497 Fast-Tracking Varicose Vein Treatment: A Post COVID Pathway for Effective Care

Abstract

Abstract Aim Standard treatment pathways for varicose veins (VV) consist of a referral, first clinic appointment, vascular ultrasound (VUS) and a follow-up appointment to determine eligibility for intervention. Multiple appointments cause delays in treatment. Publication of the ‘NHS 10-year long-term plan’ and post-COVID waiting lists motivated this quality improvement project combining One-Stop Venous Clinics (OSVCs) and office-based truncal venous radiofrequency ablation/sclerotherapy (OBRFA/ST). The OSVCs aim to reduce waiting time from first appointment to treatment. Method All VV referrals (2021-2022) were prospectively assessed and seen in a combined VUS and vascular surgeon appointment: OSVC. Suitable patients underwent OBRFA/ST. Time from referral to surgery was compared to routine practice pre-pilot, and patient satisfaction questionnaires (PSQ), assessing the five Care-Quality commission standards, were conducted. Results Of 639 pilot patients, 175 (27.4%) underwent OBRFA/ST. 201 (31.5%) were discharged, 204 (31.9%) did not attend (DNA’d) appointment, 24 (3.8%) were unsuitable for OBRFA/ST, and 35 (5.5%) had other outcomes. Mean age was 52.1yrs; 53.8% female, 46.2% male. Mean time to intervention fell from 315 days to 61.6 days comparing routine practice to combined approach. PSQ’s demonstrated: 98% patients felt well-informed, 98% felt safe, 96% had adequate pain management, 97% felt it was a responsive service and the overall satisfaction was 91%. Conclusions This project demonstrated a substantial reduction in time to treatment with this combined approach and may positively influence a new pathway standard for VV patients.