Pioneers in patient care: consultants leading change
Midlands
<img src='/ap.nsf/AttachmentsByTitle/PhotoLorettaLight/$FILE/LorettaLight.jpg' alt='Dr Loretta Light'align='left'>Innovation: Paediatrician to Young Substance Misuser Project to give young people holistic health assessment
Dr Loretta Light
St Michaels Hospital, Lichfield, Staffordshire
Job title: Consultant community paediatrician
Speciality: Community child health
For young drug users, the medical and psychological repercussions of their habit can be devastating. In a bid to help these children, the Paediatrician to Young Substance Misuser Project, introduced by the local health authority and Dr Loretta Light, aims to provide a holistic health assessment for teenage substance misusers.
The project offers a complete paediatric assessment, a service which many young substance misusers may not otherwise receive. It also goes out into the community and visits teenagers in their homes, hostels and local clinics.
“Some GPs are very reluctant to work with teenage substance misusers and without our service many of them may not receive any routine medical treatment. Our aim is to provide a total health assessment, which does not just focus on the drug problem.
“We screen for hepatitis B and C, provide immunisation for Hepatitis B, and ensure that these young people receive any immunisations they may have missed out on. We also discuss sexual health with them and provide STD screening, pregnancy tests. I also provide substitute and detoxification prescribing. This involves liaising with local pharmacies to arrange daily, supervised consumption of medication.”
Dr Light says: “In the project’s first year in 1999 we received 79 referrals and that was just the tip of the iceberg. The service has proved to be popular with young drug users. We are now receiving self referrals through word of mouth from existing or past clients. Young people trust the service and see us as approachable.”
Dr Light says: “The potential need for this service, and services like it, is enormous. The average age of the young people we see is 16 to 17-years-old. If they could be helped now, many could be prevented from going into adult life with problems. If the service was funded by the NHS, the incidence of hepatitis C could be reduced and young people helped away from a life which could entail crime and prostitution.”
Although government spending has had some effect on the project, a lack of funding and resources are still the major challenges facing the project. Dr Light explains: “Project funding for paediatric input is currently for only one-and-a-half hours a week and this is inadequate for service needs. Greater input would allow me to see more patients more rapidly. I would be able to develop greater expertise in detoxification and alternative prescribing.
“These young people need enormous amounts of time to deal with their multiple problems adequately and we need to see them very frequently in order to engage with them and keep their trust. Any improvements we have tried to make have been thwarted by a lack of time and resources.”