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This Month's News

Paediatric Oncology Shared Care Unit (POSCU)

Evening Spotlight Seminar – Paediatrics

The new paediatric Rapid Access Clinic

RAC Service Update

The Paediatric Diabetes Service

Paediatric A&E

Welcome to ...

Better food for young patients



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May 2010


Paediatric Oncology Shared Care Unit (POSCU)

The Paediatric Oncology Shared Care Unit (POSCU) is situated within Little Oaks Children’s Ward at St. Peter’s Hospital.

Paediatric Matron Dagmar Gohill

Paediatric Matron Dagmar Gohill



It was formally opened in March 2004, thanks to the generous support of the local community. This brightly furnished dedicated unit has four beds with facilities including television and telephone units by every bed, as well as indoor and outdoor play areas for the children to use. The oncology team work closely with colleagues at the Royal Marsden and Great Ormond Street Hospitals, to provide treatment and supportive care to children and their families in an environment closer to home. Over the last year, we have treated about 17 children diagnosed with cancer and provide full in-patient care for these patients. We are also fortunate to have facilities such as pathology, lab, imaging and support from other allied professionals onsite.

The Medical Team consists of Dr Tariq Bhatti, Lead Clinician for POSCU and Dr Tanya Bernard, Consultant Haematologist. The Nursing Team is lead by Julie Eade and Nicola Rogers.

Parents are encouraged to contact us directly so that children with cancer can be seen and reviewed at the earliest opportunity.



Evening Spotlight Seminar – Paediatrics

Where:
Brooklands Hotel, Brooklands Drive, Weybridge, KT13 0SL

When:
Thursday 20th May, 6pm-9pm



A hot buffet will be served at 6pm and the talks will start at 7pm.

To reserve your place please contact Joanna Matthews by phone: 01932 723716, fax: 01932 872951, text: 07747776648 or email: joanna.matthews@asph.nhs.uk



The new paediatric Rapid Access Clinic

n by their GP and require an urgent opinion from a paediatrician but not necessarily hospital admission. It allows ill children to be seen by a paediatrician very promptly, avoid attendance to A&E and, in some cases, admissions to hospital.

The Rapid Access Clinic (RAC) is a weekly out-patient clinic run by a paediatric registrar under the supervision of a consultant. It is easy for GPs to refer suitable cases to the RAC, as shown in the flow chart opposite. Children will be booked an appointment for the next available clinic and we expect to see all children within a few days.


Referral criteria

Children who need early assessment and can’t wait for a routine out-patient appointment.


Exclusion criteria

Children with acute illness should be sent straight to Paediatric A&E and children with chronic problems should be referred to outpatients.


Diagnostics

Children seen in RAC will have access to pathology, imaging, ECG and Echo.


Who Can Refer?

GPs (no Choose & Book facility available).


How is a referral made?

GPs have all the relevant details for the referral pathway and should discuss referrals with the paediatric registrar before faxing the children’s out-patient department. Children will be booked into the next available RAC and parents will be informed by the out-patient reception staff.

Once children have been seen in the RAC, their parents and GP will be sent a discharge letter and follow-up appointments will be arranged as necessary.


Eligibility Criteria - (common conditions are listed below):
  • Respiratory - chest pain

  • Cardiovascular - palpitations, faints

  • Neurology - funny faints, abnormal movements and severe worrying headaches (recent onset)

  • Gastro - severe abdominal pains (recent onset), abdominal pains with bleeding, PR, babies with rapid weight loss

  • Renal- haematuria, Nephrotic syndrome, Metabolic Diabetes (not with DKA)

  • Allergies - urticaria (recent)

  • Rheumatology- Joint pains (recent)

  • Haem / Onco -concern req malignant growth




RAC Service Update

Paediatric Referral Flowchart





The Paediatric Diabetes Service

The paediatric diabetes service continues to grow and respond to the new technology that is now available.


Every child newly diagnosed with diabetes is seen immediately by our team. It is the role of the Paediatric Diabetes Nurse Specialist (PDNS) to contact the child’s GP, school or nursery to provide any information / education required as well as supporting the family in the first few days after diagnosis by one or more home visits.

We offer the first diabetic clinic appointment one month after diagnosis followed by a minimum of an appointment every three months thereafter depending on clinical need. Once a year every child has a diabetes review, prior to which they have the appropriate screening tests done.

We launched our insulin pump service in August 2009. The child and their family are offered an intensive package of education and support to help them adapt from insulin injections to insulin pump therapy. The PDNS co-ordinates the pump service and ensures that all the different facets are addressed - from contacting their GP and organising any additional prescriptions, to ensuring that the child’s school is sufficiently educated to support them manage the essential pump tasks during the school day.

The paediatric diabetes clinic has now extended the age range of patients we see from 16 to 18 years, which means we will continue to treat adolescents with diabetes (including new referrals) in the paediatric clinic until they are 17, at which point they will be transferred to the transition clinic (run jointly by ourselves and our adult colleagues).

