Join Dr. Ruth Bowen as she interviews local specialists from around Bristol, North Somerset, and South Gloucestershire on a range of topics related to primary care paediatrics -- the non-blanching rash, enuresis, the limping child, infant feeding issues, and more! This podcast is aimed at primary professionals only and does not substitute professional medical advice or consultations. Topics will be discussed with BNSSG primary care in mind, and with references to local referral pathways, but the majority of content covered will be based on national guidelines and applicable nationally.
Speaker: Dr Neky Sargant: Consultant Paediatrician with an interest in Eating Disorders, UHBW Clinical Lead for Eating Disorders, BNSSG Clinical Lead for Paediatric Mental Health. Blurb IN THIS PODCAST FINALE Neky Sargant shares her 'top tips' for assessing and managing eating disorders in Children and Young People in Primary Care. She highlights key guideline changes with the 2023 MEED guidelines and guides us through an effective assessment of potential eating disorders, safe management plans and appropriate onward referral pathways. Episode resources MEED Happy Maps Bristol HEADSSS Eva Musby Resources Beat Eating Disorders MIND Feedback Send your feedback for this series by emailing ruth.bowen2@nhs.net or send a brief voice note here.
Speakers: Dr Katy Pike: Senior Lecturer at the University of Bristol, Honorary Consultant in Paediatric Respiratory Medicine and BNSSG ICB asthma lead Dr Deborah Marriage: Consultant nurse in Allergy and Asthma and BNSSG ICB asthma lead Blurb: Hot of the press: NICE, BTS and SIGN all reached agreement for new, revolutionary asthma guidelines. In this episode Katy Pike and Deb Marriage demystify the guidelines, guiding us through the changes and impacts for the diagnosis and management of asthma in Primary Care. Episode resources: New NICE/BTS/SIGN Asthma guideline Primary Care Respiratory Society: How to calculate and interpret peak flow rate variability Bristol Children's Hospital: Child asthma plan Bristol Children's Hospital: Teenage MART asthma plan Bristol Children's Hospital: Teenage non-MART asthma plan Asthma and Lung UK: Inhaler technique
Speaker: Mr Julian Gaskin -Paediatric ENT consultant at Bristol Royal Hospital for Children Blurb: When are sleep studies warranted for children with suspected obstructive sleep apnoea? How do we avoid missing cholesteatomas? When should we refer infants with laryngomalacia? Is there a link between gastro-oesophageal reflux and laryngomalacia? Paediatric ENT consultant Julian Gaskin answers these questions and more as GP Ruth Bowen interviews him the common Primary Care ENT scenarios of obstructive sleep apnoea, laryngomalacia and acute, recurrent and chronic supporative otitis media. Resources: -ENT UK -Bristol Royal Hospital for Children guideline: Obstructive sleep apnoea -NICE guideline: Acute otitis media -NICE guideline: Otitis media with effusion -NICE guideline: Chronic supporative otitis media
Speaker: Dr Frances Hutchings -Consultant General Paediatrician at Bristol Royal Hospital for Children Blurb How should we assess the child with recurrent infections? When can we reassure with a diagnosis of toddler diarrhoea? How do we manage Tics and when should we be concerned? What is benign transient hyperphoshatasemia of infancy? Dr Frances Hutchings answers these questions and more, addressing common themes in Paediatric Advice and Guidance letters. Resources 10 warning signs of primary immunodeficiency BNSSG Remedy: Dietary management of toddler diarrhoea parent information leaflet BNSSG Remedy: Tic and tourettes in children Tourettes action Great Ormond Street Hospital: Tics Happy maps Off the record
Speaker: Dr J-C Sconce: General Paediatric consultant at BRHC, co-author of the BRHC 'Gastro-oesophageal reflux in infants' guideline. Blurb When should we prescribe for infants with reflux? How can we help parents practically giving medications? Do dummies have a role? Are pro-kinetic agents still an option? General Paediatric consultant Dr J-C Sconce guides us through these questions and more with this systematic approach to gastro-oesophageal reflux in infant as we discuss complications, management options and red flags for serious differential diagnoses. Resources BRHC Gastro-Oesophageal Reflux in Infancy BRHC Gastro-Oesophageal Parent Information Leaflet BRHC Milk-Related Problems Guideline ICON
