Dr kinder young adult clinic

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Dr kinder young adult clinic

  1. 1. Young Adult Rheumatology clinic (from 16-25 years old) Dr Alison Kinder FRCP Rheumatology consultant
  2. 2. Why?• Unmet need in Leicester• Young adults with chronic diseases have additional challenges in negotiating the complexities of their adolescence by virtue of their medical needs
  3. 3. Differences between adult centred and paediatric careAdult care Paediatric careIndividual consultations Family consultationsLimited multidisciplinary team(often less More likely multidisciplinary team andaccess to psychosocial support) psychosocial supportPayment for medication Usually free medicationLarger patient number Smaller numbers of patientsConsultation less likely to include Educational and vocational aspects key tovocational aspects consultationShorter consultation time Longer consultation timeProcedural pain relief – less sedation or ga More sedation or ga useuseLess tolerance of immaturity Greater tolerance of immaturityLess chasing of patients who DNA Greater chasing of famillies who DNALess direct supervision of trainees Greater direct supervision of traineesLess likely to see same dr at consecutive More likely to see same dr at consecutiveconsultations visits
  4. 4. • “ emerging adulthood ” is a time of exploration, a crucial part of growing up and as such remains a time of continued vulnerability (Arnett 2000)
  5. 5. Several policies• Royal college of nursing 2004• Department of health 2006• Department of Children, Schools and Famillies 2007• Royal college of physicians of Edinburgh 2008• Chief medical Officer 2008• Review the evidence of benefit of good quality transitional care and setting out best practice models
  6. 6. Core set of principles• Transition starts early and is a future focussed active process• Young person centred and inclusive of family, carers and kinship groups• Multidisciplinary involving paediatric and adult services with GP
  7. 7. For young adult• Age appropriate• Developmentally appropriate• Culturally appropriate• Flexible process equipping him/her with skills in communication, decision making, assertiveness, self care and self management
  8. 8. • Ultimate aim of transitional care is to enable adolescents to take control of their healthcare needs and emerge into adulthood with maximal function and potential
  9. 9. Young adult clinic• Set up Jan 2011 in adult setting• Leicester Royal Infirmary• Only for 16 to 25 years old• Consists of – Consultant Dr Alison Kinder – Specialist nurse Toni Dorman – May be SpRs present for training
  10. 10. • Accepting transfers of young adults with long term rheumatology conditions that live in Leicestershire from – Nottingham – Birmingham – Leicester – Transfers from other paediatric units for Leicester university students
  11. 11. • I attend rheumatology paediatric clinic 1x/month in Leicester• Try and meet patients prior to transfer from other centres
  12. 12. Current case load• Mainly JIA• SLE• Sarcoid• Ankylosing spondylitis – If on methotrexate injections or biological therapy requires transfer of prescription to adult service
  13. 13. New referrals• Young adults with new presentations of rheumatological diseases• Needs to be as named referral• Not on choose and book• Clinic from Jan 2012 1x/month
  14. 14. Needs to be a service the young adults want• Currently developing a questionnaire asking patients what they want from the service• Informal feed back – Like to come to young adult clinic only – Meet other young adults – Get to see the same dr and nurse
  15. 15. Any questions?

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