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Paeds Liaison Form – EPR

The Paediatric Liaison Form (PLF is now part of EPR – how to guide)

This form alerts the Paediatric Liaison Team to your concerns so that they can investigate and provide appropriate support to the child & family.

You SHOULD inform the family that you are completing the form as the Paeds Liaison Team or other agencies (e.g. social services or school nurse)may contact them.

You SHOULD NOT use this form for patients who have either suffered or at risk of significant harm. In this case you should discuss directly with the paediatric consultant on-call.

PDF: Paediatric Liaison Form

PDF: Safeguarding Guide

 

Directory of External Services

Select the area required for further details:

Councils

Patients can attend whichever they wish

Calderdale:

  • Walk in Centre – Calder Community Practice Sat & Sun: 8am – 8pm.
  • Park Community Practice Sat & Sun: 8am-8pm

Kirklees:

  • Walk-In Centre – Kirklees, West Yorks (Dewsbury and District Hospital) Mon – Fri: 9am – 8pm, Sat & Sun: 10am – 6pm

Wakefield:

  • King Street Walk in Centre, Wakefield, 7 days a week, 10am – 10pm
Gateway to Care
ServiceProviderReferral detailsWhat is the service?
Gateway to CareCalderdalecalderdale.govFirst point of contact for adults social care. Protection of vulnerable adults.
Gateway to CareKirkleeskirklees.govFirst point of contact for adults social care. Protection of vulnerable adults.
Trauma/Abuse
ServiceProviderReferral detailsWhat is the service?
Calderdale – Domestic Abuse SupportWomen Centrecalderdalestaysafe.org.ukFree, confidential support service for anyone affected by domestic abuse; help to explore options including safety advice, help with civil protection orders and court support.
Victim SupportNationalvictim support.org.ukFree confidential service for victims of crime
Men Standing UpBradford Cyreniansbradfordcyrenians.org.ukConfidential free helpline providing advice, information and emotional support to male DA victims
Sanctuary ServiceCalderdale Councilcalderdale.orgSecurity measures and safety advice whether it is the persons own home, housing association or private landlord.
Dogs Trust freedom ProjectDogs Trustdogstrust.org.ukTemp care for pets. Referrals from agencies and/or direct from the owner
KCRASAC – Rape and Sexual assault counselling and helplineCalderdale
Kirklees		kcrasac.co.ukHelpline: We are here to listen, to believe you without judgement and offer support and advice to survivors, family members, friends and partners, as well as signposting and referring to other appropriate services
Counselling: Counselling can help you explore the difficulties you may be experiencing in a non-judgemental, understanding environment.
Embrace Child Victims of Crime Embraceembracecvoc.org.ukOur support is usually delivered weekly for an average of 6 sessions remotely via Video Call or telephone through one of our team trained in trauma informed support. Referrals are accepted from all safeguarding professionals and young people may also self-refer.
EdShift SPOTLIGHTedshift.co.ukA home based outreach independent community interest company, supporting children with ‘Prevention Sessions’ - ‘Act out, Speak out’, using digital resources to advocate healthy relationships.
Respect Young People’s ProgrammeCalderdale Council Calderdale.govSupport for young people & families where young people are abusive to parents, carers and siblings
Mental Health
ServiceProviderReferral detailsWhat is the service?
VITA Health (Talking Therapies)Vita Health Group vitahealthgroup.co.ukFree, confidential talking therapy
Adult Mental Health ServicesSouth West Yorkshire partnership Foundation Trustsingle point of accessA variety of services including crisis, early intervention in psychosis and community mental health support.
Adult/Child Therapeutic servicesNoah’s Arknoahsarkcentre.org.ukCounselling and Psychotherapy (donation/fee applies) 12-24 weekly sessions offered
NorthpointYorkshirenorthpoint.org.ukone of the largest charitable providers of therapeutic services in the region, working with adults, children and young people.
NightowlsWest Yorkshirewww.lslcs.org.ukWest Yorkshire Night OWLS is a confidential support line for children, young people, their parents and carers who live in Bradford, Leeds, Calderdale, Kirklees and Wakefield. This is a pilot scheme funded till March 2022.
Forensic CAMHSYorkshireyorkshireandhumberfcamhs.co.ukA regional Forensic Child and Adolescent Mental Health Service that works with children and young people whose behaviour may be of concern to professionals, their families and/or their communities.
Sexual Health
ServiceProviderReferral detailsWhat is the service?
Calderdale Sexual health ServicesCHTsexualhealth.cht.nhs.ukConfidential treatment and education service to improve sexual health.
Brunswick CentreBrunswickthebrunswickcentre.org.ukConfidential services offering:
HIV support
HIV prevention
LGBT Mental health
Counselling
Housing
ServiceProviderReferral detailsWhat is the service?
Calderdale Housing Options ServiceCalderdale CouncilCalderdale.govTemporary accommodation
Smart MoveCalderdalesmartmove.org.ukIf you are homeless or vulnerably housed or your tenancy is at risk,
The Acorns Domestic Abuse Accommodation Support Calderdale CouncilCalderdale.govProvides a temporary safe house (refuge) and women are supported to move on.
Happy DaysHappy Dayshappydaysuk.orgCommunity support for homelessness
Men Standing UpBradford Cyreniansbradfordcyrenians.org.ukCrash pads and housing support for male’s fleeing domestic abuse
Money
ServiceProviderReferral detailsWhat is the service?
Citizens Advice Citizens Advice Bureaucitizensadvice.org.ukFree, confidential advice with debt, money, benefits, hate crime and work.
BeGAMBLEawareBe Gamble awarebegambleaware.orgWe offer free, confidential help and support to anyone who’s worried about their – or someone else’s – gambling.
Noahs Ark Money adviceNoah’s Arknoahsarkcentre.org.ukBudgeting, debt relief orders, debt management plans, individual voluntary arrangements. As part of our response to the COVID19 pandemic they are also running a food bank.
Drugs/Alcohol
ServiceProviderReferral detailsWhat is the service?
Branching Out Calderdalecalderdalerecoverysteps.org.ukFree, confidential drug, alcohol and tobacco advice and support service
the BaseKirkleeschangegrowlive.orgWe are a free and confidential drug and alcohol service for young people up to the age of 21 in Kirklees.
Stabilisation, Detox, Sober Living, Therapeutic SupportCalderdale in recoverycalderdaleinrecovery.comA range of services to help people get their lives back without the need to abuse drugs or alcohol. Hubs in Halifax and Todmorden.
Stabilisation, Detox, Sober Living, Therapeutic SupportKirklees in recoverykirkleesinrecovery.comA range of services to help people get their lives back without the need to abuse drugs or alcohol.
Hospital – Quick Codes
Airedale General #6 285
Barnsley General Infirmary #6 218
Bradford Royal Infirmary #6 172
Harrogate District #6 196
Hull Royal Infirmary #6 294
Leeds General Infirmary #6 189
Leeds St James #6 188
Manchester Royal #6 279
Mid Yorkshire Hospital 01924 541000
Sheffield Childrens #6 230
Sheffield Hallamshire #6 232
Sheffield Northern #6 231
York District General #6 306