Speaker: Dr Rachel Gaywood -GP clinical lead for Learning Disabilities and Autism in Devon Blurb: How do we identify learning disabilities? Why is the learning disability register import? What are the common pitfalls around learning disabilities? How can we support families? Join us as Dr Rachel Gaywood explores these questions and more. Resources: NHS England: Improving identification of people with a Learning Disability NHS England: Finding out more about the Learning Disability Register Get checked out Mencap Unique Support group for parents of children with special educational needs Bristol Somerset Gloucestershire RCGP Learning Disability Special Interest Group
Speaker Dr Clare Sheahan: consultant in Community Paediatrics Blurb When should we suspect Autism? What social factors can muddy the water? Who should we refer? How can we practically support families? What is the role of the education sector? Why are the rates of Autism increasing and what is BNSSG ICB doing to tackle the increased waiting times? Join us as Consultant Community Paediatrician Clare Sheahan tackles these questions and more. Resources The Autism Assessment Service for Bristol, North Somerset and South Gloucestershire Local offer: Bristol, North Somerset, South Gloucestershire Bristol Autism Support Teen life National Autistic Society Neon Daisy Parent Carer Organisation: Bristol, North Somerset, South Gloucestershire Paper 1: Study of England and Northern Ireland finds 8-fold increase in autism diagnosis over the last 20 years Paper 2: Autism phenotype vs registered diagnosis in Swedish children: prevalence trends over 10 years in general population samples Accurx template BNSSG Neurodiversity Transformation Programme
Speaker: Pippa Bowen - General Paediatric consultant BRHC with an interest in endocrinology. General Paediatric consultant Dr Pippa Bowen brings the child with precocious or delayed puberty to life. She guides us through a methodical Primary Care assessment with underpinning explanations. We explore cases of delayed puberty, precocious puberty and premature adrenarche. Resources Archives of disease in childhood - Fifteen minute consultation: Clinical pubertal assessment NHS: Early or delayed puberty BSPED patient information leaflets Bristol Royal Hospital for Children guidelines: Delayed puberty Bristol Royal Hospital for Children guidelines: Premature or precocious puberty
Speaker Dr Dan Magnus - consultant in Paediatric Emergency Medicine Blurb Want to brush up on your knowledge on your knowledge of measles and pertussis? Refresh your clinical knowledge, keep up to date and be prepared to answer any parental queries. Paediatric Emergency Medicine consultant Dan Magnus guides us through diagnosis and management of measles and whooping cough as well as taking us back to basics with a methodical approach assessing the sick child. Resources Adam Finn Ted talk: How Vaccines Really Work Healthier together Handi app
Speaker Dr David Capehorn - GP partner and Honorary Associate Specialist in Paediatrics. Blurb Should we always investigate lymphadenopathy in children and how worried should we be? Is fever a predictor of illness? When should we investigate intermittent abdominal pain? How do we interpret investigations in children? GP and Honorary Associate Specialist in Paediatrics tackles these questions and more, challenging us with common myths and pitpalls in Primary Care Paediatrics. Resources Bristol Children's Hospital: chronic abdominal pain in children (https://uhbw.mystaffapp.org/diliboards/46/diliboard_contents/12401/document_view.pdf) Park: Evaluation of neck masses in children (https://pubmed.ncbi.nlm.nih.gov/7762481/)
Speaker Dr Anirban Majumdar: consultant Paediatric Neurologist Blurb Join GP Ruth Bowen exploring the challenging topic of chronic headaches with consultant Paediatric Neurologist Dr Anirban Majumdar. We discuss management of migraines and tension headaches including alternative medicines and supplements, the often challenging overlap between headache phenotypes in CYP, red flags and indications for referral. Resources Headsmart (https://www.mybrainfirst.org/) Migraine trust (https://migrainetrust.org/) Bristol Children's Hospital: Paediatric headache for Primary Care (https://uhbw.mystaffapp.org/diliboards/46/diliboard_contents/307/document_view.pdf) British Paediatric Neurology Association: CHaT (Children's Headache Training) (https://courses.bpna.org.uk/index.php?page=childrens-headache-training)
