G313(P)\u2005A qualitative study using a patient questionnaire to establish whether parents of paediatric patients will use proposed out of hospital models of care (OOHMS) instead of the paediatric emergency department and if not why not?

Abstract

Aims and objectives Recently published evidence suggests a large proportion of children presenting to Paediatric Emergency Departments (EDs) could be managed in proposed out of hospital models of care (OOHMs) described by NHS England’s Five Year Forward View (FYFV). The main aim of this study was to assess whether or not families would choose the new OOHMs instead of the current ED and explore the reasons behind these attitudes. The study secondly aimed to identify motivators of attendance to Paediatric A and E. Methods This study was qualitative in design. Ethical approval was obtained and data collected over a one-week period using an electronic anonymous patient questionnaire (response rate 72%). Ninety responses were evenly distributed across the days of the week between the hours of 10am and 10pm; the likely opening hours of the proposed OOHMs. The questionnaire was composed of open and closed questions derived from the FYFV’s description of the OOHMs and previously published motivators of attendance to the ED in adults. Thematic analysis was used to identify themes in free text responses and mean Likert scale responses were calculated for closed questions. Results The proposed OOHMs were generally well received, except for assessment utilising digital technology. Mean Likert scale responses to descriptions of each aspect nearly all demonstrated agreement or tended towards strong agreement that study participants would like to use each of the proposed models if put in place locally. The most supported aspect was the introduction of a GP Paediatrician service (mean Likert response 4.34 out of 5). Motivators of attendance largely mirrored those seen in adults, though thematic analysis suggested patients would like to attend their GP rather than ED provided they could access appointments and had confidence in their practitioner’s access to Paediatric support and ability to assess their child. Conclusions In conclusion the study participants’ responses reflected a willingness to access the proposed OOHMs particularly the concept of specialist GP Paediatricians. This evidence can be used to support future planning of services to provide cost effective, optimal patient care. It is also imperative that the identified recurring motivators of attendance to ED are addressed.