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Thankfully I’ve only had one visit to A&E with my little one, it was very early on - before he was formally adopted and when I told them the circumstances they were brilliant. Luckily it was nothing serious, but it was the first time I’d experienced him being ill - I now know that very lethargic, floppy and drowsy is his typical illness mode but it was alarming at the time given that’s he’s a swinging from the curtains, fast forward for four hours without a break kind of child! What they did well was treating him as though he was younger than he actually was, checking with me if there was anything they need to know about his behaviour or fears and being very calm and patient - I think they’re mostly the qualities I’d hope for anyway with paediatric care. At my GPs they are pretty good too. He tends to go into baby mode when he’s in a new situation - talking in a baby voice, crawling on the floor and doing ‘fake’ shyness to mask his fears. Most of the people there are really understanding and just go along with it, but one person does seem a little judgemental and short in their interactions, which makes my son worse and me tense and embarrassed, even though I know it’s only my son’s self-preservation mode. Also warning children about what’s about to happen, I know this is standard practice, but at a hospital consultation one time the doctor just pulled my son’s pants down without any warning. I was horrified - Surely against all current safeguarding practices - and I had a long talk with my son after about it to make sure that he knew it wasn’t ok. I think an awareness that parents may have limited knowledge of medical history too or may need more time to answer questions. For example, if a child has had an allergic reaction in the past, a parent who was there when it happened will remember, a parent who’s only read it in a CPR is much less likely to.

I think the limited medical knowledge is a good one - and also that there may be old injuries that are not linked to the current parents care - so being careful about being quick to judge. The medical records might not be updated either.

ive had one bad experience of A&E when my son was 2 and had to have an X-ray - the lady made him lie down on a table and then lowered the massive X-ray machine which was above him down towards him. Naturally he cried and she was very insensitive - had made no attempt to explain beforehand - to me or him - what was going to happen - in fact I was behind a screen as instructed. Afterwards she came into the waiting room and gave him a sticker - saying “not that you deserve it”. I think that was atrocious management - again for any child though - but a sensitive nurturing approach is particularly needed with traumatised children - and stickers don’t mean a thing. Otherwise care has been generally excellent but sometimes I have had to remind people of the fact that one of them is adopted despite it being in their records - so some way of making this clear so it doesn’t have to be the focus unless it needs to.

(no idea why it’s its italics today!)

I don't know if this is something within your field of influence, but my daughter has had a lot of A&E trips both before and after the adoption order (severe allergies, severe asthma) and we have had all sorts of trouble getting her pre-adoption order records summarised and appended to her post-adoption order records after she got her new NHS no, despite me being pretty well aware of what would happen and taking great pains to get the GP, paediatricians, community nurses and everybody I saw to understand the issue. This has caused all kinds of problems, specifically, all her repeat prescriptions (including those set up by community nurses and the hospital) being forgotten, all of her allergy tests being re-done as they couldn't find the results from the first time, food challenges being delayed, and worst of all, a two-year delay getting put on the list for the paediatric respiratory clinic because according to the hospital's notes, her asthma difficulties only started when she was nearly two (when her new records started) and all the A&E visits and admissions prior to that were nowhere on the system. The referral to the paeds respiratory list only happened because she was admitted to paeds HDU earlier this year and the consultant couldn't understand why he hadn't seen her in his clinic before. Before then she had been to A&E loads of times, and been admitted to the children's ward several times, but all of that was forgotten once she got her new NHS no. I'm not arguing against the new number being given - I can understand the reasons why - but the systems don't seem to be working too well. Finally, after years of struggling, we have a medication regime that means she is not admitted to hospital every time she gets a sniffle, and at random other times too, but it has been a long haul, and I knew in advance that she'd be getting a new number and made sure everyone knew, but people still didn't seem to get the significance. I don't know exactly what the procedure is for making sure all these records from all these various medical professionals are collated and then carried forward (appropriately redacted), although I have been led to believe a HV should spearhead it, but it doesn't seem to be working very efficiently!

Just seen this topic. Communication can be difficult here especially with unknown people. Using basic language helps when asking questions rather than medical terms. For us anxiety is a big issue so have to be careful how things are explained. Also hypersensitivity is an issue.

I also agree with treating as younger and a lot of reassurance. Sometimes when seeing a medical person it would be helpful to have a small form to note any things that would help as not always easy to explain in front of child.