877 Evaluation of ‘Providing Assessment and Treatment for Children at Home (PATCH)’ service at Hillingdon Hospital for VIW and Asthma

• Published in: Archives of disease in childhood 2023-07, Vol.108 (Suppl 2), p.A331-A332
• Main Authors: Yashasvi Rajeev, Patel, Akhil, Manuel, Anthea, Tyrrell, Madeline, Summerfield, Alison, Palanivelu, Shanmugapriya, Goldring, Stephen
• Format: Article
• Language: English
• Subjects: Asthma; Children; Continuity of care; Feedback; Home Visits; Hospitals; Observation; Parents; Pediatrics
• ISSN: 0003-9888; 1468-2044
• DOI: 10.1136/archdischild-2023-rcpch.524

ObjectivesHillingdon Hospital has operated a ‘Providing Assessment and Treatment for Children at Home (PATCH)’ service since May 2021. Clinically stable children who required observation or low-intensity treatments were discharged to our PATCH team of senior paediatric nurses who reviewed them in their own homes. If required, PATCH referred children back to the hospital for review by a paediatric registrar or consultant. A large cohort of children our PATCH team reviewed were those who attended A&E or were admitted to our Paediatric Assessment Unit (PAU) or the Paediatric Ward with acute asthma or viral-induced wheeze (VIW). We aim to describe our experience running our PATCH service and highlight its utility.MethodsPATCH referral data from 1st May 2021 to 31st December 2022 was retrospectively collected and analysed.Results252 children were referred to our PATCH team between 1 May 2021 and 31 December 2022 – 157 (62%) for VIW and 95 (38%) for asthma. 147 (58%) of these referrals were from A&E, 64 (26%) from our inpatient ward, 39 (15%) from PAU, and 1 from the community. The median age of children referred was 2.45 years, with 88% of children being between the ages of one and five, 3% under one, and 9% above five. The majority of referrals (59%) were made between September 2021 and March 2022 – September 2021 had the most referrals (33).Children referred to our PATCH team remained under their care for an average of 1.86 days. The mean number of telephone reviews and home visits per child were 1.07 and 0.68 respectively. 25 (11%) children were asked to come back to the hospital for a review. There was a 2% hospital re-admission rate. Figure 1 illustrates the distribution of PATCH team referrals, including hospital reviews and re-admissions.Feedback received from parents was overwhelmingly positive (96%). Indeed, 63% of parents stated that, if concerned, they would have returned to A&E if it was not for our PATCH service, and 37% would have contacted their GPs or called 111, as shown in graph 2.Abstract 877 Figure 1ConclusionOur data shows that PATCH is a safe alternative to hospital admission for observation and low-intensity treatments. The service undoubtedly ensures continuity of care and helps to support parents and carers during their child’s illness. The low re-admission rate, potential reduction of repeat presentations to A&E or GP, and enormous positive feedback are a testament to this.