6069 Improving the care of children with cerebral palsy

Objectives The aim of this project was to improve the care of children with cerebral palsy in our area in line with current NICE guidelines.¹ Local guidelines were created based on these NICE guidelines including the development of a new Cerebral Palsy Checklist. A baseline audit was completed in 2021, which identified 60 children with cerebral palsy in our area. The last clinic letter for these patients contained their diagnosis in 98% but only specified their GMFCS level in 8.3%. No children over 14 years old were recorded as being listed on the Learning Disabilities Register. Only 5% of patients had the date of their last hip x-ray documented in their last clinic letter and none of the children were reviewed for risk factors of low bone mineral density. Overall, the documentation of co-morbidities commonly seen in patients with cerebral palsy was low. Methods A new Joint Clinic has been established this year for all children with cerebral palsy attending two local specialist schools. This clinic involves an annual review of each child by a specialty doctor in community paediatrics and the physiotherapist based at the school, facilitating a multidisciplinary discussion between the family and relevant professionals. After each clinic appointment, the completed Cerebral Palsy Checklist is put in the clinic letter and patient's electronic notes to provide a summary of the child's health needs related to cerebral palsy. Results All 25 children with cerebral palsy attending the two local specialist schools are due to be reviewed by the end of 2023. The Cerebral Palsy Checklist has been completed for all patients seen in the new Joint Clinic meaning that all relevant areas of the current NICE guidelines are clearly documented in their last clinic letter. By October 2023, six Joint Clinics have taken place involving 19 patients, due to initial high non-attendance rates in this new clinic. One family opted out and one patient has been discharged due to repeated non-attendance at clinic. One more Joint Clinic for the remaining 4 patients is scheduled in November 2023. Conclusion Our new Joint Clinic has improved the care of children with cerebral palsy in the two local specialist schools. The use of the Cerebral Palsy Checklist is currently being rolled out for all children with cerebral palsy in our area. We plan to re-audit the whole local cohort of children with cerebral palsy at the end of 2023. Reference Cerebral Palsy in Under 25s: Assessment and Management, National Institute for Health and Care Excellence (NICE), 2017.