6174 Addressing social determinants of health in a busy children’s emergency department in Birmingham, UK: a preliminary evaluation of the early help offer

Objectives The rise in UK child poverty has significantly impacted on child health1 and the increase in children's attendances to Emergency Departments (EDs) is a clear indicator of the challenges faced.2Early Help (EH) was introduced in our ED in October 2021. Figure 1 shows the wide-ranging support to children and the wider family that EH provides.3 The first 250 referrals were analysed to understand the reasons for referral and outcomes achieved. Methods Data was collected from EH and hospital records and pseudonymised data was entered on an excel spreadsheet for analysis. Only patients who were referred by an ED clinician with adequate patient information provided in the early help data sheet were included. The study was deemed a service evaluation by the trust. Results 250 patients were referred to EH between 22/10/2021 and 24/05/2022. 16 patients were excluded from the analysis because of inadequate data. For the remaining 234 patients, gender split was nearly half with 49.6% female and 50.4% male. The most frequent age category was between 11 to 16 years old (29%) and the least frequent being under 1 year old (20%). Of the 13 patients who had five or more attendances in the previous year, 10 had less than 5 ED attendances the following year after an EH referral. Respiratory illness (27%) followed by mental health concerns (12.8%) were the most common reason for attendance. Over half of referrals (56%) were for patients in the lowest socio-economic decile (Index of Multiple Deprivation score 1). 168 (72%) patients were not known to social services. Figure 2 shows the main reasons for referral: family support (34%), housing (21%) and mental health (12%). Nearly half of referrals (46%) resulted in family connect forms which provide multiagency support. Conclusion Preliminary data shows the EH offer helps target families from deprived areas, addressing the social determinants of health. The high numbers of families provided 'family support' (intensive, multi-disciplinary support) demonstrates unmet needs in our population. Future evaluations should study the impact of early years interventions (in EDs as well as other departments across hospitals in the UK) in more detail, including child and family wellbeing. References Wickham S, Anwar E, Barr B, et al. Poverty and child health in the UK: using evidence for action. Arch Dis Child. 2016 Aug;101(8):759–66. doi: 10.1136/archdischild-2014-306746. Rudge GM, Mohammed MA, Fillingham SC, et al. The combined influence of distance and neighbourhood deprivation on emergency department attendance in a large english population: a retrospective database study. PLoS One. 2013 Jul 16;8(7):e67943. doi:10.1371/journal.pone.0067943. Birmingham Children and Families Vision- A Vision for all professionals working in our city. 2021. https://www.localofferbirmingham.co.uk/wp-content/uploads/2021/06/Birmingham-Children-Families-Vision-FINAL.pdf.