Spasticity in under 19s: management

Care for children and young people with spasticity

In the NHS, patients and healthcare professionals have rights and responsibilities as set out in the NHS Constitution (www.dh.gov.uk/en/DH_132961). All NICE guidance is written to reflect these. Children and young people with spasticity and their parents and carers (if appropriate) have the right to be involved in discussions and make informed decisions about treatment and care with the healthcare team. Their choices are important and healthcare professionals should support these wherever possible. All children, young people and their parents and carers should be treated with dignity and respect.

To help children and young people, and their parents and carers, to make decisions, healthcare professionals should explain spasticity and the possible treatments for it. They should cover possible benefits and risks related to the circumstances of the child or young person. Children and young people, and their parents and carers, should be given relevant information that is suitable for them and reflects any religious, ethnic, or cultural needs they have. It should also take into account whether they have any learning disability, sight or hearing problem or language difficulties. Children and young people, and their parents and carers, should have access to an interpreter or advocate (someone who helps you put your views across) if needed.

When parents and carers are involved they should be able to discuss or review the child's care. As treatment progresses, or circumstances change, it is possible for children and young people and their parents and carers to change their mind about assessments, investigations and treatments.

Healthcare professionals should follow the Department of Health's advice on consent (www.dh.gov.uk/en/DH_103643) and the code of practice for the Mental Capacity Act. Information about the Act and consent issues is available from www.nhs.uk/CarersDirect/moneyandlegal/legal. In Wales healthcare professionals should follow advice on consent from the Welsh Government (www.wales.nhs.uk/consent).

If the child or young person is under 16, their parents or carers will need to agree to their treatment, unless it is clear that the child fully understands the treatment and can give their own consent.

Care of young people who are moving from services for children to adult services should be planned according to guidance from the Department of Health ('Transition: getting it right for young people' available from www.dh.gov.uk).