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Dr John Hardman General Practitioner Bonnyrigg, Midlothian 17 th June 2009

Healthcare Professionals Working With Exceptional Healthcare Needs Children A Primary Care Perspective. Dr John Hardman General Practitioner Bonnyrigg, Midlothian 17 th June 2009. Introduction. Who am I? Why am I here? Working with children with exceptional

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Dr John Hardman General Practitioner Bonnyrigg, Midlothian 17 th June 2009

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  1. Healthcare Professionals Working With Exceptional Healthcare Needs ChildrenA Primary Care Perspective Dr John Hardman General Practitioner Bonnyrigg, Midlothian 17th June 2009

  2. Introduction • Who am I? • Why am I here? Working with children with exceptional healthcare 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….

  3. 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

  4. Why am I here? • Sam… • Other children with exceptional healthcare needs • Care coordination process

  5. 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

  6. What is the general practitioner’s role? • Ever changing… • Holistic family care • Care management • Keeping perspective on medicalisation?

  7. What did I find helpful? • Care coordination meetings • Community palliative care nurse • Rachel House • Explicit care planning • Good out-of-hours communication

  8. What was not so helpful? • Communication with secondary care • Difficulty accessing psychological supports • Poor coordination between health and social care funding

  9. What would I change? • Systems to further improve communication • Electronic access to information • Strengthen key worker role • Formal case managers? • Debriefing or peer supervision

  10. 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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