Adolescents and Young Persons (AYP) gastroenterology training and service survey

Question Title

* 1. What is your place of work or training rotation currently?

East of England

E Midlands (LNR)

E Midlands (Trent)

E Scotland

Mersey

Oxford

Peninsula

Severn

NW Thames

SW Thames

NE Thames

SE Thames

Kent, Surrey & Sussex

Northern Ireland

W Scotland

SE Scotland

N Scotland

NW England

Northern

Wales

West Midlands

Wessex

Yorks/ Humber N

Yorks/ Humber S

Yorks/ Humber W

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* 2. What is your gender?

Female

Male

Prefer not to answer

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* 3. Are you:

Paediatric gastroenterology trained

Adult gastroenterology trained

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* 4. What is your current grade?

ST3

ST4

ST5

ST6

ST7

ST8

SpR

LAT

LAS

ACF

<1 year post CCT

1-3 years post CCT

4-5 years post CCT

Question Title

* 5. Which subspeciality is/was the focus of your clinical training? (tick all that apply)

IBD

Nutrition

Hepatology

Advanced Endoscopy

Paediatric GRID gastroenterology

Paediatric GRID Hepatology

Other (please specify)

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* 6. How confident do you feel that your current/ previous training offers adequate experience in AYP gastroenterology, hepatology and nutrition?

Very confident

Confident

Neutral

Unconfident

Extremely unconfident

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* 7. Have you undertaken an identified period of training in AYP gastroenterology, hepatology and nutrition?

Yes (go to Q9)

Maybe

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* 8. Do you wish to undertake an identified period of training in AYP, gastroenterology, hepatology and nutrition?

Yes

Maybe

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* 9. Have you had access to AYP training within your current or previous posts? (select all that apply)

Transition clinics (for both adult & paediatric doctors)

Paediatric clinics for adult trainees/ consultants

Adult clinics for paediatric trainees/ consultants

Endoscopy- specific training

AYP specific courses/ Training

Adolescent Health e-learning

No training

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* 10. If you have attended specific AYP training, how many training events have you attended prior to CCT?

1-5

6-10

>10

>20

Question Title

* 11. Do any of the following barriers to training in AYP gastroenterology apply to you? (select all that apply)

There are no barriers to my training in AYP gastroenterology

I have no interest in AYP gastroenterology subspecialty training

Limited local training opportunities in my deanery

I would have to move regions to access AYP gastroenterology training

Lack of exposure to AYP gastroenterology during my training

Limited eportfolio competencies related to AYP gastroenterology

Other (please specify)

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* 12. If you are post CCT, are you involved in AYP training or delivery of care? (tick all that apply)

Transition clinics

Young Person Clinics

Endoscopy lists

AYP Research

Defined AYP lead (with job planned time)

AYP national role

Other (please specify)

Question Title

* 13. If you are involved/ have been involved in AYP care, what conditions do you include in your designated AYP service? (tick all that apply)

IBD

Coeliac disease

IBS and Functional GI disorders

Liver disease (including pre and post transplantation)

Nutrition disorders (requiring EN including neurodevelopmental patients)

Nutrition disorders (requiring PN)

Eosinophilic oesophagitis

Other (please specify)

Question Title

* 14. If involved/ have been involved in AYP care, wich allied professionals do you have in your transitional service clinics? (tick all that apply)

Dietician

Psychologist

Specialist nurse (Adults)

Specialist nurse (Paediatrics)

Surgeon

Other (please specify)

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* 15. If the above professionals are not involved directly in the clinic, which named professionals do you have access to as part of the overall AYP service? (tick all that apply)

Dietician

Psychologist

Specialist nurse (Adults)

Specialist nurse (Paediatrics)

Surgeon

Other (please specify)

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* 16. Do you have a dedicated transition MDT?

Yes

Don't know

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* 17. Do you know who the gastroenterology clinical lead for AYP is in your current trust?

Yes (if yes, please state)

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* 18. In your opinion, what age constitutes when adolescence?

