This is a  a new National Enhanced Service Specification for the unscheduled vaccination of children and young people who have outstanding routine immunisations.

The specification has been agreed between the Welsh Government and General Practitioners Committee (Wales) (GPC(W)) of the British Medical Association (BMA) and is directed at GP practices delivering vaccination and immunisation services in Wales

This specification details arrangements for the vaccination of those children and young people who are not reached by routine national immunisation programmes delivered by primary care and school based programmes or those who have missed the opportunity to be vaccinated at the recommended scheduled age. 


For some years now child development team meetings (CDT) have been held monthly in each of the Gwent boroughs. Since 2010, one point of access for referrals to the CDT has existed in the Caerphilly area. This is known as ISCAN – Integrated Service for Children with Additional Needs. This has successfully provided a managed referral process for children with two or more developmental needs.

The ISCAN service is now operating across Gwent in all 3 children centres.

ISCAN North, based at Nevill Hall Children’s Centre, will take referrals for Blaenau Gwent, North Monmouthshire and North Torfaen. ISCAN South, based at Serennu Children’s Centre, will take referrals for Newport, South Monmouthshire and South Torfaen and ISCAN West will continue to take referrals for Caerphilly. Each ISCAN sector will be managed by a co-ordinator and supported by an administrator.

From October 2016 it is also the referral management point for all children with suspected developmental delay including Autistic Spectrum Disorder or Attention Deficit/Hyperactivity Disorder.

Any professional from Health education or social care can refer to the ISCAN. GP’s should never have to refer on behalf of another agency.

Referrals to each ISCAN sector can be made via letter or the ISCAN template referral form which indicates the information that enables the team to discuss, make decisions and arrange appropriate assessments. We are working to develop an e-referral option and e advice line and are currently reviewing the letter template.

Referrals will be accepted for children / young people aged 0 – 18 years of age with or without an existing diagnosis who are displaying concerns in two or more elements of their development. This includes referrals for children / young people with or without a diagnosis of ASD / ADHD who previously would have been referred to the CAMHS service.

When a referrer feel that multidisciplinary assessment is required for developmental concerns refer to the local ISCAN outlining clearly the child / young person’s difficulties and full background information. Up to date reports will be required to enable the team to make an informed decision about the next steps in managing the child / young person’s care. If this information is only available from other professionals, the contact details of these professionals are requested. It is essential that the children and family are aware that the information will be discussed in a multiagency and multi-agency meeting that includes professionals from education and social service disability teams. This must be confirmed in the referral. A template consent letter is available for use.

1. A framework for assessing the sustainability of GP practices has been in place since April 2015. Whilst the sustainability assessment framework has provided for a consistent decision making process, concerns have been expressed by some GP practices about the effectiveness of delivery.

2. The revisions to the sustainability assessment framework streamlines the process to enable a GP practice request for support to be reviewed on a more effective and efficient basis.