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There are a range of services that are available to everybody, without the need for any assessment or referral (although you will probably need to register with them), to help manage their health. 

Superlambanana with a bandage on its tail

These are often called ‘Universal’ services and they include GPs, Dentists, Pharmacists, Opticians and Walk-in centres. You can find the details of these services here – NHS Service Search. Emergency and urgent care is available to everyone in the normal way of going to a local A&E or calling 999 as necessary.

There are services that support and treat people with certain conditions and normally you will have to be referred to the services by certain professionals or agencies e.g. GPs, schools, etc.    

These are called ‘Targeted’ services.

Children and young people with a disability, medical condition and/or a special educational need will probably be supported by one or more of these services through their life.

With very complex medical or health needs it may be necessary for individuals to get some very specialised treatment, medication or therapy which is provided locally.  These would be called ‘specialist’ services and access to these will be via the clinical consultant that is managing the care and treatment of that individual.  It is not possible to list all these specialised services, but information should be provided directly to the patient and their family when the treatment etc. is being discussed/arranged.

The services have all been flagged as either universal need or additional need.  All NHS services are universally available to all children and young people.  Additional Services are those that require assistance under Continuing Health Care, this is where a  child requires something in addition to all of the NHS services.

The role of the Designated Clinical Officer (DCO)

Q. What is a Designated Clinical Officer (DCO)?

A. The DCO is a health professional who works for the NHS, and is responsible for making sure everyone in health is doing what they should to support CYP with SEND. They work with professionals across health, education and social care and YP/families to join up the support being delivered.

Designated Clinical Officer for Children and Young People (0-25) with SEND

 The SEND Code of Practice (SEND code of practice: 0 to 25 years - GOV.UK ( requires the appointment of a medical/clinical practitioner to support the Clinical Commissioning Group (CCG) to meet its statutory responsibilities for children and young people with SEN and/or disabilities between the ages of 0 and 25 years. Please note CCG’s were disbanded 1 July 2022 to form Integrated Care Systems (ICS), with place based commissioning and responsibility for each geographical area. The Designated Clinical Officer (DCO) continues to be a key role in supporting health services, with the implementation of the Children and Families Act 2014, Part 3 (Children and Families Act 2014 ( The scope of the role is very broad and can vary regionally.  However, the key responsibilities of the DCO are:

Oversight – across all health professionals delivering healthcare to individual disabled children, young people and those with special educational needs. The DCO works in partnership and co-production to ensure the understanding of SEND; supporting with signposting to appropriate professionals/services; and networking with the wider system, including the voluntary sector.   

Coordination – supporting providers in relation to responsibilities and accountability relating to SEND, such as health information shared on the Local Offer, processes regarding the health element of Education, Health and Care plans (EHCP), complex case management, Early Notification of children with SEN/possible SEN to the LA, and many other groups such as Children & Young People’s Continuing Care and the transition of young people with SEND to adulthood.

 Strategic – contributing to the various SEND boards and groups, including SEND partnership, SEND joint commissioning and SEND health performance and compliance. The identification of gaps in provision are escalated to appropriate NHS Place.


The Designated Clinical Officer (DCO) for NHS Liverpool Place and NHS Sefton Place is Ingrid Bell. If you would like help and support on a SEND health matter, please use the following e-mail address: