5999 Learning experience from Solihull ADHD service of minimising risk to patients in challenging circumstances

Objectives Our ADHD service is provided by both Community Paediatric medical team and nursing team and we had two challenges to deal with in 2023. First was of long waiting time up to 11 months post pandemic and compounded by sickness of ADHD nurse. Hence we were unable to meet the NICE guidance recommendation of follow up of ADHD patients on medication in 6 months. Second was challenge of national shortage of ADHD medication in 2023. This generated a lot of additional work for our team to make changes to medication making it even more challenging for our small team. Our objective is to share our positive learning experience of our team since January 2023 till end of September 2023. Methods Our number of referrals were increasing post pandemic and with limitations of resources it was challenging to meet the needs of the patients. In addition long term sickness of our ADHD nurse made it challenging for our clinical support worker to deliver their service. We highlighted the risk on Trust Risk Register and drafted a plan for mitigating factors in place with our Matron. It was an innovative approach of using mixed skills to monitor growth parameters and developing a questionnaire (about side effects, control of symptoms and school performance) for clinical support worker who saw 120 patient since Jan 2023. This information was shared with the treating clinician who could make changes to treatment as appropriate hence minimising the risk. This was in addition to responding to any phone calls to our service. In addition effective communication with 2,500 families via parent carers voice forum and primary care ensured patient safety and reduced complaints. Results We reviewed complaints to our department from January 2023 to September 2023. There was one formal complaints about Information Governance. We had total of 28 informal complaints via PALS. Majority of them 17 were due to delay in appointment, 2 were due to cancellation, 3 were due to communication issues and remaining were due to other factors eg delay in prescriptions received. None of them were escalated to a formal complaint. We also had incident reporting increase after training of our department on incident reporting process in July 2023. Only 2 medication errors were reported and in both patient didn`t come to any harm. Conclusion This was an innovative approach taken by our department which enabled us to minimise risk to patients and deal with staff sickness. It made good use of available skills and reduced medication errors and formal complaints as there was a an interim contact with Clinical support worker. Joint working and solution focussed approach can make a positive difference to patient care and outcome. References Attention deficit Hyperactivity disorder :diagnosis and management NICE guideline NG87 Published 14 March 2018. Michael O Ogundele, Hani F Ayyash, Cornelius Ani. The impact of Covid-19 pandemic on services for children and adolescents with ADHD: Results from survey of Paediatricians in UK, AIMS Public Health. 2022;9(3):542–551.