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Medical Paediatrics

Patients aged 0-15 years, i.e. up to their 16th birthday, with general medical paediatric presentations requiring secondary care, should be referred to medical paediatrics for acute and outpatient services at either the Royal Hospital for Children and Young People (RHCYP) Edinburgh or St. John’s Hospital (SJH) in Livingston.

Edinburgh, Mid and East Lothian: RHCYP site

Emergency care: The Paediatric ED at RHCYP is open 24/7, 365 days a year and provides emergency care for babies, children and young people age 0-15 years. To advise parents on directions on see Royal Hospital for Children & Young People – Royal Hospital for Children and Young People (nhslothian.scot)

Neither phone nor written referral is required. However, if you feel this would be beneficial, a letter can be given to accompany the patient.

If you need to handover a patient, they can be added to the expected list by calling the paediatric ED department staff base on 0131 312 0009/0012.

Urgent telephone advice for health professionals is available via bleep on Lothian Hospitals switchboard 0131 536 1000 (or GP Hotline):

  • Monday to Friday 9am – 5pm: bleep 9250 – duty Consultant paediatrician
  • Out-of-hours: bleep 9424 – duty senior medical paediatric trainee

Medical Paediatric Outpatient Clinics: Please refer via RHCYP SCI Gateway – see Referral guidelines tab below.

Urgent referrals that do not require same day review can be discussed by bleeping a duty senior paediatrician (as per urgent telephone advice for healthcare professionals above) OR referred as an urgent OPD referral via SCI Gateway

Non-urgent advice: Please request via SCI Gateway stating ‘advice only’ within “reason for referral” box on Sci-Gateway and a consultant paediatrician will get back to you within a few working days via email. For patients already known to a consultant, contact can be made via the secretarial team on 0131 312 0437 or via email at loth.medicalpaediatrics@nhs.scot

Phlebotomy: click here for the Outpatient Phlebotomy Service

Radiology: click here for Paediatric Radiology guidance.

West Lothian: (St. John’s site)

Emergency care: The ED at St John’s Hospital is open 24/7, 365 days a year and provides emergency care for babies, children and young people and adults.

Paediatric patients aged 0-15 years requiring emergency care should be directed to the Emergency department at St John’s Hospital. If felt beneficial to provide a handover whilst the patient is in transit, the resident paediatric tier 2 bleep holder can be contacted by by phoning SJH switchboard 01506 523000 and asking to Bleep 3564.

For ‘same day’ paediatric review on the Children’s ward or for paediatric telephone advice for healthcare professionals for babies, children and young people aged 0-15 years:  discuss with the resident Paediatric Tier 2 bleep holder by phoning SJH switchboard 01506 523000 and asking to Bleep 3564. A referral letter is not required but if felt to be beneficial this can be sent with the patient. Accepted referrals will be seen on the Children’s ward, level 2, St John’s Hospital. If the child’s condition suggests that immediate/ urgent attention will be needed, we will recommend that the child presents to ED for assessment rather than attending the ward directly.

Community midwives – can contact the resident Neonatal tier 2 bleep holder via St John’s Hospital switchboard 01506 523000 on bleep 3565.

General Paediatric clinics: Please refer via SJH SCI Gateway.  See referral guidelines tab below.

Please note that all Medical Paediatric referrals from West Lothian should be made to St John’s Paediatrics (apart from diagnosed Type 1 DM). The Consultants all have special interests and cover all the medical subspecialties working closely / jointly with their specialist colleagues at RCYP, often holding clinics jointly with the specialists at St John’s Hospital. These referrals will only be triaged to RHCYP if this is considered to be appropriate but usually only after initial assessment locally.

Urgent outpatient referrals that do not require same day review can, if needed, be discussed with a tier 2 Bleep holder (as above via hospital switchboard 01506 523000 and asking to bleep 3564) or referred as an urgent OPD referral via SCI Gateway. These referrals are triaged by the team within 24 hours in the working week.

Non-urgent advice can be obtained via SCI gateway, by marking referral ‘for advice only’ or for patients known to Consultants already for the same problem by emailing Consultant directly. If not available/ appropriate, please contact paediatric secretaries on 01506 524379 / 81 during weekday working hours.

Paediatric phlebotomy at St John’s Hospital:

Request from GPs for blood tests should be made by emailing loth.cwstjhpiu@nhs.scot  with details of child and priority of test (routine / urgent). Please also note:

Blood tests MUST be ordered by GP on ICE before an appointment will be sent to family.

It is the responsibility of the GP requesting blood tests to follow up results. Parents will be advised that follow-up of results is with GP and that parents should not call paediatric ward / secretaries for results.

D.R.M & C.H. 04-11-24

Who can refer:

GPs and ANPs

Who to refer:

Children that require secondary care input from medical paediatrics can be referred to RHCYP or SJH (West Lothian).  Individual condition RefHelp pages are in progress and links to these pages will be added to the top of this main page in due course.

