Endocrine Abstracts

Introduction: The COVID-19 pandemic accelerated the execution of the 2019 NHS Long Term Plan with rapid introduction and widescale uptake of virtual consulting. While these are associated with lower Was Not Brought (WNB) rates, we observed that patients in our Paediatric and Adolescent Gynaecology (PAG) clinics were frequently absent, with parents (usually mothers) attending alone, unlike Face-To-Face (F2F) consultations, where the patients are always present. To investigate this, we explored patient attendance in virtual PAG consultations.

Methods: Our retrospective observational study reviewed all clinic letters from a single consultant’s virtual PAG consultations at a UK specialist Children’s Hospital from 26/3/2020 to 1/3/2023. Demographic data, WNB rate, consultation medium (video or telephone), parent/carer attendance and patient attendance with reason for absence if applicable, were analysed using Pivot Tables.

Results: All 274 virtual consultations from the study period were analysed. Patients’ age ranged from 10 to 18 years (mean: 14.5±1.9yrs, median & mode: 15yrs). WNB rates were 16% for F2F consultations compared to 8% for virtual consultations (P=0.0036). Of the virtual consultations that took place 72.3% were conducted by telephone and 27.7% by video, with the proportion of video consultations increasing over time from 2% in 2020 to 57% in 2023. Overall, patients were absent in 30% of virtual consultations compared to 0% in F2F. Absence was higher in telephone (36%) compared to video (13%) consultations (P=0.0001). Whilst absence was more likely in younger patients, the phenomenon was observed at all ages studied (10–18 years). Reasons for patient absence included being at school (54%), having developmental or learning difficulties (15%) and being asleep (7%).

Discussion: Despite lower WNB rates in virtual consultations, patients were frequently absent. During adolescence, young people are transitioning to take ownership of their health. Arguably this is particularly important in a PAG clinic where hormonal contraceptives are being prescribed. Reduced attendance could affect the young person’s readiness to transition, potentially increasing anxiety. Without the patient, age-appropriate conversations cannot take place and healthcare professionals are prevented from exploring potential safeguarding issues. This study emphasises the importance of ensuring adolescent patient attendance while digitalising and optimising NHS services.