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Being Healthy

SEND Small Group Personal Training Sessions for young people aged 16 to 25 subsided by funding from Bedford Borough Council

SEND Small Group Personal Training Sessions for young people aged 16 to 25 subsided by funding from Bedford Borough Council

Annual Health Checks

People with a learning disability often have poorer physical and mental health than other people. This does not need to be the case

Anyone aged 14 or over who is on their doctor's learning disability register is entitled to a free annual health check.  An annual health check can help a young person stay well by enabling them to talk to a doctor or nurse about their health and finding any problems early, so they can be sorted out.

You do not have to be ill to have a health check – in fact, most people have their annual health check when they're feeling well.

Annual health check for people with learning disabilities | Bedford Local Offer

Health Care Advice - Text ChatHealth

Are you aged 11-19, living in Bedfordshire, and looking for health advice?

You can now text our school nurses on 07507 331450 to ask any health related questions you might have including mental health, drugs, relationships, healthy eating and much more.

ChatHealth is an easy, confidential and anonymous way to ask questions about your health. Our team will be there to answer your text from 9am to 4.30pm, Monday to Friday (except bank holidays).

The ChatHealth messaging service is run by the School Nursing team in Bedfordshire. Direct support and advice on all kinds of health issues such as sexual health, emotional health and wellbeing, bullying, healthy eating and general health concerns is available from a School Nurse, Monday – Friday from 9am-4.30pm, excluding Bank Holidays.

Young people from 11-19 can message a School Nurse for confidential advice and support by texting their message to the ChatHealth number 07507 331450. Just saying ‘hello’ is enough to get the conversation started. A School Nurse will reply to the message as quickly as possible. The service is confidential, unless issues emerge from a conversation that gives cause for concern for the young person’s safety and well-being.

 For more information about the ChatHealth service and general health and wellbeing advice and guidance for young people aged 11-19 Chathealth Bedfordshire - run by Bedfordshire Community Health Services | Bedford Local Offer

Help in Hospital – Hospital Passports/All About Me Booklet

Your hospital passport All About Me Booklet will give hospital staff helpful information that isn't only about illness and health. It can include lists of what you like or dislike. This might be about the amount of physical contact you're ok with, to your favourite type of drink, as well as your interests.

The passport helps all the hospital staff know how to make you feel comfortable.

If you go into hospital, your hospital passport should go with you. The passport tells the doctors and nurses that they should make a copy and put the copy in your hospital notes. 

If you are going to be an in-patient, and stay in the hospital overnight, your hospital passport should hang on the end of your bed so that anyone treating you can take a look at it.

For more information about Hospital Passports visit  Health Guides: Hospital Passports, Summary Care Records And Flu Jabs | Mencap

For more information about going into hospital visit Bedfordshire Hospitals Learning Disability Information pages | Bedford Local Offer

NHS Bedfordshire Hospitals Learning Disabilities teams

The Learning Disabilities teams at NHS Bedfordshire Hospitals are based at both Bedford and the Luton and Dunstable sites and provide specialist support for adult patients who have a learning disability (inpatient or outpatient).

Children with a learning disability who are approaching 18 will move from children’s services to adults’ services; this is often very challenging for young people and their families. The move combines a change of services and professionals at the very time when they are also negotiating wider changes to their life.

These changes should, however, be planned. If a child, is approaching the age of 17 onwards then we would like you to contact Learning Disability Liaison so that we can support the transition process, introduce ourselves and provide you with information which will hopefully reassure you as to the support that can be accessed within the hospital.

We can help you complete a Capacity Assessment and Best Interest decision under the Mental Capacity Act, provide specific training on learning disabilities for all staff, and advise on how to make ‘Reasonable Adjustments’ to provide services for people with disabilities.

​Our support may also include assistance with communication with both the patient and their usual carers, support formulating plans of care and pathways of care that meet the physical and learning disability needs.

For more information, follow the links below

Bedford Hospital Learning Disability Liaison Service | Bedford Local Offer

Luton and Dunstable Hospital Learning Disability Service | Bedford Local Offer

Bedfordshire Hospitals Learning Disability Information pages | Bedford Local Offer

NHS Continuing Healthcare

Some people with long-term complex health needs qualify for free social care arranged and funded solely by the NHS. This is known as NHS Continuing Healthcare.

