Adolescent Paediatric Subspecialty Training in Nottingham

Nottingham Children's Hospital has a vibrant team of ambassadors for adolescent medicine who work locally and nationally to promote this subspecialty. Trainees within the region can request to work with the adolescent team at ST4-8 level, gaining the opportunity to be at the forefront of this emerging subspecialty. Dr Damian Wood, Consultant Paediatrician at Nottingham Children's Hospital (and author of the recent RCPCH 'Not just a phase' document) heads up the team which includes an ST4-8 trainee. Training is given to equip interested trainees with the skills and knowledge to run adolescent services later in their career. Dr Becky Sands, a Nottingham trainee who worked within this team, has recently been successfully appointed as Consultant Paediatrician at Mansfield to oversee Adolescent Medicine.

The following is a summary from Dr Wood:

The past ten years has seen the emergence of a new paediatric subspecialty in the UK. The role of paediatricians and paediatric services in caring for young people with health problems up to their nineteenth birthday is clarified in the National Service Framework for Children, Young People and Families. In this respect the UK has been slow to catch up with the rest of the developed world and this may in part reflect British society’s view of young people. The emergence of adolescent medicine has been accompanied by a number of health initiatives which have aimed to improve outcomes and reduce health inequalities for young people. The gains made in reducing child and adult mortality and morbidity over the past 50 years have not been reflected in death and illness rates amongst young people and common health problems affecting young people are often national priority areas such as obesity, self harm, smoking, alcohol and substance misuse, teenage pregnancy and sexually transmitted infections. Adolescent health specialists may work in hospital or community settings and may have a background in paediatrics, mental health, sexual health or adult medicine.

What does an Adolescent Medicine specialist do?

This depends on the setting and people’s background and area of expertise. You should expect that someone with expertise in adolescent health would have particular skills and knowledge in:

• Communication with young people and their families
• Legal and ethical issues affecting young people
• Adolescent development
• Self harm and common mental health problems
• Contraception, sexual health and teenage pregnancy
• Fatigue and CFS/ME
• Eating disorders and obesity
• Long term illness and disability and the management of transition to adult services
• Health promotion in young people
• Common medical problems in young people
• Sports medicine
• Substance misuse

Locally there is a wealth of expertise in young people’s health and for many years Nottingham paediatricians and other healthcare professionals have been at the forefront of this burgeoning area. Dr Helen Venning, Prof David Walker & Prof Alan Watson are champions for young people within their subspecialties at a national level.

Quality Health Services for Young People

Young people are different in the way they access and use health services. Too often in the past health services have been designed around the needs of staff and older patients and have excluded young people. The Teenage Health Demonstration Sites and the You’re Welcome Quality Criteria are two initiatives which aim to improve the quality of health services for young people.

Is your service You’re Welcome compliant? This would be a good service development/audit topic for those who are seeking management experience and training.

Training in Adolescent Health

Almost all paediatricians and GPs see young people and training in adolescent health is improving. The most important development has been the Adolescent Health Project developed by the RCPCH in conjunction with the Department of Health, RCGP and RCOG. A series of well designed e-learning modules on a variety of adolescent health topics aimed at different learners are available. Each module is designed to take around 20 minutes to complete. If you haven’t registered and completed a module have a go – it’s free and all you need is your GMC number.

Becky Sands, Consultant Paediatrician in Mansfield, has developed a training module for those in years ST5-8 who wish to establish expertise in this area. The details are being finalised with the RCPCH and will be piloted later this year in a number of deaneries around the UK. Locally we have developed an adolescent training pathway for paediatric trainees in ST5-8 to support this pilot. If you are would like more information on training for paediatricians in adolescent health please contact either Damian Wood, Fiona Straw or Becky Sands.

Participation of Young People in Health Services

Young people have a right to be involved in their health care both in the decisions affecting them as individuals and as a group. This means they should have a say in which services are on offer and how they are provided. The Young People’s Health Special Interest Group in conjunction with the RCPCH has published Not Just a Phase A Guide for Paediatricians and Service Leads on the involvement of children and young people in health services. You can download a copy from the YPHSIG website.

Next time you are planning an audit, research or service development project ask yourself how are young people participating in this? Not Just a Phase has lots of advice on how to help young people participate in your project.

Transition to Adult Services

Young people grow and move on to become adults and the transition of young people with long term conditions to adult services is a key stage in their lives. There is a growing body of expertise and research in this area. For more information see the YPHSIG website. The Department of Health and Royal College of Nursing have produced some good documents on transition.

For more information on all of these aspects of adolescent health, contact details and links to useful websites and documents please see the Young People’s Health Special Interest Group website www.yphsig.org.uk

Damian Wood

 

Useful Links:

yphsig website