SURVEY ON THE VARIABILITY IN PROVISION OF PAEDIATRIC RESPIRATORY MEDICINE (PRM) SERVICES IN DISTRICT GENERAL HOSPITALS ACROSS THE UK.

Abstract

Objectives In the UK there is national guidance for provision of Paediatric Respiratory Medicine (PRM) services in tertiary hospitals.1 However, no such guidance exists for district general hospitals (DGHs). We wanted to explore if there are any disparities in the provision of PRM services across DGHs in the UK. To evaluate the variabilities in provision of PRM services in DGHs in the UK. Methods An online survey was conducted amongst PRM in DGHs between April and December 2020. Information obtained: demographics, workforce, respiratory investigations, clinic and referral pathways. Results Level of completed training and composition of the multi-disciplinary team (MDT): 34 responses were received, of whom 16 (47%) completed the PRM special interest module, 8 (24%) completed PRM subspecialty training, and 10 (29%) had no specific PRM training. Over 25 (74%) respondents have respiratory nurse specialists and physiotherapists in their multi-disciplinary team (MDT). Less than 19 (56%) respondents have psychologists and allied health professionals in their MDT. There is a variation between DGHs for the types of respiratory conditions that are managed locally or shared care with a tertiary centre from less than a third to nearly 100% (table 1). Referral pathways for tertiary care exist for certain conditions. There is a similar variability in availability of various respiratory investigations in DGHs (table 2). Conclusions There is a variability in the level of completed training, composition of MDT, conditions managed, investigations available and established referral pathways to tertiary centres. The challenges in providing adequate respiratory care vary from the MDT to difficulty in accessing respiratory investigations. Further evaluation is required to establish the reasons for differences in DGH Paediatric respiratory service and identify the expected standard of care.