6063 Screening of unaccompanied asylum seeking children and young persons (UASCYP) in warwickshire

Objectives Initial health assessment and medical screening of unaccompanied asylum seeking children and young persons in Warwickshire is one of the duties of the community paediatricians. Results of investigations are then communicated to the child/young person/foster carer, social worker and GP. Following a CAE where the results were not communicated to the GP/YP/social worker and a positive TB case was missed, this audit was to find out if investigations are being performed within an appropriate timescale and results acknowledged, acted upon and shared with the young person/foster carer/social worker/Gp To determine the duration between initial assessment and the time blood tests are done To find out how many of the tests done return as abnormal To look at our performance as a team in meeting our KPI Methods The list of unaccompanied asylum seeking CYP obtained from the clinic input from January 2022 to January 2023 A proforma was designed Data were collected from the e-records and from clinic letters on SWFT e- record systems. Different variables of each result were coded and inserted into a spread sheet and analysed Results 67 CYP were referred for IHA within period in view 3 had no NHS number so difficult to trace, 4 had NHS numbers but no records of them on the electronic systems This left a total of 60, of which 36 had investigations and evidence seen on the electronic results system, while 24 had no test results on the systems The average time from IHA to investigations was about 1 month (33.2 days, figure 1). With the earliest being 3 days and the latest being 14 months from IHA. 15 CYP referred for blood tests had no evidence of being done, while 9 had test outside SWFT Of the 36 that had investigations done, 24 had their results acknowledged and acted upon – either communicated to GP, CYP/foster career/social worker, or further tests (figure 2) The results showed the most common finding was low vit D levels, seen in 60% of the CYP screened. 4 of them (11.1%) had results indicating either previous infection with immunity to hepatitis B or acquired immunity from vaccination, while 1 had abnormal hep B and had follow up investigations including LFT and abdominal USS 4 CYP (11.1%) had abnormal TB screening test and required further tests. All CXR came back as normal. 1 also had sputum AFB which was normal. 1 CYP had X-ray due to injury LFT, bone profile and folate had 3 abnormal results each There were 2 abnormal heamoglobin electrophoresis Conclusion We were not meeting up our KPI for screening UASCYP as regards timely investigations and communication of results to relevant persons/personnel. This was not without contributions from cumbersome administrative protocols and multiplicity of electronic systems as well as the divergent nature of the area covered by the community Paediatric team in Warwickshire. Although, there were no significant abnormalities in the results of the investigations, hence no significant near misses, measures were put in place to improve our performance.