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G124(P) Running an adolescent clinic in a district general hospital
  1. R Scott-Jupp
  1. Children’s Unit, Salisbury NHS Foundation Trust, Salisbury, UK

Abstract

Aims Adolescents are poorly served by the NHS, often falling between paediatric and adult services. To address this need, an Adolescent Clinic was set up in a small District General Hospital (DGH) in 2011. It occurs fortnightly from 3 to 6 p.m. and is run by a consultant paediatrician. Young people aged from their 11th to their 18th birthday are seen, with a wide variety of problems. This study aimed to assess the effectiveness of the clinic.

Methods Ages, sources of referral, follow-up and diagnostic data were obtained from hospital information systems. Patient feedback was obtained from questionnaires completed by a random sample.

Results From 2011 to 2016 there were 815 attendances by 441 young people. 68% were female. Ages at first attendance were: 17 (6%), 16 (14%), 15 (22%), 14 (22%), 13 (16%), 12 (13%), 11 or below (7%). Referrals were predominantly through ‘choose and book’ (69%), directly from GP (23%), or other consultants (5%). 34% were discharged after first appointment. Follow-up to new ratio was 1.3:1. Non-attendance rate was 14%.

23 questionnaire responses were received, indicating high levels of satisfaction with: general atmosphere (‘good’ 48%, ‘excellent’ 30%); after-school appointment times (52%); ageappropriate communication (100%) and explanations (100%).

Primary diagnoses were varied. Among new referrals the most common complaints were musculoskeletal (13%), respiratory (7%) and gastrointestinal (7%); among follow-ups most were fatigue or chronic fatigue syndrome (26%), musculoskeletal (5%) and epilepsy (5%). Many had a psychological, behavioural or eating disorder problem as a secondary diagnosis. 15% were referred on to either a tertiary paediatric or secondary adult specialist service.

Conclusion A non-specialist adolescent clinic in a small DGH is feasible, effective and popular.

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