Paediatric Update Portsmouth - Phase Two 05/03/2020
Responses: 38
Your feedback for the Asthma Workshop
- Good
- Extremely useful especially links to training videos and new pathways on healthier together. Excellent speaker
- ran out of time to cover a lot, felt like reading from slides
- Good overview
- Good
- A very useful talk, I had forgotten about the issues of salbutamol, in under 2's and that atrovent is more useful in preschool aged children with respiratory wheeze
- absolutely brilliant speaker, loads of helpful advice and info, already printed and action plan for a mum from Healthier Together site, thank you
- very helpful and I was unaware of the potential to move away from nebulsied salbutamol in mild-moderate cases towards 10 puffs of corectly administered inhaler.
- useful and interesting
- Excellent
- reassuring to know current practice is in line with what is expected
- Not quite as General Practice orientated as I would have hoped. Need clearer guidance on at what stage to make the diagnosis of asthma - this is important for QOF...not to over diagnose because of QOF; or underdiagnose meaning we under-QOF.
- I felt this was more aimed at asthma nurses, and perhaps less relevant to myself as a GP. Although the link to acute asthma management on HT website was very useful to know about. Ample opportunity for questions which was great.
- really useful but the large room made it a little difficult to hear
- Very good and informative
- informative, reassured current practice
- Slightly dry delivery. Limited audience interaction Some useful clinical top tips but overall not a lot of new content
- Good
- Excellent summary from Dr Buckley and really useful guidance on starting treatment and the use of steroid inhalers and stepping up. Also the use of Atrovent under 18mths as lack beta receptors so ventolin not beneficial.
- Good to be updated around spacers and oral prednisolone mgt and clarifying viral wheeze v bronch
- Really useful and will change practice thank you
- much talk about poor inhaler technique and how Drs were bad at explaining how to do 10 puffs , and then no explanation as to what we should be doing . Otherwise good .
- v good
- So helpful! Cleared up so many unclear aspect of the guidelines in a practical way, as well as explaining management alot more clearly.
- Useful relevant to practice. Helpful of video of correct spacer technique could have been shown
- less interactive than the others - more of a lecture
- Really informative
- good discussion but not sure if I added to my knowledge
- Great presentation. Reassuring to know that little has changed in terms of management and be refreshed on this. Also helpful to know that diagnosis in young children is challenging even to the experts and that recent guidance on diagnostic testing is not the be all and end all.
- Very useful and well targeted at primary care and the treatment of acute asthma that is appropriate in the out of hospital setting.
- good
- Would have valued more case based learning in this topic
- Good revision. Presenter didn’t introduce herself though- I assume she was a QA consultant
- Useful- would prefer longer on chronic management than the acute management which we don’t see much of
- Excellent overview and very practical advice. Including the spacer you use. Will improve my practice
- Good update
- This talk was excellent, it was well pitched for GPs and primary care team. Useful things for every day practice and how to differentiate asthma and wheeze and management options.
Your feedback for the Constipation & Enuresis Workshop
- Good
- Brilliant as see quite a few children with chronic and acute constipation. Great to be able to revisit existing knowledge and review red flags. Good networking re websites for further advice. Excellent Speaker.
- didnt cover enuresis - was just constipation
- Really helpful for GP trainee as never had formal teaching on a lot of this yet it is a commonly encountered presentation in primary care
- Fatima was brilliant ! She is a very engaging speaker and good communicator.
- An excellent talk, very interactive and learnt some useful tips form the other GPs in the talk as well as the speakers.
- workshop only covered constipation but very useful and informative
- I found the tips and ideas to support parents and children helpful>WEspecially the ERIC website
- helpful
- Excellent
- constipation information was excellent - a reminder of the importance of neurology
- Excellent
- Very helpful. A very relevant subject to GP, I found it excellent going through cases of 'difficult constipation', i.e. what to do next when youve already done the basics. Also info on practical things such as footstools, and also the guidance on fluid requirements for age was very helpful.
- brilliant - really informative
- Good but only did constipation would of liked to of covered enuresis too.
