Persistent Physical Symptom Service

Our CYPS Persistent Physical Symptom (PPS) Service works with patients under the age of 18 and professionals across Gloucestershire to increase understanding and confidence in management of long-term physical symptoms, where there is no medical cause.

About this service

We are a joint team of medical practitioners from Gloucestershire Health and Care NHS Foundation Trust and Gloucestershire Hospitals NHS Foundation Trust. The team is made up of experienced paediatricians, a clinical psychologist, physiotherapist and occupational therapist offering support, advice psychoeducation and therapy for patients with persistent physical symptoms that are significantly affecting a young person’s daily life.

We work together with children, young people, their parents, carers and education settings to understand and manage their symptoms, with the aim of improving both their day-to-day life.

What are persistent physical symptoms?

We all experience painful or uncomfortable feelings in our body at some time in our lives. Common examples are headaches, stomach aches and ‘growing pains’. Often these symptoms get better on their own and do not need any treatment.
If our symptoms do not get better, we might ask a doctor about them. The symptoms may be assessed medically and investigations such as blood tests, X-rays or scans may be done. Sometimes a physical cause is found and treated. However, on some occasions no medical cause is found, yet the symptoms do not go away (i.e. become persistent). They may also begin to affect our daily lives.
Persistent Physical Symptom Service

How do persistent physical symptoms affect young people?

Studies show that approximately one in 10 children and adolescents experience episodes of persisting symptoms at some point in their childhood. A smaller number of these young people experience persistent physical symptoms that begin to significantly affect their daily lives.

Symptoms can vary and may include headaches, stomach aches and other digestive problems, joint and other pains, and tiredness. Less common symptoms can be episodes of collapse, seizures, muscle weakness and changes to the way a child walks or moves. The symptoms may persist for several weeks, months or sometimes longer.

Persistent physical symptoms may result in children and young people:

  • Missing a lot of school, meaning they may not achieve what they should, academically or socially
  • Seeing less of their friends, and having fewer interests, hobbies and fun
  • Losing confidence, or becoming increasingly worried, anxious or low in their mood
  • Becoming less independent than other young people their age.

In the most severe cases, children might also spend a significant amount of time as inpatients in hospital.

What can I do to help a young person with Persistent Physical Symptoms?

  • Reassure them that in most cases persistent physical symptoms resolve over time without medical intervention and do not last forever. A common fear they may have is “I will always feel like this”
  • Be clear that you believe them and know that their symptoms are real, not ‘made up’ or ‘in their head’
  • Explain that sometimes a ‘reason’ for symptoms is never found and this is OK. Symptoms can go away as mysteriously as they arrived without there being “something wrong” with them
  • Talk openly about other issues or stressors that may also be important to them. Sometimes these can play an important role in understanding why the physical symptoms are happening now
  • When needed, doctors and therapists can work with children and young people to help them live well with a symptom (i.e. so it impacts less on their daily life) while it gradually gets better with time.


We only accept referrals from professionals such as NHS clinicians and therapists for children and young people who are experiencing significant symptoms that are affecting their daily life; where no identifiable medical explanation has been found

To make a referral please contact the service for a referral form:

Professionals can also access our referral form on Gcare.


Books for parents and adolescents

  • You Don’t Understand Me by Tara Porter
  • It’s all in your Head by Suzanne O’Sullivan
  • The Body keeps the Score by Bessel Van Der Kolk
  • The Painful Truth book by Monty Lyman (for parents)

For younger children

  • The Zoe and Zak pain hacks books by Joshua W. Pate

Mental health support

Contact details


0300 421 8171


Springbank Resource Centre, Springbank Way, Cheltenham GL51 OLG