This is one of our most successful projects which is currently ongoing and is led by Dr.Mary Carroll (Head of Adult CF Care in Southampton University Hospitals and a Trustee of CHI). By working in close collaboration with doctors and other health workers in Sismanoglio General Hospital, Athens and the Adult CF centre in the North of Greece, Thessaloniki, Mary has overseen very real improvements in the provision of treatment of young adults with CF in Greece since the start of the project in 2015. One of the reasons for the success of the project is the continual contact between the staff at both sites. This has ensured a deep understanding of the challenges faced by the Athens service and made it possible for the Southampton team to provide appropriate advise informed by a sophisticated understanding of the challenges faced in Greece.
Background
Following a request for help from Child Health International by the Greek cystic fibrosis patients, Hellenic Cystic Fibrosis Association (HCFA) in Athens, Child Health International arranged a fact-finding visit to Athens in April 2014. The visit was organised by project manager Rod Halls and included Dr Mary Carroll and other specialists from Southampton University Hospitals.
They found the service in Athens under considerable strain at that time with an almost overwhelmed single CF Consultant. There was no dedicated CF specialist nurse, no outpatient services, no home IV service, very limited physiotherapy and no dieticians. Cystic fibrosis was likely to be under diagnosed as Greece had no neonatal screening. This meant the known number of cases was likely to represent less than half of all sufferers. Average life expectancy for known cases was 25 years.
Project commencement
The project was launched in November 2015 with a full multi-disciplinary team from Southampton University Hospital visiting Athens and this has led to frequent exchange visits between Greece and Southampton over the following four and a half years involving doctors, nurses, physiotherapists hospital manager and others, with Dr Mary Carroll visiting Athens 3 times a year.
The objective is to provide direct experience of how Southampton uses a multidisciplinary team to treat cystic fibrosis, to provide training and to suggest structural changes within their service. This is all done in a collaborative way that respects the Greek team’s point of view as to what is best for them.
Child Health International have developed a supportive relationship in which a rapport is established between the two country’s teams, and the team from Southampton also learn much in the process. Dr Mary Carroll states “the whole of my department have been fantastic in giving their time and expertise to assist the Greek project whenever asked to help”.
Child Health International has previously funded accommodation costs, but as the collaboration has grown and friendships have evolved, a doctor, nurse or other health worker visiting Southampton from Greece will often stay as a guest in one of the homes of a social worker or nurse from the UK team. This arrangement is reciprocal, with UK visitors often staying in the homes of their Greek hosts.
The project is providing assistance on all fronts in terms of know-how and best practice. The different health care professionals have a programme individually tailored to their particular requirements when visiting this country. The overall picture is always looked at, considering how the teams in Greece work and accounting for local challenges.
Community Nursing Service
There have been several trips by CF nurses in both directions, funded by Child Health International to establish a Community Nursing Service so that a home IV service can be set up in Athens. This is an important development that avoids the need for people to come into hospital when they can be effectively treated at home.
We have achieved so much but there is still so much we need to do to support our colleagues in Greece. There is a need to assist in setting up a smooth Transition service from the paediatric to the Adult service. Greece is establishing lung transplantation and Child Health International will work with UK CF specialists to provide support and experience in this area. Now is a very exciting time in cystic fibrosis research with the coming of the new effective CF drugs. We have already supported the Athens team in their selection and in doing of these drug trials. We feel we have developed a good working relationship with our Greek colleagues and hope to continue to contribute to the benefit of Greek CF patients.
Dr Manika spends 3-months in Southampton.
CHI facilitated a three month visit for Dr. Katerina Manika (Assistant Professor of Pneumonology) who was due to take over the running of the CF Centre in Thessaloniki after the retirement of the then senior director. She came to Southampton in preparation for her new role.
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