Need For Recovery

The Need for Recovery (NfR) score is a well validated tool to measure your need for recovery after the physical/mental strains of work. Originally designed for bus drivers, it has since been successfully used across may careers including recent studies in ED doctors and ACP’s.

Why?

  • We would like to see how you’re doing (anonymously) – so please answer honestly
  • If over time your score has increased or you think your score is high – please talk to any of the senior team

Previous studies

JobWhole populationBus DriversMerchant SailorsMinersNursesNursesParamedicsED DrsED ACP
CountryNetherlands Netherland UK IsraelBrazilNetherlandsNetherlandsUK 2020UK 2021
NFR score3827.236.455.236.439.443.670TBC

Infant Feed Volumes – what is expected?

As you know part of assesses sing an infant is asking about how well it is feeding, especially in Bronchiolitis. However, our paediatric colleagues have noticed that many infants are over fed, and although their intake may have reduced it would still be considered adequate for normal growth.

The tables below give an indication of what a healthy intake is and should be used when assessing how well an infant is feeding. Read more

Sexual Health Referrals

Appropriate Conditions for GUM
  • Genital ulcers
  • Urethral discharge
  • Pelvic Inflammatory Disease (PID)
  • Testicular pain
  • Genital warts
  • Vaginal discharge
  • Emergency/ongoing Contraception
  • HIV risk concerns
  • Possible syphilis
  • PEP follow up
  • Pre-menopausal irregular vaginal bleeding
  • Known HIV patient please contact 01484 347077
PID Referral Criteria

History/Exam. – NICE CKS (Here) 

  • History:
    • Pelvic or lower abdominal pain (usually bilateral but can be unilateral).
    • Deep dyspareunia particularly of recent onset.
    • Abnormal vaginal bleeding (intermenstrual, postcoital, or ‘breakthrough’) which may be secondary to associated cervicitis and endometritis.
    • Abnormal vaginal or cervical discharge as a result of associated cervicitis, endometritis, or bacterial vaginosis. This is often very slight and may be transient, especially with chlamydial infection.
    • Right upper quadrant pain due to peri-hepatitis (Fitz–Hugh–Curtis syndrome).
    • Secondary dysmenorrhoea.
    • Ask about the possibility of pregnancy.
  • Exam: 
    • Lower abdominal tenderness (usually bilateral).
    • Adnexal tenderness (with or without a palpable mass), cervical motion tenderness, or uterine tenderness (on bimanual vaginal examination).
    • Abnormal cervical or vaginal mucopurulent discharge (on speculum examination).
    • A fever of greater than 38°C, although the temperature is often normal.

