G250(P) Are Vulnerable Children Less Likely to be Brought to Clinic Appointments? A Telephone Survey of Parents and Carers to Identify Barriers

Abstract

IntroductionA history of missed healthcare appointments is a consistent finding in most of the serious case reviews of all children who have been seriously harmed through child abuse, particularly neglect.1Minimising missed clinic appointments is not only in the best interest of the child but also for the trust, financially. The National Audit Office found that missed first outpatient appointments cost the NHS up to £225 million in 2012/ 2013.Aims1. To classify the profile of children not brought to developmental clinic appointments.2. To investigate barriers to attendance.3. Identifying options to minimise such barriers and ways to support the family.MethodsData was collated from Trust records, the departmental databases, patient files and a questionnaire based telephone survey of parents/carers of children with missed developmental clinic appointments in August/September 2016.ResultsThe trust-wide, missed appointment rate (outpatient appointments) for 2015–2016 was14.2% vs 17.9% in Developmental paediatrics. There were 62 missed appointments in developmental paediatrics (24%). Of these, 61% were follow up appointments; 60% being morning appointments. Seventy three percent of children were male, 65% between 5–11 years, 40% had previously missed appointments and 11% attended special needs schools. Seventy three percent of children had multiple comorbidities. 24% had complicated social situations including inadequate housing and safeguarding concerns (13%). In total, 40 (65%) participated in the telephone survey. The most common reasons for missing were forgetting (46.5%). 40 percent want a ‘choose and book’ option. Only 12 percent preferred weekend appointment. All requested a reminder, preferably by text message [87%] a day or two days before [70%].ConclusionA majority of children not brought to the clinic had multiple comorbidity with some having additional safeguarding concerns. The major barrier to attendance is parents either for- getting or not able to change the date. Targeted interventions in the form of multiple reminders by text messages, an option of ‘choose and book’ and a venue closer to their address will be useful in supporting those families.ReferenceBrandon, M et al., 2009. Understanding Serious Case Reviews and their Impact: A biennial analysis of serious case reviews 2005–07.