The PURA Service and working within an MDT with Dr Jide Menakaya 

Dr Jide Menakaya, Consultant Paediatrician from Hillingdon Hospital 
Michelle Henderson, Clinical Education Manager from MacGregor Healthcare Ltd 

Weekly follow up and its success 
As part of Dr Menakaya’s PURA service, they commit to seeing children and their families every week for eight weeks, face to face in clinic. They have also established an online support group for parents who often felt isolated and alone supporting their child. As a healthcare professional, Dr Menakaya found this online forum incredibly humbling, as it gave him an insight into the emotions parents were going through as they worked with their children during difficult times. 

Of course, this is a huge commitment for Dr Menakaya, the multi-disciplinary team and the parents and children too. 

We were interested to hear about the benefits of both weekly appointments and the on-line support.  

Tips for starting a Multi-Disciplinary Team (MDT) 
Setting up a successful multi-disciplinary team (MDT) and having team members on board with ideas can be very challenging, however the results can be so rewarding – Hillingdon Hospital has seen positive results with children getting better within 8 weeks, even those who have had symptoms for many years.  Dr Menakaya discusses how it is crucial to look at the impact of constipation through the child’s eyes – and ask what we can do better in order to provide an effective service for them.  

Consistency across the team (using the PURA formula, traffic lighting the Bristol Stool Chart and more) 
Having a bank of useful resources which can be used by the entire MDT allows for consistency across the service. Dr Menakaya uses the PURA formula to assess symptoms and has adopted a traffic light approach with the Bristol Stool chart. This means that all members of the MDT, children and their parents /carers can easily record and review progress throughout the journey. 

He continues to talk about how these resources can be used successfully within the service. 

TAI and combination therapy of high and low volume 
Dr Menakaya has used a combination of both high and low volume transanal irrigation for some of his children. This approach has proven to be highly effective for maintaining adherence to treatment. This idea came from one of his children, who thought having access to both high and low volume products, would give them the freedom to use what suited their lifestyle on any particular day. 

We asked Dr Menakaya how he decided when to use high and /or low volume irrigation.  Was this decided at the start of the child’s irrigation journey or added in later down their treatment pathway? 

We would like to thank Dr Menakaya for speaking with us about his hugely successful PURA service. What he and his team has achieved is inspirational. 

If you would like to hear about the success of Dr Menakaya’s PURA service and how he ‘keeps it fun’ for children who experience bowel problems – click here to learn how an 8-year-old boy who uses Qufora IrriSedo MiniGo Flex, from Dr Menakaya’s clinic, ‘keeps it fun’.