Attendance and engagement of children in remote paediatric outpatient clinics

ABSTRACT

1529 Table 1Inclusion and exclusion criteriaInclusion criteria · Clinics taken place in the paediatric Rainforest outpatient department at Peterborough City Hospital · Children aged from 6 to 16 years Exclusion criteria · Children younger than 5 years · All face-to-face clinics. · Physiotherapy, dietician and psychological clinics · Oncology medicine clinics ResultsA total of 690 letters were reviewed that met the inclusion criteria. 182 (26.37%) were video consultations and 508 (73.76%) were telephone consultations [figure 1]. The male female ratio was almost equal to 1.091.Of the 690 consultations, in 278 (40.27%) children were present, in 37 (5.36%) the children were at school and in 375 (54.34%), the majority, it was not documented about the presence of the child or any discussion with them [figure 2].In those consultations in which children were present, 123 (44.24%) were video consultations and 155 (55.75%) were telephone consultations [figure 3].Of the 182 total video consultations, in123 (67.58%) consultations children were present. On the other hand, of the 508 telephone consultations, only 155 (30.5%) had children present during the consultation [figure 4].ConclusionsRemote consultations are not without drawbacks. A specific setting is required for a good remote consultation. This can lead to diagnostic difficulty or ambiguity and one should be more vigilant for safeguarding issues. In telephone consultations, there is a lack of inspection or visual assessment. In our study, we found that in more than half of the consultations, there was no clear documentation about the presence of the child or about the involvement of the child during paediatric remote clinics. This is an important missing element of the consultation that may further compound the issues described.The use of remote consultations will need careful planning, audit and standardized guidance from societies and royal colleges depending on the type of paediatric service, age of the patient, clinical subspecialty and new vs. follow up clinics to ensure a safe service.