NICE QUALITY STANDARD - Cerebral Palsy in Children and Young People

The guidance makes a number of recommendations, including that children not sitting by eight months, using one hand more than the other before 12 months, or not walking by 18 months, should be referred to specialist services for assessment.

The quality standard also says that children with significant risk factors – such as babies born before 28 weeks or with a low birth weight - should be given additional follow-up to help spot the signs of cerebral palsy earlier.

How can your department help support and attain NICE quality standards for children and young people with cerebral palsy and their families?

What are NICE quality standards?

NICE quality statements are produced after NICE publishes guidance on a particular topic, to ensure that the best evidence is disseminated and translated into health care.  Each quality statement includes quality measures: information on how to check to what extent the statement is being achieved, and what the statement might mean for different audiences, e.g. allied health professionals, commissioners, service users, etc.  The quality standards are sent to clinical commissioning groups for implementation.

Where can I find this information?

The quality standard can be found on the NICE website.

How can I use this information? 

This information can be used to alert physiotherapists to evidence based standards of health care, auditing physiotherapy and other health care services and possibly be used as part of a case for improving and increasing physiotherapy services. 

What are the quality statements for cerebral palsy in children and young people? 

Quality Statement 1 

Children with any major risk factor for cerebral palsy have enhanced clinical and developmental follow-up from birth to 2 year.

Quality Standard:

• Proportion of children with any major risk factor for CP attending a routine appointment up to 3 months of age who haf movement and development checked.
• Proportion of children with any major risk factor for CP and older than 3 months who have a planned schedule of developmental follow-ups.

Quality Statement 2

Children with delayed motor milestones are referred to a child development service.

Quality Standard:

• Proportion of children with delayed motor milestones who are referred to a child development service (not sitting by 8 months, not walking by 18 months, early asymmetry of hand function before 1 year).

Quality Statement 3

Parents and carers of children and young people with cerebral palsy are given information about the diagnosis and management of cerebral palsy.

Quality Standard:

• Proportion of parents and carers of children and young people with cerebral palsy who are given information about diagnosis and management of cerebral palsy.

Quality Statement 4

Children and young people with cerebral palsy have a personal folder to help them make decisions about how their condition is managed.

Quality Standard:

• Proportion of children and young people with cerebral palsy have a personal folder to help them make decisions about how their condition is managed.

How could I help implement or use this information where I work?

• Find out the extent of developmental follow-up in your area and how it is being audited according to the NICE quality statements
• Use the quality measures to audit some aspects of your service
• If you are making a case for having a physiotherapist involved in developmental follow-up, use the quality standards and measures to support your case
• Find out if personal folders are being provided for children with CP in your area and if not, determine how this could be initiated with your commissioners
• For standards 3 and 4, make a case for increased budget to provide information on CP to parents and children, and to be able to provide information on physiotherapy