Speaker Dr Nick Sargant: consultant in Paediatric Allergy and Paediatric Emergency Medicine at Bristol Royal Hospital for Children. Nick Sargant breaks down CMPA, guiding our Primary Care assessment, management and referral criteria as well as helping us distinguish CMPA from commonly confused differentials. Resources: Allergy UK -cow's milk allergy Anaphylaxis UK British society of allergy and clinical immunology ICON
Speaker Helen Tapson -South Gloucestershire Public Health Consultant. Lead for health inequalities in CYP. "We are all in the same storm but we are not all in the same boat". What local and national projects are striving to tackle health inequalities in Children and Young People? What part do we play in Primary Care? Play on to find out more as South Gloucestershire Public Health consultant Helen Tapson guides us through the challenging topic of CYP health inequalities: highlighting exciting current national and local projects and using cases to explore practical tips and resources to empower us in Primary Care. Resources South Gloucestershire Director of Public Health Report: Giving Children the Best Start in Life One stop shop (South Gloucestershire) Virtual hub for financial support (North Somerset) Citizens advice (Bristol, South Gloucestershire, North Somerset) Cost of living advice (South Gloucestershire) Cost of living advice (North Somerset) Cost of living support (Bristol) Healthy start vouchers NHS stop smoking app The Haven (BNSSG)
Speaker: Dr Dinesh Giri, consultant Paediatric Endocrinologist (Bristol Children's Hospital) With rates of obesity in Children and Young people on the rise, consultant Paediatric Endocrinologist Dr Dinesh Giri gives tips on approaching this tricky subject, what we can do in Primary Care to support and appropriately manage these children and onward referral, including the new government commissioning of severe obesity in CYP clinics. Resources NHS: fussy eaters BeeZees bodies: top tips to tackle fussy eating Change4life (renamed 'healthier families') Live well: advice for parents of overweight children Healthy start (money for healthy food for 0-4s with a carer on benefits) Health Education England Childhood Obesity elearning
Speakers: Dr Anthony Crabb: Associate Clinical Director for CAMHS in Devon and founder of Held Health Limited, a private healthcare provider of assessment and intervention for CYP with neurodiversity or mental health needs. In this episode Dr Anthony Crabb explores common Primary Care presentations of CYP non-school attendance. He shares knowledge and experience helping families navigate school support, community resources and thresholds for CAMHS input. Episode resources www.nhs.uk: ADHD www.nhs.uk: Autism ADHD UK National Autistic Society The Autism Education Trust Ambitious About Autism ADHD foundation Papyrus Great Ormond Street: ADHD Great Ormond Street: Autistic Spectrum Disorder Bristol Autism Support Bristol syndiass Bristol.gov.uk: EHCPs Bristol.gov.uk: parenting courses Addressing Education and Health Inequality: Perspectives from the North:
In this episode Paediatric Allergy and Respiratory Clinical Nurse Specialist Deb Marriage shares essential learning from her 6 month Paediatric Asthma outreach clinic pilot. Deb Marriage and Respiratory Paediatric consultant Katy Pike then explore the challenging topic of asthma, guiding us through common pitfalls in asthma diagnosis, the role of objective testing, red flags, Personalised Asthma Action Plans and management options including MART regimes. Episode resources NRAD report: Why asthma still kills Asthma and Lung UK: Personalised Asthma Action Plan Bristol Children's Hospital: Child asthma plan Bristol Children's Hospital: Teenage MART asthma plan Bristol Children's Hospital: Teenage non-MART asthma plan Allergy UK: House dust mite Asthma and Lung UK: Inhaler technique
