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G161(P) Outcome of new referrals to the paediatrician with expertise in cardiology outpatient clinic
  1. KL Kok,
  2. R Winter,
  3. W Kelsall,
  4. Y Singh
  1. Paediatrics, Addenbrookes Hospital, Cambridge, UK

Abstract

Following the Safe and Sustainable review of Paediatric Services in 2012/2013, NHS England recommended that local paediatric cardiology services should be provided by specially trained paediatricians with expertise in cardiology (PEC).

Aims To understand the burden of activities in the PEC led outpatient clinics in a busy district children’s cardiology service and to evaluate the incidence of congenital heart conditions among new referrals.

Methods A retrospective observational study included all children (0–18 years) who attended the paediatric cardiology clinics led by the PECs at Cambridge University Hospitals between Nov 2014 and Oct 2015. The children seen in the outreach cardiology clinics were excluded.

Results Over 1500 patients were seen in the PEC led cardiology outpatient clinics and data analysed from 725 patient episodes. 42 cases were excluded because they did not attend. 62% (425 of 682 attendances) were new referrals to the outpatient clinic. Cases previously seen as inpatient in Cambridge were regarded as new episodes while cases previously seen in tertiary cardiology services or other hospitals were considered as follow up cases.

77(18%) of them were diagnosed with congenital heart disease. 11 of these patients had complex pathologies with 2 or more congenital cardiac lesions as described in Table 2. The spectrum of pathologies ‘new diagnoses’ is described in Table 1.

63 of these patients were managed conservatively by routine monitoring. Eight were managed medically with diuretics or anti-arrhythmics, five required open heart surgery, and one had transcatheter device closure.

Conclusion The local paediatric cardiology services play an important role in managing new referrals to the paediatric cardiology services and managing capacity in the specialist outreach clinics. About one fifth of the new referrals to PEC led unit had significant congenital heart diseases.

Abstract G161(P) Table 1

Spectrum of congenital heart conditions among new referral to PEC led outpatient clinic

Abstract G161(P) Table 2

Spectrum of congenital heart conditions associated with 2 or more pathologies

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