Children’s Services at the RNOHChildren’s Services at the RNOH

•Overview of children’s services

•Nursing achievements

•Speech & Language Therapy

•Paediatricians

•Psychology & Psychiatry

Of all the words of tongue and pen the saddest are

- It might have been

Far sadder these it seems to me

- It is but didn’t ought to be

1929 poster in our Out-Patient clinic at Stanmore requesting donations for children’s surgery here.

Overview of children’s servicesOverview of children’s services

•Quality and safety of care provided

•Child-centred Hospital services

•Quality of setting and environment

Shane McCabeGeneral Manager

Paediatric Orthopaedic Surgery

• AHN-Adolescent & Young adult hip• PC-General paeds & limb reconstruction• DE (GOS)-General paeds, neuro-muscular• ST (St Mary’s)-General paeds, feet (Ponseti

clubfoot)• Team approach- hand on referrals, utilise spare

op lists within department

Miss TennantOrthopaedic Surgeon

Paediatric Orthopaedic SurgeryPaediatric Orthopaedic Surgery

• Outreach clinics-Hillingdon, Oldchurch• Northwick Park referrals, ? Overflow Hillingdon• Queen Charlotte’s-antenatal counselling

• Continue to see “normal variants”-• ?Role for Extended Scope Physiotherapist

Miss TennantOrthopaedic Surgeon

Paediatric Orthopaedic SurgeryPaediatric Orthopaedic Surgery

• Pre-assessment clinic for every child• Minimum-opportunity for pre-operative ward visit• Multi-disciplinary approach for complex patients• Better preparation (surgical team and child)• Improved discharge planning• Fewer pre-operative overnight stays

Miss TennantOrthopaedic Surgeon

Children’s Nursing AchievementsChildren’s Nursing Achievements

• Fully established ward team

• Local budget is well controlled

• Presented at international and national conferences, sharing our practice and knowledge

• Documentation overhaul Siobhan Lalor-McTaguePaediatric Matron

Current InitiativesCurrent Initiatives• 8 nurses studying university modules

• November ‘Festival of Lite’ Learning

• Cleanliness of equipment review

• Providing nursing care for children around the hospital where children go

Siobhan Lalor-McTaguePaediatric Matron

Siobhan Lalor-McTaguePaediatric Matron

By: One of our spinal cord injured patients

Paediatric Speech and Language Paediatric Speech and Language TherapyTherapy

• Ensuring that a child / young person’s specific needs are identified and managed

• Ensuring the child / young person has information provided in an accessible way and that their individual communication skills / systems are recognised and supported

• Ensuring that staff are informed and supported

Sophie ScottSpeech & Language Therapist

Development of the Communication Development of the Communication Passport Service (Millar – 2003)Passport Service (Millar – 2003)

• Currently established for all children / young people who attend for pre-operative assessment

• Audited in August 2007

• To be rolled out to the wider paediatric special needs population

Sophie ScottSpeech & Language Therapist

Audit of the Passport ServiceAudit of the Passport Service

• Matched questionnaires to families (24% response) and staff (24% response)

• 100% of families and staff felt the passport helped communication and care

• 100% of staff would like to see more passports in the hospital setting

Sophie ScottSpeech & Language Therapist

Paediatrics

Clinical Support

Teaching

Child Protection

Team Building

Rheumatology

Neuromuscular

Spinal Injury

Metabolic Bone Disease

Craniosynostosis

Somatoform Disorders

2 ST5 Registrar posts

Dr Jacobs Dr OrenDr Muller

Strategic Opportunities

Separate Children’s HDU

Acute Osteomyelitis Service

Rehabilitation for Somatisation Disorders

Dr Jacobs Dr OrenDr Muller

Child (C) and Adolescent (A) Child (C) and Adolescent (A) Psychiatry and Psychology at RNOHPsychiatry and Psychology at RNOH

Dr Caroline McKenna, Consultant Child and Adolescent Psychiatrist (0.3 wte)

Monica Kopershoek, Clinical Psychologist (0.5 wte)

• SLA with The Tavistock and Portman NHS Foundation Trust

• Aim: Provision of integrated medical and psychological care to children, young people (< 18) and their families

• Within multidisciplinary framework

Why is C and A Psychiatry and Why is C and A Psychiatry and Psychology Input Needed?Psychology Input Needed?

Prevalence psychiatric disorder -10% ________________________________ X2 rate – chronic illness, X3 rate – chronic illness +

disability, X5 rate – CNS disorder ↑ risk repeated hospitalization, post trauma Psychiatric disorders can present with physical sx

(e.g. AN) Physical Sx as a manifestation of psychological distress (

e.g. Somatoform disorders) Psychosocial factors – adverse outcome on course of

physical illness.

Caroline McKennaMonica Korpershoek

DevelopmentsDevelopments

Short term - Consolidation- Database, Referral pathways, Protocols, Audit, Training Longer term- Service Development - Spinal Injury, Scoliosis, Rehabilitation Research

“Attention to the mental health of the child/young person and their family should be an integral part of any children’s service,

and not an afterthought” (NSF 2004,4.25)

Children’s Services at the RNOHChildren’s Services at the RNOH