healthcare professionals working with exceptional healthcare needs children a primary care...
TRANSCRIPT
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Healthcare Professionals Working With Exceptional Healthcare Needs Children
A Primary Care Perspective
Dr John HardmanGeneral Practitioner
Bonnyrigg, Midlothian
17th June 2009
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Introduction
• Who am I?• Why am I here?
Working with children with exceptionalhealthcare needs and their families• What is the general practitioner’s role?• What did I find helpful?• What was not so helpful?• What would I change?• Challenges….
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Who am I?
• GP partner
• Eleven years as a GP
• Eight years in Bonnyrigg
• Clinical interests in cardiovascular disease and drug dependence
• Little paediatric experience
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Why am I here?
• Sam…
• Other children with exceptional healthcare needs
• Care coordination process
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Sam
• Born 16th August 2002
• Menkes disease diagnosed during admission to Edinburgh Sick Kids Hospital January to February 2003
• Multiple complex intractable problems
• Died 12th June 2004
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What is the general practitioner’s role?
• Ever changing…
• Holistic family care
• Care management
• Keeping perspective on medicalisation?
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What did I find helpful?
• Care coordination meetings
• Community palliative care nurse
• Rachel House
• Explicit care planning
• Good out-of-hours communication
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What was not so helpful?
• Communication with secondary care
• Difficulty accessing psychological supports
• Poor coordination between health and social care funding
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What would I change?
• Systems to further improve communication
• Electronic access to information
• Strengthen key worker role
• Formal case managers?
• Debriefing or peer supervision
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Challenges…
• Working with CENs relatively rare for GPs
• Primary care less holistic and family focused under new GMS contract
• Changing role of health visitors
• Fragmented out-of-hours care
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