The Cove Children's Clinic | James Paget University Hospitals NHS Foundation Trust

The Cove Children's Clinic

We provide Outpatient Services for Children and Young People, from birth to transition to adult care, at the James Paget University Hospital and in community clinics.

We have a range of specialties within our department, as well as visiting consultants from other hospitals for outreach clinics.

What services are provided?

More information about The Cove

Paediatric Diabetes team

Paediatric Diabetes team clinics are held flexibly Mondays to Thursdays in The Cove children's clinic, ground floor.

You can contact the team on 01493 453884.

We offer advice and support for children suffering from Type 1 or Type 2 diabetes.

The team see patients from the time of their diagnosis to the time of their transfer to adult services (including care of children up to their 19th Birthday).

Teenagers with type 1 diabetes are also seen in the transitional clinics which helps the young person and the parent to get acquainted with the adult diabetic team before their care is completely transferred over.

The diabetic team gives advice on various methods of insulin treatment including insulin pens and insulin pumps.

There are also facilities to download the blood glucose readings from the blood glucose meter and the insulin pump either at home before the clinic or on the day of the clinic appointment. The doctor and the paediatric diabetic specialist nurse can then review this and give advice on changing insulin doses to achieve good control of their diabetes.

In the diabetic clinic, the child and parent will be seen by the paediatric consultant with special interest in diabetes, the paediatric diabetic specialist nurse and the dietician. An appointment with a psychologist can also be arranged, if need be, after discussion with the parent and child.

What services are provided?

Diabetes focused consultation – 4 times per year
Annual Review clinic consultation (once a year)
Diabetes Advice and information leaflets.
Diabetes related emergency protocols
Glucagon Injection Training
Blood sugar and blood ketone testing training
Emergency care plans (including school/college/nursery training where necessary)
Dietetic advice
Evening structured education once a year
Home visit by dietitian and diabetic nurse specialist
Open access to ward via phone call to Ward 10.

Ward 10a and 10b are open 24 hours a day, seven days a week.

Clinics are flexible - patients and their families will be advised appropriately.

Out of hours – for parents and families only - via Ward 10.

Rheumatology

Opening times: Tuesday 2pm to 5pm, Wednesday 2pm to 5pm, Thursday 2pm to 5pm.

Location: The Cove children's clinic

Paediatric Rheumatology clinics: Fourth Wednesday of every month at the Newberry Child Development Centre.

In Rheumatology we deal with problems that affect the locomotor system, i.e. problems with joints principally, also ligaments, tendons and bones.

Although many conditions are easily identified and dealt with, others may include very sensitive concerns, sometimes causing significant distress to families and young people so our aim is to offer support and advice in a friendly and compassionate way; carefully explaining what may be the problem and how to deal with it.

We are happy to answer all your questions.

Since the locomotor system can be affected in just about every other condition, we work very closely with many other healthcare professionals in all the specialties such as allergy, ophthalmology, dermatology, orthopaedics, dieticians, child psychologists and many others. We know your time is valuable and will try to arrange all your care in a timely way to avoid unnecessary hospital trips and time lost from school.

All the Paediatric doctors at the James Paget have general paediatric expertise and see children with joint problems.

We see children with problems such as;

Juvenile idiopathic arthritis
Reactive arthritis in childhood
Hypermobility syndrome
Mechanical pains in limbs and spine
Non-specific limb/ back pains
We work closely with the physiotherapy, orthopaedic and psychology teams and are particularly keen to reduce the numbers of older children with chronic pain and inflammation, with support and education about dealing with these issues at an earlier stage.

We also link in with the specialist paediatric rheumatology service at the Norfolk and Norwich University Hospital, community paediatricians, children’s services and education and adult rheumatology services in the teenage years.

What services are provided?

