Paediatric Referrals Dr Gemma Moore Why Paediatrics The

The Audit Thank you!!!! 408 Audit Trails

Results Referrer Age Referral Type Other 2% 400 350 Locum 7% 300 250 Salaried

Top 5 Reasons for Referral • • • Behavioural Concerns – ADHD, Autism, Dyslexia,

Number of Times Reviewed in Primary Care 0 0% 6+ 10% 5 5% 4

Comparisons of Clinical Review’s Performed Reviewed ONCE Reviewed 6+ times • • • Abdominal

Could more have been done in Primary Care? Yes 18% (71) No 82% (329)

Further Analysis • • • Of the NO, nothing more could be done in

A Penny or a £ 1 for your thoughts. . • • Good Primary

Discussion Points • What could be done in primary care now? • What could

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Paediatric Referrals Dr Gemma Moore

Why Paediatrics? ? ?

The Audit Thank you!!!! 408 Audit Trails

Results Referrer Age Referral Type Other 2% 400 350 Locum 7% 300 250 Salaried 20% 200 Partner 63% 150 100 50 Registrar 7% 0 <1 yrs 13% Routine 10+yrs 32% 1 -5 yrs 29% 6 -10 yrs 26% Urgent No info Other

Top 5 Reasons for Referral • • • Behavioural Concerns – ADHD, Autism, Dyslexia, Eating Disorders, Anxiety, General difficulties with behaviour. 14% (60) Abdominal Pain - 10% (37) Feeding Problems/Intolerance – CPA, Lactose, Colic, Reflux, Allergy 7% (25) Baby Problems – 7% (24) Headaches/Migraine – 7% (24)

Number of Times Reviewed in Primary Care 0 0% 6+ 10% 5 5% 4 11% 1 42% 3 16% 2 16%

Comparisons of Clinical Review’s Performed Reviewed ONCE Reviewed 6+ times • • • Abdominal Pain 17% • Respiratory 14% • Behavioural 12% • Intolerance 7% • Headaches 4% Behavioural – 20% Cardiac – 7% Baby Problems 7% Epilepsy/Seizures 7% Headaches 5%

Could more have been done in Primary Care? Yes 18% (71) No 82% (329) 17 Resolved Problems 11 Headaches 5 Constipation 4 Intolerances 3 Abdominal Pains 55 Behavioural 42 Resolved Problems 24 Intolerances 20 Abdominal Pains 18 Baby problems

Further Analysis • • • Of the NO, nothing more could be done in primary care 44 were discharged at the first OP attendance. Behavioural Concerns – 32 were discharged at the first OP with no subsequent management or treatment advice. No serious diagnosis missed.

A Penny or a £ 1 for your thoughts. . • • Good Primary Care Locally Paediatrics – were worried, parental anxiety, fear of missing things. . . Behaviour Problems – ADHD, Autism, Eating Problems, Anxiety, Behavioural Issues – ? Service Provision gap in primary care Intolerances – CPA, Lactose, Colic, Reflux, Allergy Resolved – 15% (59) – QUIPP Saving already! Constipation Baby Problems Interim Between Phone advice and a clinic review?

Discussion Points • What could be done in primary care now? • What could be done with more specialist knowledge/ GPw. SI? • Which areas for pathway redesign? • Which areas would you want more guidelines on