Community Physiotherapy - Liverpool

Community Physiotherapy - Liverpool

A team of physiotherapists and assistants highly specialised in treating children aged 0-19 years with long term physical difficulties in various community settings. Children with recent injuries e.g. broken leg, chest infections will be seen by the team based at Alder Hey Children’s Hospital.

We actively encourage parent participation and welcome the opportunity to involve parents with our service development and with the services offered to their child.

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Who do we see?

We see children who live in or attend school within the following postcode areas:

  • L1 to L9
  • L11 to L13
  • L14 (Liverpool side; addresses in Knowsley would be seen by Knowsley services if the child does not attend a Liverpool school)
  • L15 to L19
  • L24 to L25
  • L27
  • L28 (Liverpool side; addresses in Knowsley would be seen by Knowsley services if the child does not attend a Liverpool school)

Children living in or attending school in L20 to L23 and L30 to L31 would be seen by our South Sefton Community Physiotherapy team. The Sefton team also see some children living or attending school in the L10 area although we may see some children living in the Liverpool side of L10. If you have any queries or feedback please email at CommPhysioAdmin@alderhey.nhs.uk.

Questionnaires

You may be asked to complete one of these questionnaires when you use the Liverpool Community Physiotherapy service:

Contact us

We are based at Liverpool Innovation Park, next to Edge Lane. It is a large building we share with a number of other organisations and you can access it from Digital Way. Car parking is available:

The Aimes Centre
2nd Floor, Baird House
Liverpool Innovation Park
Liverpool L7 9NJ

For general information and to contact your physiotherapist please call 0151 438 2090. You can also email us at CommPhysioAdmin@alderhey.nhs.uk

If your child is seen at their school, you can contact your physio on:

  • Broadgreen International High School – 0151 254 6829
  • Millstead School – 0151 722 0974 Ext. 26
  • Palmerston School – 0151 428 2128
  • Princes School – 0151 709 2602
  • Redbridge High School – 0151 525 5733
  • Royal School for the Blind – 0151 733 1562
  • Sandfield Park School – 0151 259 9019
  • Springwood Heath School – 0151 494 3318

How we work: Information about appointments

Which conditions do you treat?

We specialise in treating children with neurological conditions (including Cerebral Palsy, Developmental Delay, Developmental Co-ordination Disorder, Spina Bifida, Genetic Syndromes and Acquired Brain Injuries)

What should I expect during my first appointment?

Your first appointment will involve a detailed assessment of your child. This will include gathering information about the history of your child’s condition, how they are affected by their condition, what difficulties they experience and what they would like to improve and achieve. We will also discuss the impact on the family and what your concerns and aims are. A full physical examination will also be carried out in order to provide the necessary information to analyse your child’s current ability and identify areas for improvement. Following completion of your child’s assessment, discussion will take place as to the most appropriate type and frequency of treatment.

How long do the treatment sessions last?

Your first appointment will last approximately 45 minutes. Subsequent sessions are most often of the same duration, however this will be discussed at your initial appointment and the most suitable duration agreed. Time will vary depending on your child’s age, exercise tolerance and level of concentration.

How frequent are the treatment sessions?

Frequency will vary depending on your child’s condition. Following your child’s initial assessment, the most beneficial frequency will be agreed. Examples of different available frequencies include a one off assessment, regular monitoring, frequent blocks, ongoing weekly input or higher interventions for specific periods e.g. following surgery.

What appointment times do you offer?

We work Monday to Fridays and we offer morning, afternoon and after school appointments. This provides a family focused service, ensuring the flexibility of a time where your child will be most responsive to treatment and free from other commitments.

How can I refer my child?

You can refer your child yourself or you can ask a professional involved in your child’s care to refer your child.

To refer yourself you can either telephone 0151 438 2090 or you can download and complete our referral form and email it to CommPhysioAdmin@alderhey.nhs.uk or post it to Community Physiotherapy, The Aimes Centre, 2nd Floor, Baird House, Liverpool Innovations Park, Liverpool, L7 9NJ.

How long will my child wait before being seen by a physiotherapist?

