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Centres of excellence in each state/territory
Centres of excellence in Australia and in each state and territory will greatly improve quality care for our members. Paediatric Urologists in the United Kingdom agree that the best outcome for children born with Bladder/Cloacal Exstrophy and/or Epispadias, comes from centralised care. In the UK, services are provided at the central Manchester and Manchester Childrens University Hospitals and the Great Ormond Street Hospital in London.
· Surgeons learning from each other: We can start to develop expert care for our primary members for surgery and after care. Health professionals involved can share experiences and knowledge to improve care. Surgeons can share a positive attitude toward this challenge of sharing and learning with each other.
· Sharing of resources: Expensive resources are needed for medical tests, surgery, pre/post op care and ongoing health management. Training and equipment can be provided at centres of excellence rather than having these scarce resources unequitably scattered across multiple locations, as is the situation now.
· Assisting patients to access treatment in Australia: We hope patients in future will not feel the need to have to go overseas for operations and that Australia will have a number of expert urologists in both paediatric and adult urology.
The development of a “Whole of life” approach
· From birth to adulthood: These rare conditions require treatment and management throughout a person's entire life. For too long our primary members, who have the BEECHAC conditions, have been treated as babies, children and adolescents, by paediatricians, paediatric urologists and family members. But, once they turn 16 or 18, they must cut those long term ties to be treated by adult urologists, who often have not had experience with these rare conditions.
· Same surgeons and health professionals: Where appropriate we need doctors and other health professionals who have the skills and knowledge to treat our primary members from birth and throughout their lives to ensure increased expertise, continuity and improved quality care. |
A team approach and recognition of the complexity of the conditions
· Team of health professionals from the start: People with the BEECHAC conditions also have needs other than those related to successful surgery. It must be recognised that a team approach is needed in all cases. The patient must be treated by a team that includes urologist, nurse, psychiatrist and psychologist to ensure the person and their family have their psychological, sexual and social issues discussed and addressed from birth onwards.
· Recognition of anxiety, stress and depression: Our primary members and their families go through incredible endurances with many operations, often 30 or 40 from birth into adulthood and sometimes up to 90. To their credit, they develop amazing resilience; but it still must be acknowledged by all involved that the patients and their families suffer from anxiety, stress and depression at various levels and at various times throughout their lives. There should be no stigma attached to this, but rather it should be embraced; and health professionals should work closely as a team and be alert to any needs the patient or family may have.
· Taboos need to go: Because our patients have disabilities related to their bladders, ureters and genital organs, they are not discussed openly and in a positive way. Society does not want to talk about these things because it is too embarrassing; and so our people are marginalised in the health world. These issues need to be addressed, and the psychological, sexual and social issues that have been taboo need to be addressed by a team approach with attitudinal change combined increased psychological, psychosocial and psychosexual support .
Increased public awareness
· With health professionals: There needs to be more public recognition of what these disabilities mean for the people who have them and for their families and friends and health professionals.
· With schools, other educational institutions and workplaces: The worlds of study and work need to change how people are treated in schools, other educational institutions and in the work place Adequate physical and psychological support need to be available in the places where we spend so much of our lives. |