Monthly paediatric rheumatology clinic at Newberry Child Development Centre in Gorleston (JPUH NHS Trust)
Specialist paediatric physiotherapy with dedicated sessions, including hydrotherapy and orthotics
In-patient/ day-case services for children requiring iv steroids
In-patient/ day care services for children requiring intra-articular steroid injections (via fast-track referral to NNUH)
Specialist paediatric ophthalmology services for early detection of arthritis associated inflammatory eye-disease
Specialist radiologist diagnostics including ultra-sound and MRI scanning
Specialist nursing support for children on disease-modifying or biologic drugs and/or those requiring regular blood tests
Specialist psychology support for child and family where emotional issues affect symptoms and treatment
Tertiary support from consultant paediatric rheumatologist( via referral to NNUH)
Transition clinic for teenagers moving towards adult services.

How can I get a referral?

Patients under 16 years of age can be referred by their GP or any other hospital doctor who sees them for any other medical needs.

Gastroenterology

Opening Times: Monday 9am to 12noon, Wednesday 2pm to 5pm, Thursday 9am to 12noon

Location: First floor, Antenatal Clinic (outside entrance available).

In Gastroenterology we deal with problems that affect the entire digestive system from the lips to the very end of the bowel.

Although many conditions are easily identified and dealt with, others may include very sensitive concerns, sometimes causing significant distress to families and young people.

Our aim is to offer support and advice in a friendly and compassionate way; carefully explaining what may be the problem and how to deal with it. We are happy to answer all your questions. Since the bowel can be affected in just about every other condition, we work very closely with many other healthcare professionals in all the specialties such as allergy, Ear Nose & Throat, dermatology, dietetics, child psychology and many others.

We know your time is valuable and will try to arrange all your care in a timely way to avoid unnecessary hospital trips and time lost from school.

All the Paediatric doctors at the James Paget have general paediatric expertise and see children with tummy problems.

Dr Bentsi-Enchill and Dr Ambadkar have a special interest in Gastroenterology.

We see children with problems such as;

recurrent vomiting, gastro-oesophageal reflux and offer pH studies towards diagnosis.
suspected feed intolerance and allergy
swallowing and feeding difficulty; children with gastrostomies or other tube feeds
growth and weight gain problems
persistent stomach and abdominal pain
persistent diarrhoea or difficult constipation
suspected irritable bowel syndrome and inflammatory bowel disease.

We work closely with the Nurse led constipation and enuresis teams and are particularly keen to reduce the numbers of older children with continence problems, offering support and education about dealing with these issues at an earlier stage.

We also link in with the Feeding Clinic at the Newberry Centre, hospital and community dieticians, the Healthy Weight clinic, the Growth and Endocrine (hormone problems) clinic, Allergy Clinic, Paediatric Surgery and Urology, tertiary centres.

What services are provided?

Inpatient care

Some patients may need admission for treatment on Ward 10. We treat babies and young people up to their 19th birthday. Where appropriate, young adults (aged 16-19) will be referred to the adult gastroenterologists at the James Paget. Some adolescents will need transfer to the Norfolk and Norwich University Hospital paediatric gastroenterology team who treat patients in the earlier acute stages of inflammatory or complex bowel problems.

Outpatient service

We accept referrals from GPs and other health professionals for babies and children up to 16 years old.
We hold Coeliac clinics twice a year (Spring and Autumn) on a Thursday afternoon, specifically for children with Coeliac disease for their annual check-up with the gastroenterology team. Senior Paediatric Dietician Patrick Friel brings free samples of gluten free food and recipes together with specialist advice and information available. Interim appointments are made when needed.
We look forward to restarting the Joint Paediatric Gastroenterology clinic with a visiting Paediatric Specialist from Norfolk and Norwich Hospital (NNUH) so that our families can have more specialist advice, close to home. We continue to work closely with NNUH and refer patients from our clinics for children’s assessments we do not provide at JPUH such as endoscopy.
It is not usually possible to perform investigations on the same day as the clinic appointment except some for types of Xray, or blood test. For those who need blood tests, we have an excellent service provided by play specialists supporting childrens trained phlebotomists.

