6095 Patient initiated follow up – is it appropriate for our community paediatric population?

Objectives Given that NHS England set a key target of 5% of outpatient appointments being patient initiated follow up (PIFU)¹ by March 2023 we thought it would be useful to assess its use in a community paediatric setting. There were several concerns about how easily our patient cohort would be able to utilise PIFU: high rates of ADHD, ASD and communication difficulties in our patients and their carers; high rates of safeguarding concerns and our setting in a deprived, rural community. Our trust had an SOP for PIFU but it did not mention children, young people or safeguarding in its guidance and at the time there was limited specific guidance for safely utilising PIFU in a paediatric cohort. Safeguarding concerns should be carefully considered in regards to PIFU.² Methods We looked at the current list of patients in the department who had been placed on a PIFU. We then retrospectively reviewed their clinic letters to identify why there were on a PIFU, how many patients had made contact to get a PIFU appointment and to assess if there were any safeguarding concerns or barriers for the family to access PIFU. Results We identified a total of 79 patients who had diagnoses of ASD, ADHD, learning difficulties or developmental delay. They were given a mean PIFU duration of 23 months (range 6–60 months). The reasons for PIFU included following DNA/WNB (n=4), awaiting ASD/ADHD pathway (n=5), parental concerns about development (n=6) but in 56 letters it was not clear. 75 patients made no contact for follow up. 2 patients had telephone consultations and 2 patient had a face-to-face follow up. 8 of the children were known to social services, 2 of these were children in need, 2 were on a child protection plan and 1 child was under an SGO. Conclusion PIFU is a useful tool when used appropriately to reduce the burden on outpatient appointments. However, only a small number of patients made contact with the service and we need to consider whether PIFU is appropriate for all patients with clear guidance on who should be eligible. We recommend that use of PIFU needs to consider safeguarding concerns, communication difficulties and that information provided to parents needs to be clear about how and why to contact for PIFU. References 2022/23 priorities and operational planning guidance V3, NHS England, 22 Feb 2022. Available at https://www.england.nhs.uk/wp- content/uploads/2022/02/20211223-B1160-2022-23-priorities-and-operational-planning-guidance-v3.2.pdf. Implementing patient initiated follow-up Guidance for local health and care systems. Version 1,NHS England,17 May 2022. Available at https://www.england.nhs.uk/wp-content/uploads/2022/05/B0801-implementing-patient-initiated-follow-up-guidance-1.pdf.