Since the Court report was published in 1976 there has been a consensus that the needs of children with disabilities are best met by child development teams. This study explored the structure, facilities, and organisational elements of child development teams operating in the South East Thames region by means of a structured interview with senior professionals involved with organising services for children with disabilities in 14 of 15 health districts in the region. Although all districts had a designated child development team, not all core professionals were adequately represented and four of 14 districts had no child development centre. The quality of buildings and facilities was variable. Teams that did not have a physical base in the form of a centre had fewer staff in the service and poorer facilities. There is a need for further consensus work about broad guidelines on the requirements ofchild development teams. These will help to inform purchasing authorities about the needs of children with disabilities living in their districts.
After a decade of research, the parent-held Personal Child Health Record was introduced in some parts of the United Kingdom in 1991, coinciding with the enforcement of the Children Act 1989. It was designed as the main record of a child's health and development, to be used until adulthood and to be held by parents. Several Health Care Trusts have since discovered a need to maintain parallel records in the best interests of children. Barnet introduced the 'Joint Professional Record' in 1995 for selected children, such as children on the Child Protection Register. The Joint Professional Record (JPR) is a single, clinic-held, parallel record for multidisciplinary use. We undertook a programme of audit and staff seminars to develop and evaluate use of the JPR. We discuss, below, the impact of this record on professional working relationships and consider the implications of its use as a confidential record and within our policy of working in partnership with parents. In our experience, the JPR has proved a useful adjunct to clinical supervision in the arena of Child Protection and is appropriately used for children in need of protection and those with 'special needs'.
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