- just covered constipation in this session, again confirmation of current practice
- Helpful guide to average fluid intake in children Good talk
- Good. (enuresis not covered)
- Good summary of constipation but didn’t cover enuresis? Enthusiastic lecturer and interactive. Useful reminder of neurological causes of constipation and CF and hirschsprungs.
- differentials & red flags were helpful
- Good revision of common problem.
- Excellent on constipation , very helpful . No eeeenuresis
- v good
- Constipation- again amazing, has helped me approach it much more holistically, so many different aspects I didn't consider like lifestyle, simple measures, red flags that I will now in corporate into my management
- Excellent V relevant to practice B good speaker
- good start to the day 45 mins of poo
- Interactive and engaged the audience
- very helpful but enuresis wasn't covered
- Excellent presentation. Some great practical advice about talking to families and children and helpful tips such as using a footstool.
- Brilliant speaker! Gave us some useful links to resources for families.
- constipation good but didn't talk about enuresis
- Excellent, covered the topic very well, helpful advice, good case discussion
- Really useful, practical advice. Very relevant to everyday practice. Excellent speaker-very knowledgable and engaging
- Good revision
- Great cases
- Excellent again some practical tips and aslo good use of interesting cases
- Useful information
- First half was useful - constipation. Long time sent on hirchsprungs which was less useful - never had a patient with this in 15 years as GP. I think a more 'primary care' angle would have been more useful. (maybe something around obesity in children / poor diets) or more on soiling. Portsmouth constipation pathway / clinicwasn't mentioned Enuresis wasn't covered which would have been much more useful
Your feedback for the Eczema Workshop
- Cancelled
- didnt happen - speaker DNA
- N/A
- Did not happen.
- N/A
- this workshop was sadly cancelled
- NA
- N/a
- this didn't happen
- N/A
- This did not occur, but was exchanged instead for the very helpful 'complications of the 6 week check'. I found this one of the most helpful talks of the day, we have lots of teaching about how to do a 6 wek check but not what to do when you find something abnormal, so this was invaluable! I learnt a lot, thank you.
- NA
- N.A
- cancelled
- N/A
- Speaker was unavailable
- Not given!
- didn't happen
- Didn't take place unfortunately - please can this be included in a future update?
- Unable to attend , hospital appt
- not held
- Unfortunately didnt happen- was really looking forward to it :(
- N/a
- did not happen
- N/a
- didn't happen
- six week check session was very informative. Please can we have eczema next time!
- n/a
- Not held
- N/a
- Did not happen
- Na
- N/a
- wasn't done
Your feedback for the The Headaches in Childhood Workshop
- Good
- Found this very useful as see a number of patients especially teenagers with headaches and migraines. Useful tips and great to be able to revisit existing knowledge and review history taking technique and process and asking right questions. Excellent speaker
- useful
- Excellent case based presentations that were relevant and concise
- Good
- A very good talk, I had not come across the 7 point history or the headache intensity scale before. I was also blissfully ignorant of caffeine containing energy drinks as an issue, having never drunk them, and never having bought them for my 2 boys.
- excellent speaker with lots of helpful advice around red flags and managing headaches
- I will spend further time reading about the Headsmart campaign and also looking at the Headcase website and that of England regby about concussion
- really interesting and reassuring
- Excellent
- very helpful
- Excellent
- Extremely helpful. I now feel much more confident in managing headaches in children, including red flags to look out for, and would feel much more confident in reassuring parents in the future. The resource headsmart was also very good.
- really enjoyed this - very useful for ANPs
- Excellent
- very useful, reassuring, informative and interesting speaker
- Thorough talk. Helpful red flags
- Good
- Excellent summary of headaches and management in young children, looking at red flags and differentials including migraine (very common), tension headache. Fluid intake for children should be 1.5L more if movicol!
- very interesting , some useful tools advice to help support families
- Really good thank you
- Superb , very helpful
- good
- Again useful, headaches is a common problem in primary care
- V good
- Brilliant
- excellent very helpful
- Good presentation. Reassuring in confirming current practice in terms of red flags and that headaches in children are common and usually benign.
- Good talk and reminder of the red flags for headaches in children.