We cannot give you an exact length of time but we aim to see you within the 8 week guidelines. We will let you know when we have received a referral for you child and will be in touch with you to arrange an appointment at the earliest availability.

Where will my child be seen?

This varies depending on the age of your child.

Children aged 0-5 will be seen in an outpatient clinic held in one of 7 Children Centres across Liverpool. They may also be seen in a nursery setting if they have one following the initital assessment.

Primary and Secondary aged children will be seen in their own school setting. If the appointment falls during school holidays you may be asked to bring your child to one of the schools we use as bases and have access to during the holidays.

Do I need to be present at the physiotherapy sessions?

We ask that parents or guardians attend the initial assessment with their child in order for us to gain consent for your child to be seen, and also to gain the child’s history and meet the physiotherapist.

Following the initial assessment, school aged children can be seen without their parents present. The physiotherapists keep in contact by telephone, letters and reports to ensure you are aware of your child’s progress.

Children aged 0-5 generally require their parents/guardians to bring them to the appointments but if they are in a nursery setting they may be seen without the parents present. Again, we ensure parents/guardians are kept informed.

If at any point it is felt a meeting with the parents is required you will be contacted and asked to attend an appointment. Likewise, if you at any point want to attend a physiotherapy session you can contact your child’s physiotherapist.

How can I learn more about 24 hour postural management?

We run information sessions for families regarding 24 hour postural management. Please contact your Physiotherapist for further details or email us at: CommPhysioAdmin@alderhey.nhs.uk.

Information about babies, orthotics and postural care

Babies: How do they learn to move?

Babies who have not been born prematurely are usually born in a position of flexion (see photo below). This means that they are bent up at the hips and knees. Their arms are tucked in and their back is rounded.

This pattern of flexion becomes less obvious as the baby begins to experience different positions and movements. As your baby gets older they begin to explore positions of extension (being straight) and positions working against gravity, e.g. sitting and standing. Here we have some guidance on the stages of motor (movement) development as your child gets older:

  • 3-6 months – child begins to roll
  • 6-9 months – child begins sitting independently
  • 9-12 months – child begins crawling, pull to stand and may cruise around furniture
  • 12-18 months – child begins to stand independently, walk with support and walk independently

Not all children will follow this guidance e.g. some children may not crawl and may bottom shuffle.

***ALL CHILDREN DEVELOP AT DIFFERENT AGES, THEREFORE THE TIMESCALES SHOWN ARE ONLY A GUIDE***

The milestones for children who are born prematurely will often be delayed by approximately the number of weeks they were early. Similarily, if your child has been diagnosed with an underlying condition their milestones may also be delayed.

If you have concerns about your child’s development here are some play ideas that may help…

Lying on their back

Encourage baby to bring their head into the middle when on their back and encourage them to play with their hands in front of them and in the middle. A play gym can help encourage your baby to bring their hands together. Once your child is able to achieve head in midline and hands together start to place toys slightly out of their reach to encourage them to turn their head side to side. This will help them move their weight side to side which will help them learn to roll.

Lying on their tummy

This is an important position to play with your baby from a very early age under supervision. It helps to develop patterns of extension which means lifting their head, straightening their back and hips which are all important when learning to sit, crawl and walk.

*** WE ADVISE IN ACCORDANCE WITH CURRENT GUIDANCE THAT ALL BABIES ARE PLACED TO SLEEP ON THEIR BACKS ***

Lying on their side

This position helps babies to bring their hands in to midline to play with their toys. It also helps to relieve pressure away from the back of the head to prevent flattening.

If, after reading this section, you continue to have concerns regarding your child’s development then please complete our self referral form for a request for a Physiotherapy Assessment.


Orthotics service

Our Orthotics service is based at Alder Hey Children’s Hospital, but there are also clinics run in the community. Read more about the Orthotics service and how they work or call 0151 252 5318 to speak to them.

If a doctor or physiotherapist thinks that you child may benefit from wearing a splint or orthosis you will be referred to an orthotic clinic. The orthosis/splint can be for any part of your child’s body, neck, arm, hand, leg, foot etc. The orthosis/splint can have many functions e.g.