Starts

Ends

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* 19. In your experience/ opinion what is the appropriate age for the majority of patients to initiate transition:

<13 yrs

13-14 yrs

15-16 yrs

17-18 yrs

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* 20. In your experience/ opinion what is the appropriate age for the majority of patients to transfer care?

16-17 yrs

18-19yrs

20-21 yrs

>21 yrs

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* 21. What age does your service accept new AYP patient referrals from primary care? (adult gastroenterologists only)

16 yrs

17 yrs

18 yrs

Other (please specify)

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* 22. What do you perceive are the main barriers to AYP delivery and development? (tick all that apply)

Funding issues (i.e. who pays for services)

No local paediatric referral centre

Lack of interest in AYP service development locally

Lack of expertise locally

Lack of resource (clinic space, endoscopy space)

Other (please specify)

Question Title

* 23. In your opinion, what is the importance of the following patient related factors for a successful transition of a GI patient from paediatric to adult GI clinic.

	Not important	Mildly important	Moderately important	Very important but not essential	Very important and essential
Patients understanding of disease	Patients understanding of disease Not important	Patients understanding of disease Mildly important	Patients understanding of disease Moderately important	Patients understanding of disease Very important but not essential	Patients understanding of disease Very important and essential
Patients understanding of treatment	Patients understanding of treatment Not important	Patients understanding of treatment Mildly important	Patients understanding of treatment Moderately important	Patients understanding of treatment Very important but not essential	Patients understanding of treatment Very important and essential
Patients understanding of the impact of smoking and alcohol on the disease	Patients understanding of the impact of smoking and alcohol on the disease Not important	Patients understanding of the impact of smoking and alcohol on the disease Mildly important	Patients understanding of the impact of smoking and alcohol on the disease Moderately important	Patients understanding of the impact of smoking and alcohol on the disease Very important but not essential	Patients understanding of the impact of smoking and alcohol on the disease Very important and essential
Patients understanding of the impact of diet on the disease	Patients understanding of the impact of diet on the disease Not important	Patients understanding of the impact of diet on the disease Mildly important	Patients understanding of the impact of diet on the disease Moderately important	Patients understanding of the impact of diet on the disease Very important but not essential	Patients understanding of the impact of diet on the disease Very important and essential
Ability to take medications without parental supervision	Ability to take medications without parental supervision Not important	Ability to take medications without parental supervision Mildly important	Ability to take medications without parental supervision Moderately important	Ability to take medications without parental supervision Very important but not essential	Ability to take medications without parental supervision Very important and essential
Ability to undergo endoscopy/ colonscopy without general anaesthetic	Ability to undergo endoscopy/ colonscopy without general anaesthetic Not important	Ability to undergo endoscopy/ colonscopy without general anaesthetic Mildly important	Ability to undergo endoscopy/ colonscopy without general anaesthetic Moderately important	Ability to undergo endoscopy/ colonscopy without general anaesthetic Very important but not essential	Ability to undergo endoscopy/ colonscopy without general anaesthetic Very important and essential
Disease in remission/ under control at the time of transfer	Disease in remission/ under control at the time of transfer Not important	Disease in remission/ under control at the time of transfer Mildly important	Disease in remission/ under control at the time of transfer Moderately important	Disease in remission/ under control at the time of transfer Very important but not essential	Disease in remission/ under control at the time of transfer Very important and essential
Proximity of adult GI clinic to patients residence	Proximity of adult GI clinic to patients residence Not important	Proximity of adult GI clinic to patients residence Mildly important	Proximity of adult GI clinic to patients residence Moderately important	Proximity of adult GI clinic to patients residence Very important but not essential	Proximity of adult GI clinic to patients residence Very important and essential
Membership of a disease-related charity	Membership of a disease-related charity Not important	Membership of a disease-related charity Mildly important	Membership of a disease-related charity Moderately important	Membership of a disease-related charity Very important but not essential	Membership of a disease-related charity Very important and essential

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* 24. From your experience what is the importance of following patient related factors identified as the potential barriers for successful transition to adult care?