- good
- Excellent review, again case based discussion was very helpful
- Ideally a little more interactive
- Excellent overview and great clinical tips as to when to worry/or not
- Very useful highlighting red flags and when to be concerned
- Very good cover of red flags and how to approach headaches. 7 question history
- Very useful
- Useful
Your feedback for the Mental Health Workshop
- N/A
- N/A replaced with 6 week baby check which was informative and interesting but not something I am involved in at my practice. Speaker excellent though.
- didnt have
- N/a
- Did not happen
- this was replaced with 6 week baby check, some useful info but not as relevant to me as NP
- NA
- did not attend this
- N/a
- this didn't happen
- Such a shame this didn't happen
- Unfortunately, this did not occur. Please include in future teaching days if possible, as I was looking forward to this subject.
- NA
- Did the 6 w baby check and good
- cancelled
- N/A
- 6/52 check - good
- Not given?
- didn't happen- which is a shame as this occurs a lot in primary care causing a lot of parental anxiety
- Didn't take place unfortunately - please can this be included in a future update?
- Disappointed this was cancelled , the one I felt I needed most
- not held
- Didnt happen
- N/a
- they DNA's
- N/a
- didn't happen
- N/A
- n/a
- Not held, 6 week check review which was very pertinent
- Disappointed this was cancelled
- Did not happen
- Did not attend this one as had to leave early
- N/a
- wasn't done, which was disappointing, this would have been useful as is a big challenge for GPs 6 week check session was useful.
Your feedback for the chronic abdominal pain Workshop
- Good
- Again very useful as a common ailment in Primary care. Useful advice links. Knowledgeable lecturer, very useful information.
- ok - felt like reading from slides, less talking around topic than others
- Very helpful and great speaker who was very enthusiastic and approachable and maintained our attention
- Fatima is a very good speaker.
- Another useful interactive talk with lots of useful nuggets form the audience as well as the speakers. I was not aware of the issues in faecal calprotectin levels in pre- school children or that 25% of cases of IBD present in people under the age of 18.
- covered a lot of same things as constipation workshop so perhaps could have just been one abdo workshop giving opportunity for another workshop
- I had not considered the presence of abdomina migraines in children so will consider this more in future. I am now more familiar with extra intestinal childhood presentations of IBD and the importance of an early diagnosis where psosible.
- reassuring
- Excellent
- a good reminder of the more uncommon but not that uncommon diseases
- Very good.
- Going through the different cases were very helpful, very relevant to GP - tricky cases that dont quite fit the textbook and how best to manage them. This also really highlighted to me the prevelance of IBD amongst teenagers and to look out for this in future.
- again really good - although felt the topic could have been discussed for a lot longer
- Good
- Least helpful talk
- Good
- Very useful including coeliac disease what to look out for, CMPA, IBD, IBS and abdominal migraine. To do bloods, faecal cal protection and an USS abdomen and renal tract if necessary.
- good to cover red flags , IBD and IBS -
- Really useful and will change practice thank you
- Excellent , the registrar was a fantastic speaker . Very clear , easy to ask questions .
- good
- So useful- a minefield that I dont usually know how to approach so help to break things down with practical solution and Fatima got us to think outside of the box
- Good speaker Relevant to practice
- V good
- Good
- helpful but went on too long
- Excellent presentor. Very useful advice about when to do blood and faecal calprotectin tests in children.
- Very enjoyable and interactive.
- Useful case based duscussion
- Good brief summaries of common conditions. Again very good speaker-made the session interactive and interesting
- Good revision and case series. Really engaging presenter
- Great cases
- Work shop on 6 week check This was a very good run through and why and when referral is needed.
- Useful
- Too long on Inflammatory Bowel disease. very rare in children, other much more common causes in chronic abdo pain in children which we see in primary care.
97%
Question 7: Did today meet your learning needs
- Yes 36
- No 1
- Don't know / unsure 1
What is the main thing that you have learned from today
- Headaches in children very useful
- Good overall review of everything. Useful tips and guidance. Changes to healthier together website brilliant and really useful. Use it all the time, easy to navigate and information easy to follow.
- couple of useful resources & tip for vitamins in tension headaches
- Differentiating serious and less serious pathology in children
- DKA can present as abdominal pain.
