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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