Endocrine Abstracts

Introduction: Paediatric endocrinology typically has high follow-up rates in out-patients from the first appointment because of the nature of the conditions seen. When there are clinical capacity problems, large follow-up waiting lists can easily develop.

Methods: 124 outstanding endocrine follow-up appointments in a district general hospital endocrine service with sickness and capacity problems were triaged to review the need, urgency and method of follow-up. Using a pre-populated spread-sheet, an experienced paediatric endocrinologist reviewed the electronic notes, recorded the diagnosis, decisions made when last seen, relevant investigations and decided whether to discharge with or without a letter or offer a face-to-face or telephone appointment. The reasons for discharge were recorded. Most of the diagnoses related to growth, puberty, weight or thyroid issues. The time and cost / patient were calculated.

Results: Triage of the 124 patients took about 4.5 minutes / patient, equivalent to about 10 hours of clinical time. Because of the delay, 54.8% were over 16 years old at the time of triage. The cost of triage was £10.73 / patient and a total cost of £1330. 98 [79%] could be discharged with no further action required. 9 [7.3%] were offered face-to-face appointments. 19 [15.3%] were offered telephone follow-up which were accepted by 10. I urgent appointment was required.

Outcome: Our experience is that an apparently large waiting list problem can be managed in an efficient and cost effective way by clinical triage. This outcome data may not apply to other specialties or outside paediatrics. This is a good use of resources when there are clinical capacity problems and should become a routine tool in waiting list management. Waiting list are dynamic, not static tools and require active management.