- the 7 point headache history and the headache intensity score as works across all ages
- how to utilise Healthier Together site better
- The use of inhalers instead of defaulting to nebuliser in the management of mild-mod asthma exacerrbation
- use wessex healthier together more useful websites for signposting
- new updates of pathways and what is new on website
- Overview on above topics. Found the 6 week check usuful.
- Lots of helpful tips! That IBD often presents in teenage years, that headaches are common in children but parents often think they're not - and the red flags to look out for, updates on HT website inc corona virus and also the MMR section etc.
- reassuring my practice is appropriate
- confidence in current practice importance of MH/birth history childhood constipation
- Must use Healthier Together website in consultations
- Simple tips for parents re: constipation - footstool etc - which I tend applied to a pt at work the next day!
- Asthma to treat with steroid inhalers as one course 3 day prednisolone is equivalent to 9 months inhaled steroids!
- if any concerns around presentations to contact and DW someone refresher on red flags
- More confidence to manage headache in primary care with a really good history and exam
- when to worry with headaches and abdo pain . No use using movicol without lots of extra fluids .
- 6 week check work shop v useful, also main doctor organising v good
- Amazing 6 week check review as I have yet to do it Asthma and how to diagnose in the younger children- that there is no limit to salbutamol Constipation- when to refer, red flags to consider, how to do a full exam Abd pain- atypical presentation of organic causes like coeliac, IBD etc
- See below
- 25% of IBD presents before 18!
- useful to network , and good refresher on managing headache and constipation
- Headaches are common in children; something we see in practice but in contrast to some previous teaching. If it looks like asthma, treat as asthma in children under 5.
- I should sign post parents to the WHT website far more often than I do!
- Working together website very useful resource
- Resources to signpost parents to. Better understanding of what to look for in the 6 week check
- Better knowledge of the WHT website
- Red flags in headaches and when to be concerned When to be concerned in a do pain and how to investigate
- Rechecking inhaler technique To use steps in constipation medication
- Use of riboflavin for migraine prophylaxis
- remember to look at healthier together website, to give info to patients. resources - asthma website
How will today's event change your practice
- Assessing and managing headaches in children
- General overview of practice with relevant updates. Nice to know that practice is up to date but useful to have access to additional links and support to take practice further and promote best practice.
- yes
- Less daunted by a lot of paediatric presentations and more confidence in my approach and management
- Better treatment acute and chronic asthma.
- I was aware of the wessex healthier together site, and had downloaded the app, but had not yet used it, I will certainly start to use the URTI safety net advice sheets
- I will use the site more to influence my treatment and to help parents to self care
- Many additional tips to offer parents including the use of additional websites as further reading resources.
- will feedback to team re healthier together and the suggetsed websites
- increase use of wessex healthier together with patients
- Better assessment of the ill child.
- I will consider IBD amongst my differentials in teenagers with bowel symptoms, I now feel much more confident in assessing headaches in children and reassuring parents where appropriate, I will continue to use HT website for extra safety netting and info resource for parents, I will aim to complete the extra CPD on headsmart website, and look at the enlgand rugby headcase resource for more info on post concussio headache.
- Encourage more use of WHT website for paThways and signposting
- more confident in the treatment of viral wheeze
- Improve info able to give parents
- Direct parents more to the healthier together website
- Initiation of clenil or flixotide if cough occurs. Use of nasal triptans over 12 years, migraine diary and fluids. Test reflexes in children with constipation and check if delayed >48 then meconium passage. What to look out for on the 8 weeks baby check, causes of increased head circumference and which murmurs to refer as urgent, loud, harsh and not at left sternal edge, signs of failure. The use of the paediatric advice line and patient information leaflets on HT website
- to be safer and current in my practice , support the recommendations from colleagues in secondary care
- Asking even in older children re delayed passage meconium in constipation 7 point hx for headaches Look for early extra-intestinal sx of IBD
- as above
- help enormously
- Better at 6 week check now- have a better guide to follow than doing it blindly! Feel more confident diagnosing asthma in the 5 year olds How to manage constipation long term and from a life style perspective
- I will try and use spacer rather than nebuliser for a acute asthma. Consider Ibd as a diagnosis in children with abdo pain Be confident about starting migraine prophylaxis in primary care. Be aware of abdominal migraine symptoms in history when assessing children with a do pain
- use asthma page of Healthier Together for borderline cases
- Use faecal calprotectin if indicated in children over 4. Initiate migraine treatment in older children and teenagers.
