{
  "abstract": "Introduction Demand within gastroenterology outpatients has significantly increased over the last few years, outstripping an increased capacity. Overdue follow-ups are a major problem for patient safety, chronic disease management and RTT rates. We present a new approach to managing these patients in the context of unselected gastroenterology clinics, without the need for patient contact.Methods Over a 6 month period, Remote Review Clinics were created when standard clinics were unavailable - 10 min appointment slots over a 4 hour session using patients (20-24/clinic) from overdue review list prioritised by time waiting. 8 clinicians reviewed cases - 3 Substantive Consultants, 2 Locum Consultants, 3 Middle Grades (STR/SAS). Each case was reviewed, without patient contact, using electronic patient records of clinic letters, endoscopy reports, and pathology results. Each patient was sent a letter explaining the clinic, with an outcome, with a copy sent to GP. Outcomes were – 1) Follow up - ensure investigations up-to-date (incl. surveillance) with further bloods, endoscopic procedures, scans, or treatment changes being actioned and then prioritising follow up timeframe 2) Discharge - aim in patients without recognised chronic disease (e.g. IBD, cirrhosis) with summary of care and a detailed written management plan sent to follow 3) Further Investigations ?Discharge - arrange outstanding investigations before discharging if appropriate. Results 34 clinics (740 patients) were undertaken over the study period - Substantive Consultants (13), Locum Consultants (9), Middle Grades (12). 384 patients (51.9%) had follow-up arranged, 339 patients (45.8%) discharged, 17 patients (2.3%) further investigations before discharge. Outcomes for Locum Consultants and Middle Grades were similar with discharge rates at 40.8% for both, and follow-ups close to each other (49.1% and 57.4% respectively). Substantive Consultants achieved higher discharge rate of 54.1%, with 4.3% attempted to be discharged pending investigation, follow-ups were lower at 41.6%. Of note some individuals from Locum Consultant and Middle Grade groups improved their discharge/follow-up rates as they gained experience and had further training. This method showed significant advantages 1) increased number of patients seen compared to standard clinic 2) allowed delayed investigations before next appointment, 3) prioritisation of future follow-ups with agreed timeframe in a clinic setting 4) allowed focus on discharges, with a strategy for patients, with significant discharge rates.Conclusion We have shown that Remote Review Clinics are a new and successful way of managing long waiting unselected gastroenterology follow-ups. Every patient was some able to have their care progressed with investigations requested before review, and a significant number of others avoiding unnecessary follow-ups and being able to be discharged, creating capacity in the system. We hope that others may consider using this method when appropriate to improve overdue patients on review lists.Abstract O4 Table 1Follow upDischargeFurther Ix ?DischargeTotalOverall384 (51.9%)339 (45.8%)17 (2.3%)740Substantive (13 sessions)116 (41.6%)151 (54.1%)12 (4.3%)279Locum (9 sessions)116 (59.1%)80 (40.8%)0196Middle Grades (12 sessions)152 (57.4%)108 (40.8%) 5 (1.9%)265",
  "authors": [
    {
      "affiliations": [
        "Mersey West Lancs NHS Trust, Southport, United Kingdom"
      ],
      "name": "Michael Roberts"
    },
    {
      "affiliations": [
        "Mersey West Lancs NHS Trust, Southport, United Kingdom"
      ],
      "name": "Khaled Shaban"
    },
    {
      "affiliations": [
        "Mersey West Lancs NHS Trust, Southport, United Kingdom"
      ],
      "name": "Kate Grace"
    }
  ],
  "title": "O4 Improving overdue follow-ups in unselected gastroenterology outpatients: remote review clinics – a new concept",
  "uid": "95c3a716-cff1-58d8-a737-af85eed7ff8b"
}