How can I get a referral?

Patients under 16 years of age can be referred by their GP or any other healthcare professional.

What are the opening times?

General and gastroenterology clinics:

Monday 09:00-12:00 - Dr Ambadkar

Wednesday 14:00-17:00 - Dr Bentsi-Enchill and Dr Ambadkar

Thursday 09:00-12:00 - Dr Bentsi-Enchill

Gastroenterology clinics second Thursday of the month 14:15- 17:00

Coeliac Clinic (April/May and October), second Thursday of the month.

Healthy Weight Clinic

Opening times: Monday morning every week.

Telephone: 01493 453914

Location:The Cove Childrens Clinic

We are an outpatient service run by the Paediatric team. Clinics are run weekly at The Cove Childrens Clinic.

Nurse led follow up clinics may be run in other locations.

Usually children with weight above their normal range are picked up by health visitors, GPs and also School Health through the National Child Measurement Programme. In this clinic we see children who are referred by GPs and other health care professionals as needing assessment and guidance on weight loss.

In this clinic you will be seen by a Consultant Paediatrician with interest in Endocrinology and Growth. You will also be seen by a Paediatric Dietitian and Healthy Weight nurses who can give advice on healthy eating and lifestyle changes appropriate for your child’s age. A psychologist also works as part of the team to help the child and parents to achieve their goals.

If your child is diagnosed with a medical condition causing weight gain or has developed a complication due to the weight, the doctor will explain the diagnosis in simple terms and answer all your questions. Often we might need to do further investigations like a blood test and this will be explained and organised at the James Paget University Hospital.

The dietitian will discuss your child’s diet with you and guide you in making necessary changes so that it is healthy and helps your child to achieve a healthy weight. The healthy weight nurses will arrange to see you regularly should you require extra support.

What services are provided?

Medical assessment for overweight and obese children
Dietetic advice
Advice on lifestyle changes
Referrals for Psychology input if required
Referrals to Norfolk CAN and Feel Good Suffolk to provide single and group work and exercises

How can I get a referral?

Children with BMI above the 99.6th centile for age (98th centile if there is a medical condition) above two years and less than 18 years of age can be referred by their GP or any other hospital doctor or nurse who sees them for any other medical needs.

Consultant clinics are usually on a Monday morning every week

Allergy Services

Cardiology

In our outpatient clinic, The Cove, we see children who are referred by GPs and other health care professionals if they have a suspected heart condition.

Children's Cardiology team

Key staff

Paediatric Diabetes clinical lead

Dr Gurung

Diabetes Nurse Specialists

Sister Sarah Shreeve, Sister Gillian Macgregor-Linnett and Sister Amanda Dench

Dietitians

Patrick Friel, Caroline Ellam, Jen Jarmey

Clinical psychologist

Dr Bridget Coleman (based at the Silverwood Centre, Great Yarmouth)

Consultant Paediatricians

Dr John Chapman, Dr Sudeep Damodaran, Dr Esi Bentsi-Enchill and Dr Priyadarshan Ambadkar

Consultant Paediatric Rheumatologist

Dr Kate Armon (based at Cambridge University Hospital)

Paediatric Physiotherapist

Becky Bingham (based at the Newberry Centre, Gorleston)

Gastroenterology Paediatric Nurse Practitioner:

Linda Ewart

Children's Community Nursing Team

Julia Loydall, Amanda Cox

Paediatric Nurse Practitioner

Clive Ellis

Useful links

Children's Chronic Arthritis Association

CCAA - Kids with Arthritis

British Society of Paediatric Gastroenterology, Hepatology and Nutrition

Working with children with digestive, nutritional and liver disorders

Great Ormond Street Hospital

NHS Foundation Trust

ERIC - The Children's Bowel & Bladder Charity

Dedicated to improving children’s bowel and bladder health