P24 Improving the patient pathway for timely referral and management of infantile haemangioma

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Abstract Infantile haemangiomas (IH) are vascular tumours which typically present soon after birth and grow rapidly at a young age. Complications can arise depending on location and rapidity of growth of the lesion1. Timely treatment with an oral beta-blocker can limit growth and speed up resolution of IH. Not infrequently, we noted babies were being referred at a stage when most of the growth of the IH had already taken place. These patients often had skin breakdown, or a large haemangioma, making successful treatment harder to achieve. We aimed to educate GPs and health-visitors regarding the need for timely referral and to speed up the triage process for these patients. Information was sent to regional GP practices, with instructions on referral criteria according to the BSPAD guidelines for treatment of IH. A photograph of the IH was requested at the time of referral. Submitted referrals were triaged promptly and where appropriate, booked directly into a telephone clinic. After telephone consult, IH meeting the criteria for propranolol were booked directly for commencement of the beta-blocker with a paediatric review. If there was diagnostic doubt or other complications, a timely face to face review was arranged. Patients not requiring oral treatment were discharged back to GP. A patient satisfaction questionnaire revealed that parents appreciated the speed of assessment and reduced hospital visits. We describe an educational intervention and triage strategy resulting in improvement in the timing of referral and management of infantile haemangioma.