning Disability to access support from the Community Learning Disability Nursing (CLDN) team or CAMHS Intellectual Disability team?
Is the teacher questionnaire really necessary?
Why is there a new optional parental views form?
Information Leaflet for Children/ Young People
Information Leaflet for Parents and Carers
Early Years Response Team
The East Lothian Early Years Response Team (EYRT) is a multi-agency network designed to offer relevant and timely support for children with an identified need before they start school. Children who access this service will be deemed to have significant and complex additional support needs affecting their development. Recommended support will be identified using a staged intervention framework, in order to meet specific needs at the right time. Referrals for this service should be made through the Single Point of Access (SPA).
The EYRT panel has active representation from:
Inclusion & Wellbeing Service (Education)
Early Learning & Childcare (Additional Support Needs)
Early Years Outreach
Health Visiting
Speech & Language Therapy
School Nursing (Additional Support Needs)
Occupational Therapy
With wider support links with the Community Learning Disabilities Nursing team (CLDN), Community Child Health (CCH), Early Years - Child & Adolescent Mental Health Services (EY CAMHS) and the Educational Psychology Service (EPS).
The EYRT panel will review Requests for Assistance approximately every two months, and make recommendations for accessing the most appropriate intervention from the range of services available for that child at that time e.g. home play sessions, parenting programmes, support transitioning to an Early Learning & Childcare setting etc. The Early Years Response Team is the main referral pathway to access Education’s 0 – 3 Outreach Service including ‘Kidz Play’ (formerly KidZone).
Requests for Assistance forms are available above and should be submitted to cypspa@eastlothian.gov.uk
Who is present at the SPA?
The group is chaired by the Mental Health and Wellbeing Coordinator and comprises representatives from CAMHS, Social Work, Mental Health Youth Workers (MHYW), MYPAS Counselling Service, representatives from the Neurodevelopmental Pathway team and Early Years Response team. The MHYWs present each child or young person from their area.