title: Variable implementation of good practice recommendations for the assessment and management of UK children with neurodisability.
abstract: OBJECTIVE
  The aims of this study were to determine whether UK child development teams (CDTs) have implemented good practice recommendations for the co-ordinated assessment and support of children with neurodisability and to explore some of the factors associated with variations in good practice implementation.
  
  
  METHODS
  Surveys were sent to every UK CDT in 2009/2010. Responses about CDT provision and ways of working were compared with good practice recommendations from national policy documents and professional organizations. The extent to which CDTs in England and Wales met 11 selected good practice recommendations was scored; teams in Scotland and Northern Ireland were given a score out of 9 to reflect the optional use of the common assessment framework and early support materials in these countries.
  
  
  RESULTS
  Responses were received from 225/240 (94%) UK CDTs. Thirty-seven per cent of CDTs in England and Wales had implemented nine or more of the 11 recommendations. Fifty-nine per cent of teams in Scotland and 78% of teams in Northern Ireland met between six and nine recommendations of good working practice. Higher levels of implementation of recommendations were found when the CDT had a Child Development Centre base and for teams who had received increased funding in the 5 years preceding the survey.
  
  
  CONCLUSIONS
  There was considerable variability in the degree to which CDTs implemented good practice recommendations for the diagnosis and management of children with neurodisability. Evidence about child and parent satisfaction, and the effectiveness of CDT practices and provision, is required, so policymakers, healthcare commissioners and clinicians can provide the most appropriate services to children with neurodisability and their families.
authors.affiliation: Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK.
authors.forename: L
authors.initials: L
authors.lastname: Gray
authors.affiliation: Countess of Chester Hospital NHS Foundation Trust, Chester, UK.
authors.forename: J
authors.initials: J
authors.lastname: Gibbs
authors.affiliation: Guy's and St Thomas' NHS Foundation Trust, London, UK.
authors.forename: N
authors.initials: N
authors.lastname: Jolleff
authors.affiliation: Nottingham University Hospitals NHS Trust, Nottingham, UK.
authors.forename: J
authors.initials: J
authors.lastname: Williams
authors.affiliation: Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK.
authors.forename: H
authors.initials: H
authors.lastname: McConachie
authors.affiliation: Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK.
authors.forename: J R
authors.initials: JR
authors.lastname: Parr
mesh_terms: D002648:Child; D002662:Child Health Services / Q000458:organization & administration* / Q000592:standards; D004185:Disability Evaluation; D019988:Children with Disabilities; D019468:Disease Management; D004739:England; D019538:Health Care Surveys; D015277:Hotlines; D006801:Humans; D065886:Neurodevelopmental Disorders / Q000175:diagnosis* / Q000628:therapy; D010348:Patient Care Team / Q000458:organization & administration; D014852:Wales; D016526:Workload
keywords: child development teams; children; neurodevelopment; neurodisability; services