  • To make your child more steady in standing
  • To keep your child’s foot or leg in a good position
  • To help your child walk better
  • To help your child use their arm in a better way
  • To help your child sit in a better position
What might happen at the clinic?

If your child goes to a mainstream school or a nursery a convenient appointment time and location will be discussed with you by your child’s treating physiotherapist or physiotherapy assistant.

If your child attends one of the schools listed below you will receive a letter inviting you to attend the next available clinic in your child’s school:

  • Broadgreen High School
  • Childwall Medical Centre
  • Millstead Special School
  • Palmeston Special School
  • Princes Special School
  • Redbridge High School
  • Royal School for the Blind
  • Sandfield Park School
  • Springwood Heath School

24-hour Postural Care

Postural Management is the term used to describe the 24-hour physical management of a child who has a physical disability and limited independent movement.

Under normal circumstances, babies begin life unable to independently achieve a balanced and straight posture. Th e child’s body grows and remains straight if it is able to move in a varied and even way. It is generally agreed that, because children with neurological or motor impairment, e.g. Cerebral Palsy, lack this ability, they are at high risk of developing postural problems if not properly managed.

If these children are routinely placed in or adopt positions that do not keep their spine in line or that they are unable to move out of, they become uncomfortable and stiff and the body eventually becomes fixed in that position or other destructive postures. This is likely to cause pain, lead to damaged skin, reduce function and limit access to “normal” activities.

Postural Care is carried out on a day to day basis by all people involved in the child’s care. Postural management should start as soon as a movement problem has been identified.

Who should be involved in postural management?

Postural Management should involve everyone who has contact with the child at home, school or in a health professional capacity.

The Postural Management Plans

A postural Management Plan will include assessment, the setting of postural management goals and a package of interventions (including the provision of often highly specialised equipment).

We are currently creating A5 laminated Posture Management plans for our clients with movement disorders. These are made in conjunction with Parents, Liverpool Children’s Occupational therapists, Liverpool Wheelchair Service and Liverpool Manual Handling Team. If you would like to know more about this project then please contact your Physiotherapist.

What are we aiming for?
  • Give comfortable, symmetrical support for children who are unable to move well
  • Protect a child’s body shape during the day and night, encouraging them to grow as straight as possible
  • Give advice and training in positioning your child, including the use of specialist equipment

Disabled children and young people with postural needs are usually provided with specialist equipment to help them sit and stand. With help from Aiming High for Disabled Children there has been additional equipment in Liverpool to support their posture around the clock.

Looking after posture is not just about getting a good sitting position in a wheelchair or a school chair. Out of nearly 9,000 hours in a year around 4,000 are spent in bed! Night time positioning equipment can have a therapeutic benefit even whilst a child is asleep. Sleep pattern, position and posture can all be improved as well as reduced pain and better mood. Stress levels may also improve because the less a child needs their position changed in the night and the longer and better they sleep, so do their parents.

In consultation with children and parents we are in the process of developing a Night-time Positioning Pathway and 24 Hour Postural Care Plans for all children with a postural need. These care plans can go wherever the child goes so their requirements are met in a consistent way by everyone involved with their support. In addition to equipment for home, night-time positioning equipment is also available in short breaks settings including Claire House, Prescot Drive, Woolton High and Zoe’s Place. There is also new postural care equipment in use at Alder Hey Hospital to use on the wards. Parents are key to identifying their child’s needs and, working together with therapists, to working out what’s required to protect their child’s body shape. Our project group actively encourages parents to participate and still needs more parents to get involved. If you are interested then please contact us by email or telephone contact us

If you have any concerns or questions please contact your therapist.

Information for professionals: Referrals and clinical placements

To make a referral, please download and complete the Community Physio Referral Form, then return it to deborahfisher@nhs.net or by post to:

Community Physiotherapy
The Aimes Centre
2nd Floor, Baird House
Liverpool Innovations Park
Liverpool L7 9NJ

Information for students

If you would like an elective placement with us please email CommPhysioAdmin@alderhey.nhs.uk.

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