- Use the WHT resources as part of my patient education to back up what we've discussed in clinic.
- More confident in managing constipation, abdominal pain in children
- Will bookmark and use guidance from WHT more
- As above
- Yes I feel better able to offer practical advice to my patients and identify worrying features in headaches in children,which can also apply to adults!
- Will try to apply new knowledge
- Learning points ASTHMA / WHEEZE https://what0-18.nhs.uk/professionals/gp-primary-care-staff/clinical-pathways/padiatric-pathways Prednisolone - can give normal tablets crushed (in chocolate spread etc) instead of sol (expensive) or liquid https://www.asthma.org.uk/advice/inhalers-medicines-treatments/using-inhalers/ aim for lower dose ICS ICS required for effective asthma control. - start ‘moderate’ e.g. 200bd clenil, (100bd flixotide) as GP start clonal FIRST - but beware it may cause cough, and so flixotide is an unlicensed alternative - prob more goes into lungs and more effective. Action plans- on the website. Headache Headsmart website and education module https://www.headsmart.org.uk concussion - https://www.englandrugby.com/participation/playing/headcase/resources 6 week check - https://www.piernetwork.org/child-t.html
85%
Question 10: How would you rate the course organisation
- Poor 0
- Average 0
- Good 17
- Excellent 21
87%
Question 11: How would you rate the course venue
- Poor 0
- Average 1
- Good 13
- Excellent 24
Any other comments
- Great day, all speakers excellent as usual. Longer time slots definitely better. Will definitely be back next time.
- Please ensure that wessex healthier together is more spread amongst health visitors/midwives - they send a lot to GP where patients could be signposted to this. Most patients have not heard about website before we tell them.
- I attended the first paediatric update which was excellent ...so was a hard act to follow !.. this update was a bit lacking in content. I was disappointed Dr Patel was not doing a presentation as he is very inspiring re WHT etc... some speakers cancelled too I think.
- I hope there will be more days like this in the future
- I really enjoyed the 6 week check talk and wonder if this could be added into future programmes
- it would be good to have the slides for the 2 workshops that didn't take place if possible
- Fantastic catering - one of the best I've had at a course, also comfortable good sized rooms for workshops. Please try and get the voting for the answers buttons working for next time, as this was very good at the previous course.
- it was a real shame that the eczema and MH workshops were cancelled as would of been very helpful - the 6week check talk was interesting but perhaps not so relevant to ANPs
- disappointing eczema/mental health shop cancelled
- Best food provided on a course - ever! This shouldn’t be important but it made a big difference!
- I
- well done all involved another very informative / useful and interesting study day
- Can't not mention the food - amazing thank you. Speakers were clear, approachable and pragmatic. I always really enjoy these updates, thank you.
- I attended last years and I applaud you for taking on the feedback which was to reduce the introduction to give more time for the first work shop- this was successfully executed this time around and I found we thankfully had alot more time to ask questions in the work shop- thank you!!!
- Excellent venue and catering best course I have attended
- parking great heating too hot / cold
- venue - is poor for parking and food - nothing green available at lunch apart from fruit I think it was a great shame not all the work shops took place . in the afternoon should have run 2 work shops back to back so we could leave earlier . For 2 of the talks it was clear the slides were not put together by the speaker . I think not as helpful as first course -
- Thank you!
- A further course to include the mental health session which had to be cancelled today.
- Shame no eczema and certainly no mental health that would have been freaky useful
- It was a shame we didn't have the 'clickers' for the cases, they do make you commit to an answer and concentrate on the case. Enuresis, Eczema and mental health would have been useful so it was disappointing these weren't covered. sicky but thriving babies useful to cover (I know this was done a bit in phase 1 talk)
Any "Don't know" responses are not included in the calculation of the average.
