Endocrine Abstracts

Aims: Within Imperial College Healthcare Trust, St Mary’s Hospital has a large one-stop shop thyroid service. On average, 700 encounters have been recorded per annum in the St Mary’s thyroid nurse-led service since its inception in June 2017. We aimed to critically evaluate the role of the specialist nurse within safe and robust monitoring clinical parameters, to determine the conditions managed in the nurse-led service and assess attendance rate.

Methods: Patients attend clinic for monitoring of blood pressure and thyroid function levels. A discussion of the presenting condition and a mutually agreed management plan takes place between the nurse and patient, with supervising consultant involvement as necessary. The data profile of those who were referred to the nurse led service over a one-year period were collated (2019 to 2020).

Results: Over the one-year period, 733 encounters were recorded for 269 patients. 61.7% (452) attended their appointments: 13.2% (97) did not attend (DNA rate in consultant thyroid service 10.5%), 15.6% (114) of patients cancelled their appointments and 9.5% (40) of appointments were cancelled by the trust. Of the 269 patients within the service, 62.8% (168) were diagnosed with autoimmune thyrotoxicosis (Graves’ disease): 23% were attending the service for other thyroid conditions including surveillance monitoring for toxic multi-nodular goitres, toxic autonomous nodules, subclinical hyper/hypothyroidism and post-radioiodine treatment. An additional 2.2% (6) had a diagnosis of thyroid cancer (incorrectly booked into the service): the remainder of encounters related to further specified endocrine conditions e.g. growth hormone monitoring (32.0%,n = 12).

Conclusion: This service offers an enhanced and improved patient experience where an effective point of contact delivers a safe and efficient mechanism for thyroid follow up. It does not only create appointment slots for the consultant led-clinics but also enables patient to be closely involved in their care and treatment journey.