NHS continuing healthcare can be provided in a variety of settings outside hospital, such as in your own home, supported living or in a care home.

NHS continuing healthcare is for adults. Children and young people may receive  continuing care if they have needs arising from disability, accident or illness that cannot be met by existing universal or specialist services alone

For most people, there's an initial checklist assessment. This is used to decide if the child, young person or adult needs a full assessment. Depending on the outcome of the checklist, the child, young person or adult will be advised either : 

  • Your needs do not meet the criteria for a full assessment of NHS continuing healthcare. Therefore, you are not eligible or:
  • You will be referred for a full assessment of eligibility

The assessment is based on clinical evidence and will consider needs under the following headings:

  • Breathing
  • Nutrition (food and drink)
  • Continence
  • Skin (including wounds and ulcers)
  • Drug therapies and medication
  • Mobility
  • Psychological and emotional needs
  • Behaviour, Communication and Cognition (understanding)                               
  • Altered states of consciousness
  • Other significant care needs

Your eligibility for NHS Continuing Healthcare depends on your assessed needs, and not on any particular diagnosis or condition. If your needs change then your eligibility for NHS Continuing Healthcare may change.

If you are not eligible for NHS Continuing Healthcare, you can be referred to the local authority who can discuss with you whether you may be eligible for other support.

Continuing Healthcare - BLMK Integrated Care Board (

How Do I Appeal the Continuing Health Care Decision?

If you are dissatisfied with the outcome of your CHC assessment you or your representative, who has the authority to act, can contact uBLMK ICB in writing to appeal the decision within 6 months of the assessment. We are also able to put you in touch with agencies that can offer support and advice. 

Useful links and other websites

The following trusted organisations also provide a wealth of useful information on NHS Continuing Healthcare.

Age UK

Alzheimer’s Society

Beacon – If you would like more information on NHS Continuing Healthcare, you can contact Beacon who will provide 90 minutes of free impartial advice, (NB after the initial 90 minutes there is a financial charge which they will inform you of). Beacon can be contacted on 0345 548 0300 or via their website which has free resources and information.

Personal Health Budgets

A personal health budget (PHB) is an amount of money to support a person’s identified health and wellbeing needs, planned and agreed between the person and their local NHS Team.

At the centre of the personal health budget is a care and support plan. This sets out the agreed health and wellbeing outcomes that the individual wants to achieve, and how the budget will be spent to help them.  It isn’t new money, but a different way of spending health funding to meet the needs of an individual.

Personal health budgets are a way of personalising care, based around what matters to people and their individual strengths and needs. They give disabled people and people with long term conditions more choice, control and flexibility over their healthcare.

To learn more please visit the NHS England's Personalised Care pages.

There are three types of personal health budgets:

  • Notional – you would find out how much money is available and how it could be spent to meet your needs. Your NHS team will arrange the agreed care and support for you.  No money changes hands.
  • Third party – a different organisation holds the money for you and arranges the care and support agreed.
  • Direct payment – you hold the money directly to buy the things set out in your support plan. The Integrated Care Board will need to see how the money is being spent in accordance with your support plan

Who can get it?

The right to have a personal health budget applies to people who are:

  • adults receiving NHS continuing healthcare (NHS-funded long-term health and personal care provided outside hospital) NHS continuing healthcare (CHC)
  • children receiving NHS continuing healthcare Children’s continuing care
  • people with mental health problems who are eligible for section 117 after-care as a result of being detained under certain sections of the Mental Health Act (this does not include detention under section 2 of the Act).After-care services under section 117 of the Mental Health Act 
  • People who are referred and meet the eligibility criteria of their local wheelchair service, and people already registered with the wheelchair service, when they require a new wheelchair  or specialist buggy either through a change in clinical needs or in the condition of the current chair

How is a personal health budget worked out?

If you are able to have a personal health budget, then together with your NHS team you will develop a personalised care and support plan. The plan sets out your personal health and wellbeing needs, the health outcomes you want to achieve, the amount of money in the budget and how you are going to spend it.

A care co-ordinator, who will be your first point of contact in case you have any concerns, should be identified in the planning process.

Find out more about Personal Health Budgets through the NHS: personal health budgets.