In this episode ERIC Paediatric continence nurse Brenda Cheer guides us through the systemic assessment of nocturnal enuresis, effective promotion of healthy bladder and bowels and targeted further management. Dr J-C Sconce explores nocturnal enuresis in children with complex needs, highlights red flags and guides us through appropriate referral routes. Episode resources ERIC 'Advice for children with night-time wetting ERIC 'Advice for children with constipation' ERIC 'Advice for children with daytime bladder problems' ERIC 'Children's continence pathway' ERIC 'Night-time diary' ERIC 'How to use macrogol laxatives' ERIC 'A parent's guide to disimpaction' ERIC 'Guide for children with additional needs' Bladder and bowel UK 'Understanding bedwetting in children with Down's Syndrome and other learning disabilities Sirona CCHP: Neurodiversity advice and signposting
Dr Michael Malley, Paediatric Emergency Medicine Consultant at Bristol Children's Hospital, is back, guiding us through evidence-based management of head injuries in children. We discuss red flags warranting immediate referral to A&E, NICE guidelines for CT heads, expected course of symptoms, concussion, safety-netting resources and later indications for hospital referral. Episode resources: NICE head injury assessment and early management Bristol Children's hospital head injury guidelines BNSSG remedy head injury advice leaflet for parents The handi app Healthier together Headcase resource for concussion
Two podcasts in one! In this episode we are joined by Dr Natasha Smallwood, Paediatric consultant with an interest in Rheumatology, and Mr James Barnes, Paediatric Orthopaedic consultant. They share their approaches to the complex topic of the limping child. We discuss the possible breadth of differentials, red flags, referral criteria and tips for assessment in primary care. Episode resources BCH limping primary care assessment of acute limp in children NICE: acute childhood limp
In this episode, we're joined by Dr. David Capehorn, Honorary Associate Specialist and Expert in Paediatrics, who's been at the forefront of the Primary-Secondary Care interface for 30 years. With reference to two classic cases, David helps us navigate key learning from the new 2022 NICE guidelines on correct management of UTIs in children and his own summary article on identifying and treating UTIs promptly for under 16s. More specifically, we discuss: Diagnosis Urine interpretation When to send urine for culture tests Immediate management Follow-up investigations Referral And prevention Feedback: Let us know what you thought about this episode of BNSSG Paeds Pod here, via our feedback form! Completing the form should take between 1-3 minutes, and your responses are invaluable in helping Ruth and the team to shape future episodes. Episode resources: “Identify and Treat Urinary Tract Infection Promptly in Under 16s” by Dr. David Capehorn NICE Urinary Tract Infections in Under 16s: Diagnosis and Management guidelines BNSSG Remedy Urinary Tract Infection in Children: Management and Referral guidelines NICE Fever in Under 5s: Assessment and Initial Management guidelines ERIC – The Children's Bowel & Bladder Charity
In this episode, we're joined by Dr. Michael Malley, Paediatric Emergency Medicine Consultant, as he guides us through the non-blanching rash in children. More specifically, we discuss: Differentials of meningococcal septicaemia Other causes of sepsis with DIC Non-accidental injury Haematological malignancies Henoch schonlein purpura Idiopathic thrmbocytopenic purpura And benign mechanical causes of petechiae And all with respect to the discerning features of each, when to refer, management in Primary Care, and good safety-neating advice for parents. Feedback: Let us know what you thought about this episode of BNSSG Paeds Pod here, via our feedback form! Completing the form should take between 1-3 minutes, and your responses are invaluable in helping Ruth and the team to shape future episodes. Episode resources: Bristol Children's Hospital Non-Blanching Rash guidelines Bristol Children's Hospital Henoch Schonlein Purpura guidelines Thanks to the Bristol Royal Hospital for Children for these resources.
Watch this space for episodes of the new BNSSG Paeds Pod, brought to you by BNSSG Training Hub, and set to cover topics relevant to local primary care clinicians.