6860 Paediatric bronchiectasis in the UK: current status, challenges and opportunities

Objectives Paediatric bronchiectasis (PB) is an orphan disease.¹ In 2021, the Paediatric Bronchiectasis Network UK (PBNetUK) was set up by clinicians interested in improving the care of PB in the UK. In 2023, a national audit of 1) current bronchiectasis service provision in UK tertiary paediatric respiratory centres and 2) a snapshot of children and young people (CYP) with PB seen across these centres was initiated. Methods All 24 centres participating in the PBNetUK network were contacted and asked to register the audit locally. An agreed template for data capture was developed. The audit has two parts: 1) service provision data and 2) patient data. Centres were asked to provide data on as many CYPs seen over a 6-months period as possible. Submission of data from district general hospitals (DGH) in the network was encouraged. Data variables included outpatient services provided, total numbers of patients with PB in the service and demographic data for a cross-section of the patients. Data was pseudo-anonymised and analysed centrally. Only CYPs with CT confirmed bronchiectasis were included. Results 17 of the 24 centres (71%) have responded to date serving a total of 744 patients. Data on 375 individual patients (50% of total), have been submitted for further analysis. Eleven centres (52%) have dedicated bronchiectasis (or chronic suppurative lung disease) clinics. There was variability between centres regarding frequency of patient reviews (by clinicians, physiotherapists and respiratory nurses). Only 4/17 (24%) have access to a psychologist or a dietitian. Less than half of the centres (7/17) have a structured transition service in place despite 13/17 centres having a dedicated adult service available. Specific PB SOPs are only in place in four centres, although most centres stated they follow ERS 2021 guidelines.² All centres agreed with eradication of Pseudomonas aeruginosa on first isolation although eradication strategies varied between centres. Conclusion This large national audit supports benchmarking and demonstrates the scale and importance of PB. Current challenges such as inequity of service provision are revealed. The importance of paediatric centres to develop dedicated PB services for better patient care and expansion of MDT teams to include dietetic/psychology support are highlighted as areas of opportunity. It is hoped that the audit will encourage paediatricians leading DGH to capture data on PB in the future and closely work with tertiary units for support. The results have been submitted on behalf of the members of the Paediatric Bronchiectasis Network UK. References Regan KH, Hill AT Emerging therapies in adult and paediatric bronchiectasis. Respirology 2018. Chang AB, Fortescue R, Grimwood K, et al. Task Force report: European Respiratory Society guidelines for the management of children and adolescents with bronchiectasis. Eur Respir J 2021.