Who not to refer:

  • Young people who are 16 years or older should be referred to adult services

 Edinburgh Mid & East Lothian – RHCYP Neonatal Registrar by phoning switchboard on 0131 536 1000

or

West Lothian St John’s – (01506 523000 bleep 3564) contact the resident Neonatal Tier 2 bleep holder via St John’s Hospital switchboard 01506 523000 on bleep 3565

How to refer:

Refer via Sci-Gateway (Royal Hospital for Children and Young People > General Medicine > LI Basic Sign Referral) 

Refer via Sci-Gateway (St Johns Hospital > Paediatrics > LI Basic Sign Referral) 

See tabs above for condition-specific primary care management advice.

Clinical guideline directory | RCPCH

General information on medical paediatric topics

For GPs

Guidelines for GPs covering several medical paediatric topics Paediatric Pathways :: Healthier Together

Clinical knowledge summaries – child health section – guidelines on various topics Child health | Specialities | CKS | NICE

Royal College of Paediatrics and Child Health (RCPCH) guideline directory: Clinical guideline directory | RCPCH

For parents

Information for parents on common health issues

Common Health Problems :: Healthier Together

Scottish health information you can trust | NHS inform

Health A to Z – NHS

Sleep

Useful resources for parents:

The sleep charity: Home – The Sleep Charity https://thesleepcharity.org.uk/ 

Sleep Action (previously Sleep Scotland): useful page on children’s sleep for parents Gateway to good sleep – Sleep Action

Parentclub Scotland: filters through age group, particularly useful for babies and toddlers Sleeping tips | Parent Club https://www.parentclub.scot/topics/sleeping/sleeping-tips?age=0

For teenagers: Home – Teen Sleep Hub https://teensleephub.org.uk/

PIL CAMHS Childrens sleep difficulties for younger children (useful for ages <8 yrs) add leaflet here

Nutrition

useful resources for parents e.g. fussy eaters and general advice on nutrition:

www.parentclub.scot explore by topic -> food & eating

https://raisingchildren.net.au/ nutrition section under every age group

www.firststepsnutrition.org/ general advice on weaning; vegetarian/vegan diets in children

Toddler and Infant Nutrition Advice – Infant & Toddler Forum (infantandtoddlerforum.org) general nutritional advice for young children

How to help your child gain weight – NHS (www.nhs.uk) children where weight is low, useful website pending paediatric review

Advice for parents of overweight children – NHS (www.nhs.uk) children overweight advice e.g. pending weight management referral

Developmental milestones

Useful website for GPs with summary of developmental milestones

Developmental Assessment (paediatrics.co.uk) https://mrcpch.paediatrics.co.uk/wp-content/uploads/2014/06/Development-Assessment-MRCPCH-Website.pdf

Speech

Website for parents with children speech issues / to help promote speech development: Let’s Talk | Speech & Language Therapy | NHS Lothian (scot.nhs.uk) https://www.lets-talk.scot.nhs.uk/

Behaviour

lifestyle history – sleep /screens / diet / sugar / caffeine intake etc.

If any developmental concerns, consider referral to community child health.

If concerns child has ADHD, CAMHS only accept a referral once the child has had at least one term in primary school. Please see CAMHS page: AD(H)D CAMHS – RefHelp

Useful resources for parents

Behaviour | Parent Club  www.parentclub.scot useful advice for parents on behaviour ranging from advice on toddlers to teens under behaviour tab.

https://raisingchildren.net.au/ accessible and practical advice for parents for children ranging all ages from new born to teenage.

www.joininedinburgh.org/parenting-programmes/ – parenting courses – from toddlers to teens

Support for families – The City of Edinburgh Council – free parenting courses for different age groups.

Autism spectrum disorder

If concerns child has ASD, please see CAMHS page: Autism Spectrum Disorder (CAMHS) – RefHelp

Useful document for GPs when assessing children for ASD – more info under community paediatrics

ASD leaflet GPs final (nhslothian.scot) https://apps.nhslothian.scot/files/sites/2/Paeds-ASD-assessment-Diagnosis-leaflet-GPs-Mar16.pdf

Headaches

Useful resource – Headsmart website – information for teens, parents, health professionals on headache: Better safe than tumour – Signs and Symptoms (headsmart.org.uk)

For families: www.headachereliefguide.com

For GPs

NICE guidance: Recommendations for children aged under 16 | Suspected neurological conditions: recognition and referral | Guidance | NICE

Always ask re sleep, caffeine and screen time as addressing these often improves headaches significantly. Worries / anxiety make headaches worse.

Helpful tips on this website: Home – The Migraine Trust

Endocrinology

Website for clinicians with useful endocrinology guidelines SPEG Clinical Guidelines – Scottish Paediatric Endocrine Group (nhs.scot)  of particular use for GPs guidelines on:

Investigation of early (precocious) and late (delayed) Puberty in boys and girls see quick reference guide on page 2 NSD610-016.19-SPEG-Precocious-Delayed-Puberty.pdf (nhs.scot)

Adrenarche (management of children presenting with early signs of pubic hair/body odour/acne) see page 4 with flow chart 3.-2022-SPEG-Adrenarche-Guideline.pdf (nhs.scot)

Short stature NSD610-016.15-SPEG-Short-Stature-Guideline.pdf (nhs.scot)

Useful resource for GPs

Podcast Podcasts | Fontanelle (fontanellepod.com) Puberty what’s normal what’s not

Fontanelle has some good podcasts other topics worth listening if of interest: food allergies in children; abdominal pain in children.