We meet regularly to discuss clinical issues, do regular audits of our service and are continually updating our guidelines in line with national ones. We are pleased to have a 98% patient satisfaction score and strive to maintain the high standards required to look after this very challenging group of patients.


Contact:

Paediatric Diabetes Nurse Specialist:
01932 723314,

Dr Shailini Bahl:
01932 722722.



Paediatric A&E


At St Peter’s Hospital we operate a 24-hour dedicated paediatric emergency department. This is run as an independent unit alongside the adult emergency department.

Dedicated paediatric resuscitation bay in A&E

Dedicated paediatric resuscitation bay in A&E


Children are seen in a separate area with dedicated staff, waiting room, and resuscitation bay. We work closely with our colleagues in paediatric inpatients and the community and also have strong links with paediatric intensive care units in London teaching hospitals.

Ten years ago we saw around 15,000 children a year. This number has steadily increased and during the last year we saw 26,000 attendances. Despite this throughput, 98.5% of these children are seen and either discharged or admitted within four hours.

Paediatric sister  in one of the treatment rooms at A&E

Paediatric sister in one of the treatment rooms at A&E


Recently we have begun to accept most young people up until their eighteenth birthday. Whilst this has obvious implications on our activity it also enables us to tackle the problems of those young people who have often fallen between adult and paediatric services.


The unit is able to offer paediatric trained doctors and nurses around the clock and access to a dedicated associate specialist and liaison consultant. It is one of only 38 units in the country to offer this level of care.


Contact:

Marcus Wootton,
Charge Nurse in Children’s A&E:
01932 723624,
Bleep 5062.



Welcome to...


Justin Collins
Consultant Urologist.


Background

Justin graduated in1996 from Bristol University and achieved an MD from there in 2008, which was awarded ‘Best Overall Research Paper’ at the World Congress of Endourology in 2006. He recently completed specialist training in the Southwest rotation, which included two fellowships in laparoscopic and robotic surgery. Said Justin: “Having worked at the main centre for laparoscopic surgery early in my training I was “bitten by the bug.”

Justin spent six months working in Bordeaux where he was involved in over 250 major laparoscopic and robotic cases in six months, before returning to a fellowship in Southmead Bristol in laparoscopic and stone surgery. This culminated in a locum laparoscopic consultant role prior to his appointment at Ashford and St.Peter’s Hospitals.


Special Interests

Patient information - Justin is currently developing a website for patients and GPs with urological information to inform and aid decision making.


Aims

To help the trust become a centre of excellence in laparoscopic surgery and to develop the current laparoscopic pelvic oncology service. To improve the patient journey in urology through online resources.


Key services

Laparoscopic total and partial nephrectomy, laparascopic pyeloplasty and laparoscopic radical prostatectomy.


Location

Weybridge clinic on Mon & Wed (alternate weeks) and St Peter’s on Mon and Thurs (alternate weeks).


Contact Number

01932 723719




Better food for young patients


The food for our younger patients has been improved with main courses now including more popular dishes such as pasta bolognaise or breaded fish and chips with fresh fruit available daily.

Ash Ward Housekeeping Assistant Alvin Asis taking the snack trolley around the ward

Ash Ward Housekeeping Assistant Alvin Asis taking the snack trolley around the ward


Specialist Paediatric Dietician Catherine Casewell says “When children come into hospital their appetite often reduces but their nutritional requirements may be higher than usual as their body fights to get better. As parents know, it can be difficult to persuade children to eat sensibly when they feel well, so it’s even harder when they’re poorly. We’ve redesigned our menu to include more tempting choices, improved the way we serve food and ensured it’s always available when patients are hungry.”

If children don’t feel hungry or are out of the ward when the main meals are delivered, for example because they are having their operation, they can heat up a microwave ready meal, which are available on the ward, or take something from the designated snack fridge.

Another new addition is the snack trolley, which is manned by Ash Ward Housekeeper Alvin Asis and taken round twice a day so patients can grab a juice or milkshake, sandwich, biscuit or piece of fruit. Catherine adds: “For those children who require small, frequent meals or who prefer to graze between meals, they can choose something from the snack trolley. We really want to make it as easy as possible for children to eat when they feel hungry and keep their energy levels up.”

In the future, the team also hopes to create a separate eating area to encourage all children to eat together at a table laid with cutlery, cups and water jugs. Said Catherine: “We would like to offer the children a routine they are used to at home and also make mealtimes a more social occasion – after all, if children see other children eating they are more likely to follow suit themselves!”



National Patient Safety Alert (NPSA):
Bowel Cleansing Agents
An NPSA alert has been issued requiring action to reduce the risk of harm from oral bowel cleansing solutions.

For the full NPSA alert click here.




Your Contacts:

ASPH queries in general -

Joanna Matthews,
GP Liaison Manager.
Tel: 01932 723716
joanna.matthews@asph.nhs.uk


ASPH queries related to CAB only -

Michael Hooker,
CAB Manager
Tel: 01932 723511
michael.hooker@asph.nhs.uk


For queries related to Ashford & St. Peter’s appointments please call 01932 723831 or 01784 884351