G341 Does the NHS offer equitable access to specialist paediatric clinics? A study of inequalities in outpatient referrals to eight paediatric subspecialties

Abstract

Background Previous research has established the relationship between socioeconomic deprivation and both emergency hospital use and General Practice use amongst Paediatric patients in the UK. To the best of our knowledge, no large-scale research has been conducted into this relationship in paediatric outpatient clinics. Aim To assess the distribution of socioeconomic status across different subspecialty outpatient clinics in a large paediatric service. Methods 32 369 consecutive, accepted, new referrals to selected paediatric clinics at a large London hospital from April 2007 to June 2018 were reviewed (Allergy, Asthma, Chronic Fatigue Syndrome/ME, Diabetes, Endocrine, Epilepsy, General Paediatrics and Rapid Access). Data collected included age, postcode, referral date, referral source, clinic code and appointment attendance. The mean Index of Multiple Deprivation rank for each postcode was obtained from The Department for Communities and Local Government. The proportion of patients in the most and least deprived quintiles were also calculated. 229 postcodes were unmatched. Results Table 1: Conclusions The socioeconomic profile of secondary care clinics for Allergy, Epilepsy and General Paediatrics broadly matched the profile of our hospital inpatient population (4.4% and 37.9% in the least and most deprived quintiles). Secondary care Asthma and Rapid Access clinics were slightly more skewed towards patients from more deprived areas. In contrast, Endocrine, Diabetes and CFS/ME clinics showed a much higher proportion of patients from more affluent backgrounds – perhaps reflecting a larger proportion of these patients who live outside our local area. Further research will now be conducted to determine the extent to which these findings may also reflect unmet need and difficulty in accessing more specialist clinics for families living in more deprived areas.