June 2019 – Dr Aikaterini (Katerina) Manika, Assistant Professor of Pneumonology from the Pulmonary Department Aristotle University of Thessaloniki attended a 3 month training programme on Adult Cystic Fibrosis from 4th March – 3rd June 2019 at Southampton, UK. This service looks after 300 adult patients. The CF paediatric service is in the same hospital and cares for 250 children.
During Prof Manika’s stay she was able to observe and take part in the management of adult CF patients, both as in patients and out patients. This involved daily morning meetings where the care plans for the patients were discussed. Following this she attended the ward rounds where a wide variety of patients were seen. On the wards, Prof Manika observed our protocols for caring for patients needing routine IV’s and those who were further on in their disease requiring high dependency observation and sadly in some, the circumstances around their death. The latter case involved our collaboration with the Palliative care team. Prof Manika spent time with the Palliative care department.
In outpatients Prof Manika was able to observe the Cystic Fibrosis annual review ‘process’ which involves assessment by the whole Multi-Disciplinary Team- lung function, physiotherapy, dietetics, nursing reviews, psychology, social, as well as the medical assessments. Following on from seeing the patients from an annual review we involved Prof Manika in reviewing the data collected, writing the annual review report and then feeding this information back to the patient at another appointment. In outpatients we also demonstrated routine out patient’s appointments and appointments in response to urgent requests to be seen.
During her time with us, several of our patients required referral to our lung transplant centre at Harefield. Prof Manika was able to observe our decision making processes as to whether to refer the patients for transplant, and if the patient was to be referred, the documentation and investigations required.
Our Research Facility for delivery commercial studies is located near to the CF department. Prof Manika was able to observe a research visit of a CF patient undergoing a trial with the new CFTR modulators. Prof Manika also attended the regular research meetings where ongoing and upcoming projects were discussed in relation to status and projection.
Prof Manika spent time with each member of the CF MDT- specialist nurses, physiotherapist dieticians, pharmacist, social workers, CF psychologist, specialist Microbiologist and palliative care team. We provided her with protocols in each of these areas and particularly pharmacy protocols IV antibiotics. In addition, Prof Manika attended adolescent transfer clinics run in the paediatric department, the purpose of which is to smoothly transfer adolescents over to the adult CF service. Prof Manika spent time with our service manager who discussed organization and delivery of CF services, which included management of a MDT, infrastructure and logistics around maintaining an efficient, well-resourced service.
During her time with us, Prof Manika was able to attend a conference in London on Gastrointestinal complications of CF, a conference on CF commercial research, a Quality Improvement meeting, and a consultants meeting in Dorset where the treatment of NTMB was discussed as well as CF renal complications and CF radiology.
Prof Manika was very interested in the department’s initiative in Quality Improvement. We are hopeful that this can be the basis of a UK-Greece research project. Another area was cross infection, again a research area we hope to take forward between the two departments. Prof Manika’s visit should not be in isolation and we plan to follow up by a nurse and dietician visiting Thessaloniki and welcoming any member of her CF team to visit Southampton.
October 2018 – Since we started work in Greece the department have appointed an administrator and delegated routine prescribing to family doctors so that the CF specialist can spend more time with patients. Danai Chandrinou, a physiotherapist funded by the patients’ association visited Southampton General Hospital for three weeks to study the latest practice. Among other things she said that her visit “helped me to understand the significance of keeping records and having a continuously updated overview of the patient’s history, which might affect positively patient’s performance”.
Dr Carol continues to hold a clinic in Athens every couple of months and the new staff have come to Southampton for training. Most recently a microbiologist came to Southampton in May to learn how to identify the various infections that affect CF patients and select the most appropriate antibiotics.
In February 2019 Mary and two nurses from Southampton University Hospital will visit Athens for approximately three days, to assist them in the developing a program of patient visits at home, specifically in the setting up of IV systems.
And also in February a CF consultant from Thessaloniki, the other major CF clinic in Greece, is coming to Southampton for three months in preparation for taking over the CF unit there after the forthcoming retirement of the current senior doctor.
February 2017 – Dr Mary Carroll gave an interesting talk on her work in Greece at the CHI committee meeting. Click here for her slides.
January 2017 – During 2016 two physiotherapists from the adult CF service in Athens spent a week with the adult service in Southampton and the new head of the Athens service spent 3 months here funded by a grant from the European Respiratory Society studying all aspects of the service. In the summer we funded two physios to attend training in Belgrade organised by CF Europe and in September a physio from Thesaloniki spent a week in Southampton.
Plans are now being developed for a further full multi-disciplinary team visit to Athens.
For more details click here.