The Metro-Regional Intellectual Disability Network is a partnership model for improving health care for people with intellectual disability in regional and remote areas of New South Wales (NSW) run through the Kogarah Developmental Assessment Service. The MRID Network is one of three specialised projects commissioned by the New South Wales Ministry of Health to provide specialised services for people with intellectual disability. The MRID SchoolKit is one of a family of online toolkits – My MRID Toolkits – being produced as an initiative of the MRID Network. Look out for the MRID CodesignKit, coming soon.

The SchoolKit Clinic is an example of a model of school clinic. It is the clinic model described in the MRID SchoolKit. SchoolKit Clinics are school-based, involve a multidisciplinary team of professionals working in collaboration, and place a child and their family at the heart of the process. The SchoolKit Clinic model is neither definitive nor prescriptive, but has been shown to be an adaptable model that is sustainable and transferrable to both metropolitan and regional settings.

SchoolKit Clinics have developed out of thirty years of experience. This clinic model is based on the successful school clinics pioneered by Cairnsfoot School for Specific Purposes (Cairnsfoot SSP) in collaboration with the Kogarah Developmental Assessment Service, for students with disability. The model was later used as the basis for a MRID Network pilot in other schools for specific purposes in South East Sydney Local Health District and Illawarra Shoalhaven Local Health District. The model was further refined and improved through this process. Read more about how SchoolKit Clinics began.

A SchoolKit Transition Clinic focuses specifically on supporting a young person and their family through the shift from school to adulthood and the shift to post-school life and adult (rather than paediatric) health services. SchoolKit Transition Clinics are an extension of the SchoolKit Clinic model. All of the same foundation principles, aims and benefits apply, and in general terms the process of arranging, running and following-up after clinics is much the same. The primary purpose of the clinics is different to a SchoolKit Clinic however and requires a different approach. Clinics concentrate on the development of a transition plan and a ‘whole of life’ approach is used. Read more about SchoolKit Transition Clinics.

The health team brought together to participate in a SchoolKit Clinic may be assembled in a number of ways. An existing health service may offer access to a range of medical and health professionals and the various specialists involved in a clinic may be drawn from within this group. Or, an independent clinician – for example, a paediatrician – may have a number of specialists he or she works with regularly who might be brought together to participate. In a regional or remote area it may be most effective for a locally-based group of professionals and service providers to be assembled, with the necessary additional specialist expertise brought in from a larger metropolitan centre. In every case, the decisions on who should be involved and how the health team is assembled must be geared towards best addressing the needs of the child and their family. Some lateral thinking may be required and some creative solutions put in place, including making maximum use of contemporary communications technologies.

SchoolKit Clinics can be organised on an as-needs basis to address issues as they arise for a particular child and their family. Or, clinics may be organised in regular cycles so that everyone involved knows when to expect the next round of discussion and follow-up for a child and their family, and can plan accordingly. Clinics for a number of children and their families, from one school, may be organised so that they fall back-to-back on a single day. This may be particularly important where participants – such as health specialists, or a consulting teacher from a school for specific purposes – are travelling from some distance. Likewise, specialists travelling to participate in clinics at one school may arrange to hold a clinic or clinics at another school in the same area on the same day.

Where a number of children at one school may potentially benefit from advice on a particular subject – feeding or sleeping issues, for example – multiple clinics may be organised on a specific day and involve specialists on that subject – for example, a gastroenterologist and dietician addressing issues such as digestion, bowels and nutrition. In this situation the regular SchoolKit Clinic team or a general paediatrician may have referred the children and their families could be approached to see whether this clinic would be right for them.

Through the government system, the clinic can be billed in a similar way to a regular medical appointment. To do this the medical team needs to request the Medicare details of the child or adolescent.

SchoolKit Transition Clinics have been evaluated formally using surveys of participating parents, carers and school staff from 2010 and onwards. Feedback was very positive. Survey use is ongoing with the aim of improving service delivery. A new project evaluating the general SchoolKit Clinic model is currently underway. Read more about the positive feedback from transition clinic participants.