Professor Peter Hill
MA MB BChir FRCP FRCPCH FRCPsych
35 Great James Street
London WC1N 3HB
Tel: 020 7486 2332
Child & Adolescent Psychiatrist
How I work...
I only see young people who are still at school though I will follow patients I know through university if necessary. I am happy to see pre-school children (the youngest I have been asked to see was three weeks old) but often they are better served by a clinical psychologist in the first place.
I need patients to be referred to me by another doctor, usually a general practitioner or a paediatrician before I see them. This is for various reasons:
- Health insurance companies normally require it
- I often need professional information about a child's health and development
- I may need to ask the other doctor to carry out further treatments, and they are not likely to do so if they did not request the referral
- In the U.K. healthcare system, the G.P. holds the overall view of a patient's health, and is the gatekeeper to specialist care. It is professionally proper to recognise this
- I need to see the referral letter to make sure I'm the right person to be involved. Sometimes I'm not.
I see patients by appointment at 35 Great James Street on Mondays and Wednesdays only. Essentially I run a series of clinics rather than offer a continuous service. I don't ordinarily take phone calls out of office hours or do home visits.
My first aim and main responsibility is to offer a senior, expert medical opinion as to what the diagnosis is and what should be done to treat it. In order to assess a clinical problem I have to ask a large number of questions in a fairly straightforward conversational way. Some of these can only be answered by a parent, others only by the child or teenager. It helps me to see both parents. I usually start by seeing child and parents together, because this enables me to get a list of problems from all concerned (there is often more than one problem, or at least more than one aspect of it). It also enables me to observe the child or young person without embarrassing them. I don't need to see brothers and sisters unless they are part of the problem in question.
Parents are understandably wary of talking about their child's problem in front of him or her. It doesn't usually matter if the child is under six, as they will not follow much adult conversation. I like to see parents separately from their child at some stage, and similarly I often like to see all children over the age of five years on their own. This can usually be done within a single appointment.
A school report may well be particularly illuminating, but I will not contact your child's school without your permission. I may need to carry out a physical examination on a child I see, but I can usually manage without having to take all their clothes off.
I don’t often order blood tests and never take blood in my rooms. I occasionally need to send a child for a brain scan. Sometimes a psychological assessment by a psychologist is necessary and this will need a separate appointment.
I will write a letter about my assessment either to you with a copy to your referring doctor or vice versa. If there needs to be a psychological treatment I will nearly always refer on to a clinical child psychologist, or psychotherapist, since they will be more skilled at these approaches than I am. If medicines are to be involved, then I will manage these myself, often jointly with your G.P., or paediatrician.
A first appointment lasts about an hour and a half. If I need to see you or your child again it will be for a shorter period. Sometimes I need to see parents rather than the child for a follow-up appointment. This is not because I think that parents are causing the problem - they usually are not - but because they are the people who have the power to change things. It is often the case that changing the way in which parents or teachers handle a child, helps resolve the problem.
It is unlikely that I can take unscheduled phone calls myself, as I spend my time seeing patients and families face-to-face, and can't be interrupted. You can make a telephone appointment of course through Alison. Otherwise emails or letters are easier to deal with (though please be sparing with emails as I give priority to face-to-face work).
Nearly all treatment is carried out on an out-patient basis. It is very unusual indeed for me to admit a young person to hospital, and I cannot do this without full parental agreement.
Indeed I can do little in any case without your support, and I look forward to working with you.