Paediatric Liaison Public Health Nurse (PLPHN) Referral Form

Guidance notes (please read)
  • This form is for professional use only
  • The role of the PLPHN is to work within the 0-19 yrs Public Health Nursing Service utilising health promotion, prevention and early intervention approaches by working with individuals, families and communities within the health and social care system to improve health outcomes
  • The PLPHN does not require referral of all attendances of children to ED/MIIU/PAU
  • Attendances that meet the mandatory criteria will always require a referral to the PLPHN
  • Include a clear summary of any relevant discussions made with other agencies relating to the health and wellbeing of the patient and further treatment required
  • See below for the additional reasons that require a referral to the PLPHN
Additional criteria for PLPHN referrals

Additional criteria for PLPHN referrals include: (list is not exhaustive)

  • Falls in pre-school children – where further support around safety is indicated; e.g. unsupervised or from a bed/chair/elevated surface.
  • Infant feeding issues requiring feeding advice and support
  • Infant Safer sleep risk factors observed
  • Head injuries – where pre-school children are left unsupervised or concerns are identified.
  • Fractures in children under 2 or where concerns have been identified
  • Accidents and Minor injuries relating to home safety issues for pre-school age children, including burns and scalds, accidental ingestion of toxic substances and foreign objects
  • Pre-school age children requiring additional support managing chronic illnesses
  • Any child or young Person attending with a dog bite where home safety or emotional support is required and risks to the safety and welfare of children and/or a young person has been escalated to children’s social care
  • Any Child or Young person attending due to poor dental health/extractions
  • Not registered with a GP; including unknown Asylum Seekers
  • 3 or more attendances to ED/MIIU in the last 6 months
  • Any children requiring additional support with their Mental Health (& not known to CAMHS)
  • Teenage Pregnancy
  • Child/Young Person attends alone

Health Visitor & School Nurse Information Sharing
This form is to share relevant information to our HV & SN colleagues regarding the child/young person’s attendance to hospital. This will not always result in a home/school visit, unless follow-up is assessed by HV or SN as required. This form ensures information is shared in the “Best interest of the Child”. Remember to inform the child/parent/carer that you will be sharing information with HV/SN.

Safeguarding information

As an NHS employee you have a duty to safeguard and promote the welfare of children, young people and adults at risk. All children must be referred to Children’s Social Care (CSC) where there are safeguarding concerns by the practitioner treating the child. Please complete a Multi-agency Referral Form (MARF) when risks or concerns are identified.

  • Urgent safeguarding enquiries: please contact the Social Care Children’s Helpdesk – 01452 426565 (Monday-Friday between 8.00am-5.00pm)
  • Social Care Children’s Emergency Duty Team – 01452 614194 (Out of office hours)
  • Contact your Trust safeguarding team for advice and support