G521(P)\u2005Nurse-led out of hours clinics for adhd

Abstract

For children and young people (CYP), attending medical appointments can lead to missing school affecting educational attainment; isolation from social activity and friendship groups. In neurodevelopmental conditions there is often increased anxiety about missing activities or change of routine and hospital settings can be distressing. Specialist nurses are in a better positon to offer clinics outside of 9–5 Mon to Fri in settings away from the hospital, and offer quality intervention at a comparative reduced cost. This flexibility improves service user experience which supports medication compliance, reduces DNA rates and promotes inclusivity of patient led care. NICE guidance and best practice supports nurse-led clinics as a means of improving service user outcomes. Aims Gain opinions of service users regarding clinic times and venues Evaluate evening and weekend clinics – DNA, user feedback, staff activity Methods Families attending specialist nurse clinics for ADHD review were asked if they would attend an evening or Saturday clinic if available Simple feedback forms were used to record service user feedback following appointments Results Of 52 families, 34 (65%) preferred out of hours and 18 (35%) expressed no preference Of a sample of 48 OPAs, 42 attended, 5 DNA and 1 cancelled Conclusion There was good attendance at both Saturday and evening clinics, with a reduced DNA rate, which was also affected by adverse weather conditions. Very good feedback was received, e.g. not having to miss school, supporting working parents. Families appreciated flexibility of venue and being seen away from the hospital setting. Clinics were held where CYP may also attend for support groups and childrens centres introducing families to other means of support at the same time. This enhances outcomes for our cohort of families. Out of hours clinics were built into nursing job plans and did not attract overtime or additional payment, thus were cost negative to the service. The Community Paediatric workforce is recognised to be at crisis point with capacity and lack of qualified doctors; this report demonstrates a viable alternative which not only meets but adds to current provision. The project has also led to a Trust-wide Standard Operating Procedure to support out of hours±offsite clinics for any speciality.