6306 Identifying children and young people with persistent physical symptoms at a tertiary children’s hospital

Objectives Persistent physical symptoms (PPS) describe long-standing physical symptoms where underlying pathology is poorly understood and with functional impact on an individual's life. PPS are associated with significant distress and impairment for children and young people (CYP), leading to negative impacts into adult life.¹ UK specialist service provision is patchy and CYP are often managed across a variety of medical specialities. Identifying and characterising this population for service improvement and research can be challenging. This work aimed to identify the PPS population at a tertiary children's hospital with no specialist PPS provision as the first step in understanding their service needs. Methods Paediatric services across Great North Children's Hospital, Newcastle upon Tyne were contacted, asking clinicians to identify patients accessing services in the past 12 months who were: under 18 years old experiencing symptoms with no identifiable diagnosis/out of proportion to underlying illness or diagnosed with CFS/ME, post-COVID syndrome, chronic pain, hEDS, PoTS, FND or NEAD having functional impact from symptoms Clinicians forwarded patient details to the project team and anonymised database was created. Diagnostic coding identified all patients admitted within the study time period with above diagnoses and those admitted with 'fatigue and malaise'. These were screened and relevant CYP added to the database. Results 125 patients were identified. 107 came from clinical teams, a further 18 through clinical coding. Only 10 of the clinically identified CYP were present in the coding group. Age range 6–18 years, mean 14.7 years. Majority of patients (111/125, 89%) above the age of 12. More female patients were identified than male (F 78/125, 62%; M 47/125, 47%). 22% of patients (27/125) either had autism or were awaiting autism assessment, compared to reported general population prevalence of 0.3–2%.²Figure 1 shows indices of multiple depravation deciles for identified CYP. 38/125 CYP(30%) reside in the most deprived 20% postcodes. Conclusion This was a first attempt to characterise a poorly defined CYP cohort. Our results suggest this is a vulnerable group, with over representation of autistic CYP and high representation from deprived localities. We recognise flaws with the methods, including reliance on clinician reporting. However, these data suggest that alternative methods such as using clinical codes are not an accurate method of identifying CYP with PPS, as less than 10% of clinician-identified PPS cases were identified by coding. Further work is needed to better identify and understand this group to improve services and optimise functional outcomes. References Holsting AF, Rask MT, Frostholm L, Rosendal M, Rask CU, 2021. Self-help interventions for young people with persistent physical symptoms: a systematic review. Journal of Psychosomatic Research, 148, p.110553 Roman-Urrestarazu A, van Kessel R, Allison C, Matthews FE, Brayne C, Baron-Cohen S. 2021. Association of race/ethnicity and social disadvantage with autism prevalence in 7 million school children in England. JAMA pediatrics, 175(6), pp.e210054-e210054.