School clinics #OutOfHospitalCare

The rigmarole of clinic attendance is all-too-familiar for many young people with chronic conditions. Getting the bus to school in the morning and staying for a few hours of lessons before being picked up to go to clinic… then finding that by the time clinic has finished it’s not worth heading back to school! This repeats over and over again every 3 months. Each clinic visit resulting in missed education and time off work for parents. Once at the clinic there can be further challenges. Seeing young people with their parents can make it difficult to discuss sensitive issues like alcohol, relationships and sexual health and makes it difficult to foster a sense of independence before young people move into adult services.

This year we have been trying to solve some of the issues thanks to the work of Chris Bound, one of the clinical nurse specialists in the St Mary’s children’s diabetes team. After recognising that some of the bigger secondary schools in our area can have lots of young people with type 1 diabetes Chris decided to take the diabetes clinic into the schools themselves in the hope of reducing missed education and helping young people feel more independent. In a pilot project starting at one school, the team have replaced 2 of the 4 annual appointments with a clinic held on-site at the school.

At the clinic, young people are seen by a clinical nurse specialist, either alone, or with a friend, taking less time out of their school day. The responses so far have all been very positive. Our nurses have found that young people are more engaged when seen in a school environment and that it is easy to have conversations that can be difficult in front of parents. Students have agreed that they felt more confident to talk to a nurse or doctor on their own after the appointment. One young person gave the following lovely piece of written feedback: “I liked today’s appointment because it was more free since my mum wasn’t here”.

It’s been so encouraging that the clinics have been running well so far. We’ll be carrying on with the clinic, and if it goes well, hoping to start similar clinics in other schools in the near future.