GUM Exclusions – Ref to Gynae

  • Pregnancy
  • Sepsis
  • Abscess

No GUM Exclusions – Complete following

  • Patient to preform 2 High Vaginal Swabs- Send For:
    • Chlamydia +Gonorrhoea 
    • TV
  • If Clinical Signs of PID – Treat with following (if allergies D/W Micro)
    • Ceftriaxone 1g i.m. – ONCE ONLY
    • Doxycycline 100mg twice a day & Metronidazole 400mg twice a day for 14 days
  • Refer to GUM (with/Without Signs)
Testicular Pain Criteria

GUM Exclusions – Ref to Urology

  • Torsion
  • Sepsis
  • Abscess

No GUM Exclusions – Complete following

  • 2 Urine Samples:
    • First Pass (white top) – Chlamydia +Gonorrhoea 
    • MSU (red top)
  • Treat with following (if allergies D/W Micro)
    • Doxycycline 100mg twice a day for 14 days
  • Refer to GUM 
Contacts

Kirklees

Calderdale

  • E-Mail referral (patient details and brief description): Sexualhealthservices.chft@nhs.net
  • Patient Self Referral: 01422 261370
  • Address: Broad St, Halifax, HX1 1UB

Ophthalmology Referral Pathway

The following pathway will continue post-pandemic

InHours: Direct dial from HRI 152539, From CRH 2539.

Out of Hours: On Call Ophthalmology

We should no-longer be completing Email referrals to ophthalmology – if ophthalmology are insisting please contact Ruth Lush via switch who will fed back to staff.

Contact Lens related eye infection/ulcers – must be discussed with Ophthalmologist for early review

ED to Opthalmology COVID-19 Referral Pathway v2

Urology Referral Pathways

Referral

The first point of contact for urology advice and referral is the general surgical SHO. This is the on-call surgical SHO carrying the on-call bleep. Some of the on call general surgical SHO have a urology background.

If a time critical emergency such as torsion is presenting, then the first point of contact should be the urology registrar.

In the case of Urological/Surgical emergency

  1. Refer directly to Middle Grade on-call
  2. If Middle Grade unavailable/uncontactable – Contact speciality consultant on-call
  3. If NO senior available – inform ED senior
    • Admit directly (admission rights) to SAU/Ward 4 HRI
    • Attempt to contact surgical SHO (to inform)

(agreed with both surgical and urological leads)

 

Under 3’s go to Leeds

Urologist are happy to operate on patients over the age of 3 years old. Under the age of 3 if this on a urological emergency such as a torsion then this patient should be referred to Leeds paediatric urology services.

Streaming

Any patent with a post op complication for up to 7 days form urological procedure – should be streamed directly to the urology team via the surgical SHO. If the patient is unwell and needs resuscitation and immediate management for example sepsis, then ED team needs to be involved in resuscitation measures and the urological registrar needs to be involved as well

Pyelonephritis

Currently ALL Pyelonephritis should be admitted under the urology team. There is a conversation between urology and medical teams happening currently to see if that requires further rationalisation. However currently the position is all pyelonephritis patients who need admitting are done so under the urology team.

  • Uncomplicated pyelonephritis – does not require CT scanning or ultrasound scanning from the emergency department.
  • Suspicion of an obstructive uropathy –  CT KUB needs to be arranged from the ED

Investigations including:

  • FBC
  • U&E, CRP
  • Blood Cultures
  • Urine cultures

Appropriate Antibiotics should be prescribed using the current antibiotic guidelines.

Renal Colic

CTKUB are now available 24/7.

Patient presenting >50 years old  with a renal colic story, should have a ultrasound scan done at the bedside to ensure that there is no aortic aneurysm before being sent for a CT KUB.

Uncomplicated renal colic needs a non contrast CT scan. This should be organised by the ED

Uncomplicated renal colic patients can wait CT KUB for  results on SDEC. (The case must be to be discussed with the surgical SHO on-call and accepted by them before transfer of the patient. SDEC closes at 6 pm)

Haematuria

All frank hematuria needs investigation

  • Admit + 3-way catheter – those at risk of clot retention and shock 
    • Hb <100
    • Post void bladder scan>250 ml 
  • All those discharged: will need a OPD cystoscopy arranged as well as a USS (the request for flexible cystoscopy on EPR is Urol Cystoscopy  post Wd Dis)
Catheters

New catheters and catheter complications – follow current guidelines. Community nurses follow up for TWOC or other catheter care (HOUDINI team in Kirklees)