G147 THE DELIVERY OF OUT OF HOURS CARE TO DIABETIC PATIENTS IN THE ANGLIA REGION, WHAT GOES ON IN PRACTICE AND HOW DOES THIS MEET THE EXPECTATIONS OF THE PAEDIATRIC DIABETES SPECIALIST NURSES (PDSNs)?

A. Hewitson, J. A. Sharp, J. J. Plumb, J. J. Buck. Department of Paediatrics, West Suffolk Hospital NHS Trust, Hardwick Lane, Bury St Edmunds, Suffolk

Introduction: It is recommended that children with diabetes should have access to advice 24 hours a day.

Aim: To determine 1) the response to a typical out of hours query from a diabetic patient, training offered for “sick day rules”; and 2) how well this matched the expectations of the PDSNs in the Anglia region.

Methods: Each Anglia hospital was rung 1–2 times by one researcher between 5pm and 11pm. Advice was requested for a 12 your old diabetic patient with a sore throat, pre tea blood sugar 26, alert, moderate ketonuria, and no vomiting. The time for response and status of health professional was noted. The respondent was informed of the telephone survey and asked what advice he/she would give. The availability of training, written guidelines for these calls, and feedback to the diabetes team was ascertained. PDSNs for the hospitals were contacted between 9am and 4pm and questioned regarding their opinion of the out of hours service.

Results: 25 calls were made to 16 hospitals. Average time for a response via switchboard was 4 min (range 1–10). Calls were transferred to children’s ward (4), patient assessment unit (4), casualty (3), and direct to on call doctor (14). Calls were taken by nurses (10), junior doctors (14), and consultant (1). 7/25 (40%) respondents (all SHOs) suggested immediate admission of the patient, 11/25 (44%) suggested an extra dose of insulin, and of these 9 specified type and amount and 2 suggested a repeat blood sugar. Three respondents suggested a call to NHS direct or GP. 5/25 (20%) reported training on sick day rules, 10/25 (40%) reported written guidelines available for staff taking calls. 20/25 (80%) …