For further information on Personal Budgets across, health, education and social care Personal Budgets | Bedford Local Offer

Puberty for children/young people with SEND

Local offer pages: 

Puberty in girls/young women  with additional needs – Periods


Puberty in boys/young men with additional needs


Puberty, Anatomy and autonomy



SPACE, this group is for parents and carers of SEND children residing in Hertfordshire, but neighbouring counties (including Bedfordshire) can also attend webinars.



What's Happening to Ellie?: A book about puberty for girls and young women with autism and related conditions: 4 (Sexuality and Safety with Tom and Ellie)


Autism Friendly guide to periods

The Growing Up Guide for Girls: What Girls on the Autism Spectrum Need to Know!

Special Growing Girl: A guide to puberty for girls with special needs

What's Happening to Tom?: A book about puberty for boys and young men with autism and related conditions:

The Growing Up Book for Boys: What Boys on the Autism Spectrum Need to Know


Video Clips- BBC Bite Size (please check all 3 pages)



To help girls track their cycle apps such as Clue may help

Many send girls can struggle with traditional pads and tampons due to sensory difficulties.


Relationships, sexuality and gender identity

Relationships are an important part of everyone’s life but it can be difficult to talk about. People with a learning disability or special needs have the same rights as anyone else to express their sexuality and have personal and sexual relationships if they want to.

As young people mature they may find that they are attracted to people of the same sex, or, people of the opposite sex to their own, this is normal.

The information and links on this page will help young people, and adults, understand about the different types of relationships that they, and others may have.

Trying to understand your sexuality can be confusing sometimes. If you’re struggling to cope or you’re not sure what to do next, Childline has  advice to help. Sexuality | Childline

Gender identity can be confusing sometimes, but Childline has got advice and support to help you feel less alone. Gender identity | Childline

Growing up, sex and relationships A guide to support parents of young disabled people

growing_up_parents_new_logo.pdf (

Growing up, sex and relationships A guide for young disabled people

growing_up_young_people.pdf (


Sexual Health and Pregnancy

Sexual Health is important for everyone, but if can be quite difficult to talk about. We hope that the information on this page will help young people, and adults, understand how to take care of their sexual health and where to go for help if they need it.

iCaSH stands for 'integrated Contraception and Sexual Health'.

iCaSH Bedfordshire has two hubs across Bedford Borough, bringing all aspects of sexual health under one roof. The two clinics available to Bedford Borough residents are:

Contraception and sexual health | Bedford Borough Council

Contraception and safe sex | Childline

Sexual health easy read guides.

Sexual health - NHS (

You are pregnant: your choices - an easy read guide

Pregnancy information on Disability Rights UK.

Healthy Start information - NHS website


Someone with a learning disability may not be aware of how important diet and physical exercise is to having a healthy long life. Getting a routine of enjoying a healthy eating and good exercise plan from an early age will help ensure the person maintains this lifestyle into adulthood. Physical activity also builds confidence and social skills, strengthens muscles and bones, improves overall health and fitness and makes you feel good too! Explore activities in your local area and find out what the person enjoys. Encourage them to try new things and get active outdoors by walking, skipping or cycling, or get moving indoors using an exercise routine or virtual online class or video.

Eating a healthy, balanced diet is an important part of maintaining good health. Encourage them to eat at least 5 portions of a variety of fruit and vegetables every day and help them to make good food choices. Getting involved in choosing recipes and making meals together is a great way to learn new skills and can also be fun. There are a range of resources available to give you tips and ideas on how to keep healthy and active:

Live Well - NHS (

Get active - Better Health - NHS (

What is a Care Education and Treatment Review (CETR)?

The policy and guidance for Care, Education & Treatment Reviews (CETRs) comes from the Transforming Care programme. Transforming care is all about improving health and care services so that more people with a learning disability and/or autistic people can live in the community, with the right support, and close to home.

This means that fewer people will need to go into hospital for their care.

A CETR is a meeting. It is organised when a child or young person who has a learning disability or autism is considered to be at risk of a mental health inpatient hospital admission.

The CETR brings together those responsible for commissioning and those providing services alongside the young person and their family or carers. They seek the views and experience of the family and carers and the young person themselves to ascertain whether or not all system resources have been maximised to support the young person to remain in their local community. They also seek to understand how local services are able to support the young person and identify and barriers to accessing that provision. They make suggestions as to any other options or opportunities which could help the young person live and thrive in the community.

