Endocrine Abstracts (2019) 65 ROE1.2 | DOI: 10.1530/endoabs.65.ROE1.2

Getting it right first time for endocrinology

John AH Wass

Oxford University, Oxford, UK

There are 126 departments of adult endocrinology in England. We will be producing a national report towards the end of the year joint with the Society for Endocrinology. Endocrinology is not properly coded in hospital data systems. This is because of misattribution to general medicine or diabetes. Commonly accepted clinical standards are not being applied uniformly (e.g., steroid sick day provision). We have looked at surgical volumes. There are a large number of places where small volumes of adrenal surgery are being carried out. Doing phaeochromocytomas and adrenal cancer the recommended number is approximately 20 and if it is not the above adrenal pathologies 6 or more based on Fausto Palazzo’s work. There are 24 neurosurgical units operating on the pituitary. Figures vary. Most departments are operating on more than 30 pituitaries a year but some are dealing with much smaller numbers. There is wide variance in the number and skills of the endocrine specialist nurses. They are underutilised for clinical care, testing and education and can be a cost-effective addition to the team. Appointment of a specialist nurse would be advantageous in many services. Tier 3 obesity services (multidisciplinary obesity care but not bariatric surgery) should be present in all centres according to NHS England. Currently this is the situation in 55% of hospitals in the country. The results from GIRFT endocrinology will provide a baseline of current endocrine practice in England and robust recommendations will be made to address inequalities and inadequacies in service provision. GIRFT has already helped centres reflect on practice and develop business cases to address shortfalls in resource. Furthermore it will provide an impetus for sharing best practice to help provide a higher standard of care for all endocrine patients nationally.

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