	Important	Don't know	Minimally important	Moderately important	Very important
Limited understanding of his/her condition and medications	Limited understanding of his/her condition and medications Important	Limited understanding of his/her condition and medications Don't know	Limited understanding of his/her condition and medications Minimally important	Limited understanding of his/her condition and medications Moderately important	Limited understanding of his/her condition and medications Very important
Lack of self advocacy	Lack of self advocacy Important	Lack of self advocacy Don't know	Lack of self advocacy Minimally important	Lack of self advocacy Moderately important	Lack of self advocacy Very important
Parental reluctance to transition	Parental reluctance to transition Important	Parental reluctance to transition Don't know	Parental reluctance to transition Minimally important	Parental reluctance to transition Moderately important	Parental reluctance to transition Very important
Lack of trust in adult health care providers	Lack of trust in adult health care providers Important	Lack of trust in adult health care providers Don't know	Lack of trust in adult health care providers Minimally important	Lack of trust in adult health care providers Moderately important	Lack of trust in adult health care providers Very important
Patients/ parents high expectation	Patients/ parents high expectation Important	Patients/ parents high expectation Don't know	Patients/ parents high expectation Minimally important	Patients/ parents high expectation Moderately important	Patients/ parents high expectation Very important

Question Title

* 25. In your experience/ opinion what is the importance of following health care organisation related factors identified as the potential barriers for establishing a successful transition service?

	Not important	Mildly important	Moderately important	Very important but not essential	Very important and essential
Lack of funding	Lack of funding Not important	Lack of funding Mildly important	Lack of funding Moderately important	Lack of funding Very important but not essential	Lack of funding Very important and essential
Lack of interest among paediatric colleagues or adult colleagues	Lack of interest among paediatric colleagues or adult colleagues Not important	Lack of interest among paediatric colleagues or adult colleagues Mildly important	Lack of interest among paediatric colleagues or adult colleagues Moderately important	Lack of interest among paediatric colleagues or adult colleagues Very important but not essential	Lack of interest among paediatric colleagues or adult colleagues Very important and essential
Lack of space and time to organise joint clinics	Lack of space and time to organise joint clinics Not important	Lack of space and time to organise joint clinics Mildly important	Lack of space and time to organise joint clinics Moderately important	Lack of space and time to organise joint clinics Very important but not essential	Lack of space and time to organise joint clinics Very important and essential
Lack of supportive services (nurses, administrative etc)	Lack of supportive services (nurses, administrative etc) Not important	Lack of supportive services (nurses, administrative etc) Mildly important	Lack of supportive services (nurses, administrative etc) Moderately important	Lack of supportive services (nurses, administrative etc) Very important but not essential	Lack of supportive services (nurses, administrative etc) Very important and essential
Lack of defined policies/ protocols? E.g. on age of transition	Lack of defined policies/ protocols? E.g. on age of transition Not important	Lack of defined policies/ protocols? E.g. on age of transition Mildly important	Lack of defined policies/ protocols? E.g. on age of transition Moderately important	Lack of defined policies/ protocols? E.g. on age of transition Very important but not essential	Lack of defined policies/ protocols? E.g. on age of transition Very important and essential

Question Title

* 26. What conditions would you be most interested in learning about with regard to AYPs:

IBD

Coeliac disease

IBS and Functional GI disorders

Liver disease (including pre and post transplantation)

Nutrition disorders (requiring EN including neurodevelopmental patients)

Nutrition disorders (requiring PN)

Eosinophilic oesophagitis

Other (please specify)

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* 27. Have you attended any endoscopy lists dedicated to AYP, for example, general anaesthetic (GA) lists? (adult gastroenterologists only)

Yes

Not applicable

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* 28. Do you think training dedicated in endoscopy under general anaesthetic would be useful? (adult gastroenterologists only)

Yes

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* 29. We would be grateful for any other comments related to your views and/ or experiences of AYP gastroenterology training (state below)

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* 30. The BSG AYP section is trying to develop a UK wide network of clinicians involved in transition services. Would you be interested in being added to this network:

Yes

If you answered yes, we would be very grateful if you would express your interest via an email to ella.mozdiak@nhs.net and section members will be in contact when the network is developed.

Thank you for taking time to complete this survey.