CETRs have a set of principles that should always be upheld. These are:

  • Person centred and family centred
  • Evidence based
  • Rights led
  • Seeing the whole person
  • Open, independent and challenging
  • Nothing about us without us
  • Action focussed
  • Living life in the community

Consent MUST be given to hold a CETR by the young person or responsible adult or organisation with parental responsibility if the young person is not competent to give consent.

Types of CETR

  • An urgent CETR is called if a young person is at imminent risk of an admission. In order to facilitate this at short notice these are often teleconferences. These are sometimes called ‘blue light’ CETR’s.
  • If a young person is admitted to hospital, an inpatient CETR must be held within 10 days.
  • A community CETR is held for a young person who is considered to be at significant risk of requiring an inpatient admission, or where there is a significant risk of a family or placement breaking down.

How can it help?

The aim of the CETR is to bring a person-centred and individualised approach to ensuring that the care and treatment and differing support needs of the person and their families are met and that barriers to progress are challenged and overcome so that the child/young person avoids admittance to mental health inpatient hospital.

CETR’s are driven by the NHS, but the involvement of local authority and education services in the CETR process and its outcomes is integral to improving care, education and treatment of children and young people with learning disabilities, autism or both and their families.

At the CETR a key lines of enquiry form is completed. This is anonymised and sent to NHS England for monitoring. An action plan with timescales is produced to support the young person and their family.


How do I request a CETR?

Anyone can request a CETR, including the young person and the family or carers of that young person and professionals working with the young person. Although it is most likely that the young person will already be known to services and be on the Transforming Care draft Dynamic Risk Register this is not always the case.

Where can I go for more information?

NHS England » Care (education) and treatment reviews

What is the Dynamic Support Register?

What is the Dynamic Support Register?

Many children and young people known to the Special Educational Needs Disabled Children’s services will not require Care, Educational and Treatment Reviews (CETRs) and will live full and active lives in the community and/or in residential settings without being at risk of admittance to a learning disability or mental health hospital bed.

Some young people will need support. A Dynamic support register is a list of people with a learning disability and autistic people who need support.

People on the Dynamic support register are at risk of going into hospital if they do not get the right care and treatment in the community.

Once identified and placed on the Dynamic Support Register (DSR), each child is ‘RAG’ rated according to their current risk. The criteria used are as follows:


  • Imminent risk of being admitted to hospital; displaying signs of challenging behaviour that are significantly challenging family and existing support services
  • Young person is placing themselves or others at serious and/or significant risk of harm
  • Young person has had an unplanned hospital admission in the last year (excluding admission for physical health)
  • They have been managed by a crisis team or similar to avoid a hospital admission in the last year
  • All possible options to support in the community have been exhausted


  • Child or young person is starting to display challenging behaviour which existing services are struggling to manage; these behaviours are at such a stage that a multidisciplinary team meeting, or a review of their current services, they are likely to be able to be managed OR
  • The child or young person is living in the community (either at home or in a foster placement) but they are displaying challenging behaviours which may lead to a residential placement being sought, and there are concerns that there may not be a suitable residential placement available
  • The child or young person is in receipt of/has received all possible service options available in the community.


  • The child or young person has previously been in a learning disability or mental health inpatient setting but is currently in the community or a residential placement and there are no concerns.

The DSR is a ‘live’ document and updated in real time, but also reviewed as a whole document on a regular basis by a team of relevant professionals.


For a child or young person to be included on the DSR, they, or their parent/carer/guardian (either because of their age or because they have been assessed as lacking capacity) have to have given their consent to be placed on the register which is held securely by the ICB. This consent must be updated annually. The Lead Professional involved in the case is best placed to seek consent from the parent / carer or from a young person themselves if they are over 16 and deemed to have capacity.

How can it help?

It is important that local services including the NHS, understand the needs of people with a learning disability, autism or both in their area, so that they can make sure people receive the right support in order to avoid being admitted to mental health or learning disability hospitals unnecessarily.

By holding the register and reviewing it regularly to keep it live, key professionals continually evaluate the risk(s) and also progress of the CYP on the register. It also enables the relevant professionals/teams to plan for transition to adult services (if required) in a timely way.

How can it be accessed?

Any professional can bring a child or young person directly to the attention of the Transforming Care/CETR Holder  if they are concerned that a young person is potentially at risk of admission.

Where to go for more information?

NHS England » Dynamic registers and dynamic systems