In June 2024, Dr Silvi Plado, Christina Lõokene (physiotherapy), and Elise Kukk (nurse) from Tallinn, and Dr Anneli Viidebaum, Kaari Kasper (nutritionist) and Katri Paavel (Nurse) from Tartu visited the Children’s
Hospital for Wales in Cardiff for three days.
The team flew to the UK on Sunday 2nd June, and were greeted by Tony Wolstenholme from Child Health International at Luton Airport and transferred to Cardiff by Taxi.
Day 1
On Monday, June 3rd, the Estonian team were welcomed by the Children’s Cystic Fibrosis team at The Children’s Hospital for Wales. Prof Julian Forton gave the team a tour of the hospital and delivered them to the weekly Annual Assessment CF clinic run by Dr Dan Rigler, CF nurses Kath Azzopardi and Zoe Jennings, Physiotherapist Hannah Morgan, Dieticians Caroline Powell and Cerys Davies, and Harriet Goodman, CF Pharmacist. Here the team could review the full detailed assessment performed each year for patients with Cystic Fibrosis, with integration of sputum induction, sweat testing, Lung function, abdominal ultrasound, chest X-ray, blood tests and modulator prescribing all integrated into a busy clinic.
The clinic was followed by lunch and a teaching afternoon. Talks were given by Dr Dan Rigler on the structure of CF annual assessment, Zoe Jennings on the role of the CF nurse, and Harriet Goodman and Dr Lena Thia on pitfalls and processes involved in prescribing modulator therapy in children with CF.
Day 2
The Estonian group paired up with their respective allied health professionals for the morning. Drs Silvi Plado and Anneli Viidebaum attended bronchoscopy with Dr Lena Thia. In the afternoon, a visit to the All Wales Adult Cystic Fibrosis Centre at Llandough Hospital was arranged for a tour of facilities and Transition clinic. The Estonians were welcomed with lunch by the All Wales Adult Cystic Fibrosis Team, including the centre manager, Lorraine Speight, Clinical Director Dr Ian Ketchell, consultants Dr Dawn Lau, Dr Jamie Duckers and Dr Charlotte Addy and some members of the wider multidisciplinary team. Lunch was provided followed by a tour of the centre’s facilities. After the tour, The Estonian group attended the CF transition clinic, run by both paediatric and adult CF MDTs and were able to observe integrated working for effective transition between the services.
Day 3
The Estonia team revisited the Children’s Hospital for Wales on Thursday morning to join Prof Forton and
the CF MDT in clinic for younger local patients with CF, and where all newly diagnosed CF patients are
regularly reviewed. Here they met up with additional members of the MDT including Steve Stirk, the CF
Psychologist.
After lunch in the hospital canteen, The Estonian team attended the weekly sit-down MDT for Cystic
Fibrosis where parent phone call queries, new microbiology results and problems from other centres in the region are discussed as a team. They were also given a short talk on the role of the CF Psychologist. They also attended the general paediatric and paediatric sleep MDTs that afternoon.
Overall it was a packed 3 days with many CF patients reviewed and MDT roles explored, with opportunities for many insights into the workings and structural systems in place within a large paediatric and adult CF service.
The Cardiff and Estonia CF teams really enjoyed each other’s company and learnt a lot from each other.
Much fun was had at the farewell dinner. The Estonian team returned to Tallinn on Friday 7th June.
Outcomes
- The 2 teams committed to closer communication links to generate a forum for patient problem-solving. The Cardiff team are very happy to receive queries from all members of the Estonian MDTs in Tallinn and Tartu and problems can be brought to the weekly sit-down meeting in Cardiff each week for discussion.
- Cardiff shared documents relating to their structured CF annual assessment and transition programme to adult services (Ready Steady Go).
- Cardiff and Estonia have successfully obtained funding from the ECFS Twinning Programme. In year 1 the mentor team (Cardiff) is expected to visit the mentee nation to foster links. Prof Julian Forton and Dr Janie Duckers will next visit Estonia to foster stronger links with both the paediatric and adult services in Estonia.