An introduction to what community paediatricians do

1
An introduction to what community paediatricians
do

• Contributor
• Dr F Rahman
• Derby

2
Community paediatrics

• List one health (not GP) and two non-health
  professionals who might refer
• List four venues (not Childrens Hospital) where
  children are seen
• List three areas of clinical expertise of
  community paediatricians (not general
  paediatrics)
• Give the age-group covered

3
What do Community Paediatricians Do?

• Health community level
• Service development occ. case work
• Patch level
• Service development case work
• School/nursery etc level
• Case work with some service development
• Individual case level
• Case work

4
And

• Direct patient contact
• Liaison (cases) Planning (services)
• Education
• Social services
• GPs
• Hospital doctors
• Other health

• CME audit
• Teaching
• Managerial responsibility

5
Framework in Derby

• 7,000 births/year
• 135,000 childrenlt16
• Acute Trust
• Maternity unit
• Childrens Hospital
• AE (DRI)
• All PCTs
• 200 GP practices
• Community services

• Mental health Trust
• CAMHS
• Mother baby unit
• Other Agencies
• Education
• Social Services
• Police
• Voluntary services

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Consultant Led Care Programmes

• Health promotion
• Ass.Spec - VI
• Child development
• SCMO - EBD
• SCMO - audiology
• Special needs
• Ass.Spec - Physical disability
• Vulnerable adolescents

• Child protection
• Ass. Spec - Named Doctor
• Children from disadvantaged groups
• Ass.Spec - HIV/AIDS
• SCMO - Adoption fostering

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Community Child Health Team

• Doctors
• Consultants
• Associate Specialists
• CMOs/SCMOs
• Training grades
• Nurses
• Health visitors
• School nurses
• Specialist nurses
• Admin Staff
• Therapists

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Where do we see children

• Clinic
• Home
• School, nursery, family support centres
• Hospital
• GP surgeryetc.

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Referrals

• Who refers?
• GP
• HV/SN
• Other doctors - hospital/community
• Education staff
• Social services
• Police
• Self/parents

• What?
• General paediatrics
• Development
• Emotional behaviour problems
• Child protection issues - NAI CSA rotas
• Children in need - LAC rota

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How do we work?

• Assessment
• History
• Physical examination
• Development
• Investigations
• Treatment
• Parental support
• Professional guidance
• Specific
• Networking

• Consultant led teams
• Geographical patches
• Allocated schools, nurseries etc.

11
Direct patient contact last week

• Sites
• Peartree clinic
• Dale School
• Childrens Hospital
• Home
• Referrers
• Social services
• Education
• Hospital paediatrician
• GP

• Diagnoses
• EBD (history of abuse) x 3
• Cerebral palsy
• Developmental delay
• Sexual abuse
• Siblings of CSA x 2
• Thalassaemia
• Chronic juvenile RA
• Autism
• Recurrent UTI
• Genital warts x 2
• Sudden infant death