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Hospital Provision & Medical Outreach

RJAH

Alice Ward at Robert Jones & Agnes Hunt Orthopaedic Hospital (RJAH)

Who do we teach?

Alice Ward is the children’s orthopaedic surgery and rehabilitation 16 bed ward at the Robert Jones & Agnes Hunt Orthopaedic Hospital (RJAH). Children and young people, between the ages of 0-17 years, are routinely admitted for planned surgery, intensive physiotherapy and rehabilitation.

In-patient stays can be both short -term and long-term and the Trust serves people from both England and Wales with some patients travelling significant distances for their medical treatment.  Alice Ward provides specialist advice, diagnosis and treatment for the whole spectrum of bone, joint and muscular disorders during childhood, including treatment of:

Spinal deformity & spinal injury, Cerebral Palsy, Chronic Regional Pain Syndrome (CRPS)

Developmental Dysplasia of the hip, Leg Length Discrepancy, Rheumatology  Limb Deficiency & Prosthesis, Skeletal Dysplasia, Sports Injuries, Muscular dystrophy, Congenital Hip Dislocation, Foot Problems, Club Foot.

TMBSS educational provision is available on the ward during term-time with a dedicated TMBSS specialist teacher. Patients are generally registered with schools across both England and Wales attending mainstream and specialist provision or Elective Home Education (EHE).

Where do we teach?

Alice Ward has an open-plan classroom area suitable for both wheelchair and bed access where patients can be taught in small groups or on a 1:1 basis. There is also flexibility to teach at a patient’s bedside when this may be the most suitable option.

What do we teach?

Daily teaching sessions are provided alongside inpatient nursing, physiotherapy, hydrotherapy and any other medical procedures which are required during an inpatient stay. 

On admittance to the ward, an initial meeting with the patient and parent/carer enables relevant medical and educational information to be gathered. This also allows patients and carers to understand the TMBSS educational provision available on the ward. Positive relationships are very quickly formed with each patient and their families, to gain an understanding how patients’ medical conditions and treatments may impact their educational attainment.

Communication and liaison between the patients’ usual school setting and TMBSS staff, helps to rapidly establish an accurate starting point to build flexible, personalised learning programmes. Appropriate to each patient, these can encompass the whole curriculum and not only encourage academic development but also reflect patients changing medical and mental health needs. Information regarding academic achievements, safeguarding concerns and attendance can also be communicated between schools and the TMBSS ward teacher. Patients’ school curriculums and the programmes of study provided by their school are our main focus for the delivery of teaching and learning. However, if these are not suitable or available, a wide variety of resources are accessible to the TMBSS teacher, allowing for any gaps in learning to be recognised whilst providing suitable challenges and opportunities for progression.  

The TMBSS whole service curriculum is derived from the National Curriculum to engage patients and is often used in combination with usual school curriculums. TMBSS assessments can be used as required with support and advice from TMBSS curriculum specialists requested as needed. Our teaching provision focuses on overcoming barriers where specific medical, social and academic needs are met to access education in a positive, self-affirming manner.

How do we support our patients & promote wellbeing?

A TMBSS specialist teacher supports all school aged patients throughout their admission, including those with profound and multiple learning difficulties with a commitment to creating a nurturing, empowering learning environment. Positive relationships are quickly established with each patient and family focusing upon a holistic, collaborative multi-disciplinary team approach to their wellbeing. This should motivate and engage patients in their learning, nurturing self-esteem and confidence.

Patients often present with high levels of anxiety and so the use of strategies & ‘toolkits’  help engage patients in such a way that these levels are reduced  This leads to a more confident, positive approach to their learning, supporting their challenges toward recovery and transition back to their usual home schools.

For those patients needing to take exams whilst in hospital, provision can be made for a personalised approach to exam preparation. In the past, we have liaised with schools and facilitated for patients to sit both GCSE exams and Yr. 6 SATs whilst in hospital if appropriate.

The nature of our teaching provision endeavours to maintain a sense of normality for patient’s whilst in hospital, celebrating their achievements and successes, and encouraging resilience and independence. 

For those patients transitioning back into school after an extended absence, the teacher at RJAH liaises closely with medical staff and the usual school to ensure a smooth transition which considers the challenges each patient faces.

How do we communicate, review and report?

The intent, implementation and impact of teaching sessions with patients are recorded daily alongside an electronic register. A weekly returns sheet is also completed and summarises contact with patients which is then shared with the TMBSS senior leadership team.

Ongoing, effective communication is maintained as the ward teacher attends daily handover meetings at 9am with nursing staff and physiotherapists. The teacher will also attend a monthly paediatric forum on the ward.

The TMBSS teacher works closely with other agencies and professionals who are involved with each patient. Liaison with a patient’s usual school facilitates a bespoke curriculum which will offer appropriate levels of support and challenge.

A collaborative working partnership exists between TMBSS specialist teachers at RJAH and PRH hospitals with the sharing of good practice. Regular meetings are held between hospital teachers and TMBSS and include:

  • Half-termly meetings between hospital teachers, TMBSS Line Manager & TMBSS Head of Service. 
  • Half-termly meetings between RJAH teacher and PRH teacher. 
  • Fortnightly Huddle meetings via Teams between RJAH teacher and PRH teacher.   
  • Attendance at TMBSS Personal Development, Welfare & Behaviour Working Party.

Safeguarding

The TMBSS teacher on the ward is a trained Designated Safeguarding Lead and receives regular training updates.

Any safeguarding concerns are reported to the Designated Safeguarding Lead on Alice Ward where the safeguarding referral process is followed. After the initial event or disclosure, TMBSS staff will follow up to ensure the procedures and ongoing support are effective.

Liaison with TMBSS and safeguarding procedures are followed as appropriate.

A central electronic register (Child Protection Information Sharing, CPIS) is used on the ward which alerts staff to key information such as whether a child is subject to a child protection plan or is a looked after child.

This information is recorded in the safeguarding section of the Patient Pathway on admission to the ward and shared during handover meetings. Whilst working at either hospital site, staff and pupils follow the e-safety and Wi-fi policies of those institutions.