6653 Embedding paediatric inequalities thinking and practice in a paediatric department – journey from a lone warrior to community of practice to improve outcomes

Objectives The purpose of this abstract is to detail the journey of a paediatrician/core20plus5 ambassador in embedding paediatric health inequalities (HI) thinking and practice in a hospital paediatric department. The aim is to share the learning and resources to improve success of similar endeavours. Methods An initial survey of staff (nurses, doctors, and others) through Microsoft Forms helped to ascertain views about HI. Picture 1 shows the analysis of thirty-seven responses. 21.6% respondents disagreed they had good understanding of HI and 94.6% agreed or strongly agreed they wanted to know more about HI and its relevance. Initial embedding methods included departmental teaching sessions, handovers, and group discussions. However, the interest of staff was difficult to sustain, and feedback suggested minimal impact of interventions. The core20Plus5 ambassadors programme gave useful access to learning resources and training such as action learning sets and peer/network learning. This led to change in approach with interventions including: Change one thing form (Picture 2) Patient stories to increase engagement. Building HI champions team Embedding HI in department meetings Results The survey results suggested vast majority of respondents considered HI work important and wanted to learn its practice. The initial approach of teaching and discussion were lonely and brought limited improvement in engagement and practice. The alternate approach detailed above led to significant improvements: The 'change one thing' form (adapted with permission from HI source) led to staff feeling empowered to identify, own and resolve an issue. e.g., Increasing clinic access with virtual appointment for families unable to afford travel; Using video tools to improve information for children with autism; engaging with community partners to influence wider determinants for frequent attenders. Using patient stories were a powerful way of improving engagement with staff. Staff identifying HI and working on solutions became HI champions and this led to community of practice with ripple effect. Including HI agenda in departmental meetings meant that systemic HI could be highlighted, and improvements could be sustained over long term. Conclusion Paediatric departmental staff strongly agree that the understanding and practice of HI is important in their role. However, it is important to acknowledge that HI work can seem lonely and overwhelming at times. This experience suggests an approach of building a team of HI champions and utilising simple resources such as 'change one thing' form can bring significant and sustained improvements in reducing HI.