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G468(P) The majority of referrals from gp to general paediatric outpatient clinic could be managed by alternative methods
  1. J Sutherby,
  2. B Jiang,
  3. C Lemer
  1. General Paediatrics, Evelina London Children’s Hospital, London, UK



  1. Audit 100 referrals made to a hospital general paediatric outpatient clinic from General Practice to assess (i) Appropriateness (ii) Possible alternative methods of management

  2. Implement alternative and innovative methods of management using a multi-professional approach

  3. Improve quality of care for patients

Methods Using a proforma, each referral was assessed by 3 people: A Paediatrician (taken from a pool of 3 Consultants), A GP physician (taken from a pool of 2) and A Paediatric nurse specialist

Results 76–97% of patients seen in paediatric general outpatients could have been managed with at least one alternative method. The range reflects variation in assessor’s opinions (Figure 1 and Table 1).

Abstract G468(P) Figure 1

Alternative methods of management

Conclusions The majority of cases seen in general paediatric outpatients in this sample did not require secondary care. Importantly, this study suggests that, with the support and partnership of secondary care, General Practice has the potential to be able to provide a safe, more rapidly accessible and cost-effective paediatric service than that currently being offered at the level of a general paediatric outpatient clinic.

In terms of our progress: (i) Telephone hotline will be rolled out shortly (ii) Rapid access clinic opens in April 2015 (ii) Roll out of Community nurses (multi-professional approach) (iii) Development of email service and virtual clinic (iv) Increased support for GPs

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