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The Decision Support Tool sets out children’s needs across 10 care domains, divided into different levels of need:
breathing
eating and drinking
mobility
continence and elimination
skin and tissue viability
communication
drug therapies and medicines
psychological and emotional needs
seizures
challenging behaviour
The nominated children and young people’s health assessors will use their clinical skill, expertise and evidence-based professional judgement to consider what, for each care domain, is over and above what would be expected for a child or young person of that age. For example, incontinence would only become recognised as an issue when a child or young person has continence needs beyond those typical for their age
The needs described in the care domains and levels of need in the Tool may not always adequately describe every child or young person and their family’s circumstances. Professional judgement and clinical reasoning are paramount in ensuring that a child or young person’s needs are accurately assessed, taken into account and given due weight when making a decision regarding their continuing care needs. All four parts of the assessment process interact in defining the child or young person’s overall need for continuing care
The assessment of a child’s continuing care needs must consider the outcomes necessary to enable the child or young person to get the best from life, and outcomes relating to transition (where the child is 14 years or older).
They should be specific, deliverable and linked directly to the child’s wishes. They should include where appropriate, outcomes for transition, through key changes in a child or young person’s life, such as changing schools, moving from children’s to adult care and/or from paediatric services to adult health, or moving on from further education to adulthood.
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