Metabolic Medicine
Salford Royal Hospital
AQUA PROJECT TEAM
Dr. Chris Hendriksz (Consultant)
Lorraine Thompson (Clinic Nurse Specialist/Team
Manager)
Briony McNelly (Learning Disability Nurse)
What successes have you had to date?
• Manchester children’s hospital- 3 weekly transition clinic
• Transition team – Doctor, Clinical Nurse Specialist, LD
nurse, Physio and dietician
• Bradford has started, 2 monthly – Doctor, nurse, dietitian
(2 clinics so far)
• Liverpool- in development (to be 2 monthly)
• 1:1 consultation with nurse and patient in Manchester &
Bradford (away from parents!)
• Same day appointment at SRFT
• Transition passport – Ready, steady, go
What have been your challenges and
how have you addressed these?
• Lack of input from paediatric team
Meeting in March 2015
• Weekly clinics & Small numbers booked into
clinics – Reduce frequency of clinics
• Patient DNA – Discharged patients or Refer to
adult team
• Transition passport, engagement of patients –
patient held to professional driven.Kept in
patients notes, nurses to complete. RSG.
New Bradford clinic update
• There have been 2 transition clinics carried out so
far in Bradford, there is only one room allocated
to the clinic, as there is no space, so nurse hasn’t
been able to see the patient 1:1 without parents.
The team are altogether in one big room. Format
is usually doctor review, both paediatric and adult
dietician review, then nurse introduces adult our
service etc.
• Expected to be 25 patients this year for transition
from Bradford.
Patients with learning disabilities
Questionnaire not in easy read format – Variable results .
Patient Story
The patient attended transition clinic on two occasions, this was at the children’s
hospital and on both occasions his family were both heavily involved in the
consultation and he spoke very little. On the same day of his second appointment he
attended the transition clinic in the morning with dad and again spoke very little with
simple yes and no answers. That same afternoon he came across to the adult service
and was seen by the adult team who directed all questions to the patient and
encouraged him to respond, he was much more confident and answered the
questions with full answers. A shared decision making approach was used. It was
suggested by his consultant that he needs to have a 5 day heart test and due to the
distance he would need to travel that he might be better doing this locally, as he
would need to collect it and return it after 5 days. The patient suggested that he
would have it done at Salford travel down on public transport with his dad and then
return the tape by himself a week later. He wanted to know how he could get to the
hospital by himself and we discussed the options with him, train, bus, taxi etc. He then
started to discuss that he is looking to move out of his parents’ house and into an
adapted house. We also discussed the fact that he is applying for a provisional license
and wants to learn how to drive. We will encourage him at his next appointment to be
seen on his own for part of the consultant. The change in him was remarkable and we
hope that this continues as time goes on.
Patient improvement suggestions
• Transition document – To be made smaller,
adapted.
• Positive comments about the same day
appointment – Being offered to all patients
despite complexity
What are your next steps?
• Develop an agenda setting tool to give out
prior to the appointment
• To meet with the children’s team to engage
them more in the process
• Define 1 model for the Northern Network -i.e.
Manchester/Bradford & Liverpool