6346 There’s nothing ‘routine’ about a blood test; improving phlebotomy services for children and young people with learning disability and autism

Objectives Children and Young People with Learning Disabilities and Autism often require blood tests to guide their diagnostic and clinical management. For many, blood tests can be an uncomfortable and traumatising procedure making further visits to healthcare potentially difficult with life-long impact on health-seeking behaviours. We aimed to identify and address the challenges faced by children, young people and their families accessing our tailored phlebotomy service with the aim to shape future services. Methods A pilot specialist phlebotomy service was trialled – this included: 30 minute appointments in a calm environment, staffed by a paediatric registrar, Trainee Advanced Nurse Practitioner and Clinical Support Worker. Children and Young People with learning disability and/or autism requiring blood tests were identified and referred by clinicians. Preparatory resources were developed in-house and provided. Feedback was gathered. Results The pilot ran for 8 months. 157 appointments were offered over 13 phlebotomy clinics. Attendance rate was 73%. On 90% of visits a blood sample was obtained. Some children required more than one appointment. Minimal restraint was used for children under 5 years of age but no restraint or sedation was used for those > 5 years. Qualitative feedback from parents was positive; the extra time and ability of staff to understand their child/young person's needs was much appreciated. 75% of parents reported moderate to severe learning disabilities in their child/young person. The clinic provided invaluable learning for the Paediatric team involved and provided opportunity to upskill and shape ongoing services. Conclusion Children and young people with learning disabilities and autism often face barriers to healthcare1 and require services which are sensitive to their needs, facilitate positive experiences and work towards them being able to consent (where appropriate). Staff education, reasonable adjustments and patient feedback are important in the development of accessible appropriate services for children and young people with learning disabilities and autism and to reduce health inequalities. Our pilot clinic reflects the experiences of similar initiatives nationwide2; more research and resources are required to keep our most vulnerable children and young people healthy throughout child and adulthood. References Core20PLUS5 – An approach to reducing health inequalities for children and young people, NHS England, November 2022. Blood tests for people with learning disabilities: reasonable adjustment case studies, Public Health England, September 2017.