Endocrine Abstracts

Introduction: National guidance recommends each paediatric diabetes patient is offered four multidisciplinary team (MDT) clinic appointments annually. At University Hospital Southampton (UHS), we identified a higher “was not brought” (WNB) rate compared to other centres in our regional network. In response, we initiated a quality improvement project to reduce WNB rates.

Aim: To evaluate the impact of a patient consultation, and subsequent service improvement, on paediatric diabetes clinic attendance at UHS.

Method: In November 2024, we conducted a telephone survey with 27 families (10% of our cohort). Families with the highest WNB and cancellation rates were prioritised for inclusion. The consultation identified our fixed booking system as a key barrier to attendance. In response, from January 2025 we introduced a flexible booking system, allowing patients to choose the date and time of their next appointment. We conducted a retrospective service evaluation collecting clinic data, over two seven-month periods: before (1st December 2023–30th June 2024) and after (1st December 2024–30th June 2025) the intervention.

Results: Data were collected for 1,908 clinic bookings, and their associated outcomes. A logistic regression model was used to analyse the data.

• WNB appointments decreased by 50.6% (from 83 to 41)

• Patients were 2.3 times more likely to miss their appointment pre-intervention (OR = 2.26, 95% CI: 1.52–3.34, P < 0.001)

• Patients were 7.7 times more likely to book their own appointment post-intervention (OR = 7.67, 95% CI: 4.60–12.79, P < 0.001)

• The number of patients seen increased by 11.4% (from 516 to 575)

• The number of offered appointments remained stable (from 599 to 616)

Conclusion: Engaging families through consultation and implementing a flexible booking system led to a significant reduction in missed appointments and an increase in patient-initiated bookings. The number of patients seen increased, without expanding clinic capacity, demonstrating better utilisation of existing resources. These findings support the value of patient autonomy as a driver of service efficiency in paediatric diabetes care. Ongoing monitoring is needed to assess the sustainability of this change.