1. Paediatric Referrals Dr Gemma Moore

2. Why Paediatrics???

3. The Audit Thank you!!!! 408 Audit Trails

4. Results Referrer Age Referral Type

5. Top 5 Reasons for Referral Behavioural Concerns – ADHD, Autism, Dyslexia, Eating Disorders, Anxiety, General difficulties with behaviour. 14% (60) Abdominal Pain - 10% (37) Feeding Problems/Intolerance – CPA, Lactose, Colic, Reflux, Allergy 7% (25) Baby Problems – 7% (24) Headaches/Migraine – 7% (24)

6. Number of Times Reviewed in Primary Care

7. Comparisons of Clinical Review’s Performed Reviewed ONCE Behavioural – 20% Cardiac – 7% Baby Problems 7% Epilepsy/Seizures 7% Headaches 5% Reviewed 6+ times Abdominal Pain 17% Respiratory 14% Behavioural 12% Intolerance 7% Headaches 4%

8. Could more have been done in Primary Care? Yes 18% (71) 17 Resolved Problems 11 Headaches 5 Constipation 4 Intolerances 3 Abdominal Pains No 82% (329) 55 Behavioural 42 Resolved Problems 24 Intolerances 20 Abdominal Pains 18 Baby problems

9. Further Analysis Of the NO, nothing more could be done in primary care 44 were discharged at the first OP attendance. Behavioural Concerns – 32 were discharged at the first OP with no subsequent management or treatment advice. No serious diagnosis missed.

10. A Penny or a £ 1 for your thoughts.... Good Primary Care Locally Paediatrics – were worried, parental anxiety, fear of missing things... Behaviour Problems – ADHD, Autism, Eating Problems, Anxiety, Behavioural Issues – ?Service Provision gap in primary care Intolerances – CPA, Lactose, Colic, Reflux, Allergy Resolved – 15% (59) – QUIPP Saving already! Constipation Baby Problems Interim Between Phone advice and a clinic review?

11. Discussion Points What could be done in primary care now? What could be done with more specialist knowledge/ GPwSI? Which areas for pathway redesign? Which areas would you want more guidelines on