CEREBRAL PALSY
Integrated Pathway

In 2010 a meeting was held in Liverpool with the aim of reaching a consensus regarding the management of hip problems in cerebral palsy.

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Following this, a group of clinicians met later that year to discuss the possibility of introducing a hip surveillance programme, based on the Swedish model, for children with CP in Scotland.

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Those attending this first meeting were representatives from the Scottish Paediatric Orthopaedic Club (Miss Heather Read, Messrs Simon Barker, Donald Campbell, Jamie McLean, James Robb) Professor Gunnar Hägglund (Orthopaedic Surgeon, Lund, Sweden), Professor Peter Donnelly (Public Health, University of St Andrews) and Dr Paul Eunson (Paediatric Neurologist, Royal Hospital for Sick Children, Edinburgh). They agreed that a hip surveillance programme for children with CP was desirable for Scotland and basing it on the Swedish model was feasible. However, this was an opportunity to collect more than hip data and to include physical examination measures as well. Accordingly, meetings were then held with physiotherapy representatives from all board areas in Scotland and non-nhs providers.

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Protocols for physical and x-ray examinations were agreed and a group established to develop resources to support implementation (Laura Wiggins, Lesley Harper, Nicola Tennant, Susan Quinn and Katie Kinch). Training for physiotherapists for the physical examination of children with cerebral palsy was provided and supported by The Association of Paediatric Chartered Physiotherapists (APCP) Scotland. Audio-visual support was provided by NHS Greater Glasgow and Clyde Medical Illustration Services.

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At the same time, two MRes postgraduate students, Madeleine Baines (2010-11) and Kimberly Stevenson (2011-12) investigated the organisation of resources in Scotland for children with cerebral palsy, the feasibility of introducing a hip surveillance programme and the likely input of occupational therapists into the programme. They were based at the University of St Andrews and supported by a grant from NHS Tayside.

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This collaboration resulted in the Cerebral Palsy Integrated Pathway Scotland (CPIPS) programme, supported financially by the Robert Barr Trust, Brooke’s Dream and the Scottish Government for three years, 2013-2016.

In 2016 the CPIPS programme continued with the support of The Sick Kids Friends Foundation, a charity which supports and compliments the work of Edinburgh Royal Hospital for Sick Children as well as other children's healthcare settings across Scotland.