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G601(P) Why do looked after children and young people present to accident and emergency? review of attendances with-in a local population
  1. NIp Wan Shek1,
  2. GF Appleby2,
  3. JU Okpala3,
  4. S John-Legere4
  1. 1Paediatric (Neonates), Croydon University Hospital, London, UK
  2. 2Paediatrics (Paediatric Nephrology), Evelina London Children’s Hospital Guy’s & St Thomas' NHS Foundation Trust, London, UK
  3. 3Community Paediatrics, Croydon University Hospital, London, UK
  4. 4Community Paediatrics, Guy’s & St Thomas' NHS Foundation Trust, London, UK

Abstract

Aims To review health seeking behaviour patterns of looked after children and young people (LACYP) who present to a local Accident and Emergency (A&E).

Method Data was retrospectively reviewed from 1st September 2014–31st March 2015. This included: age, LACYP type and reason, frequency and outcome of attendance. Non local LACYP and, or non-local A&E attendance were excluded. Data was anonymised and analysed.

Results Figure 1 – Initially 88 attendances were generated by 49 LACYP (chart 1). Our population of interest, Local LACYP and Unaccompanied Asylum Seeking Children (UASC), totalled 31 and had 47 presentations. The distribution shows 90% (28 of 31) are aged 12 to 18 years (graph 1).

Figure 2 – Of the 47 presentations 36 are for reasons shared between the local LACYP and UASC (graph 2). Musculoskeletal attendances (including soft tissue injury, limb pain and sprains) are commonest totalling 33% (12 of 36) of presentations. Assault and mental health issues (including self-harm, substance abuse and suicidal intent) each account for 16% (6 of 36) of presentations. The 11 remaining reasons for local LACYP vary; although 5 are for upper respiratory tract infections (URTI).

Figure 3 – Outcomes of the 47 presentations are: 81% (38) discharged, 13% (6) admitted, 4% (2) referred and 2% (1) did not wait.

Conclusions Common shared presentations between local LACYP and UASC are for mental health issues and assault, which re-iterates that LACYP are a vulnerable population.1 Interestingly musculoskeletal complaints are the commonest presentation and the majority of our local LACYP and UASC are over 12 years old; significance of these observations should be explored further. Reasons for attendance to the local A&E are considered appropriate; although some presentations like URTI could equally be reviewed in a General Practice (GP) setting. There is no evidence that UASC are using A&E instead of their GP. Limitations of the data include: small sample size, potential non-reported LACYP attendances to local A&E and lack of comparative data of general population attendance patterns. This data has implications for future planning, including closer integration of mental health within LACYP services. Future research could compare LACYP attendances to the non LACYP population.

Reference

  1. NICE (2010) PH28 Looked-after children and young people guideline

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