P15 Does the NHS offer equitable access to specialist paediatric clinics? A study of inequalities in outpatient referrals to eight paediatric subspecialties

AimTo assess the distribution of socioeconomic status across different subspecialty outpatient clinics in a large paediatric service.Methods32,369 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. The proportion of patients in the most and least deprived quintiles were also calculated. 229 postcodes were unmatched.ResultsAbstract P15 Table 1Clinic Category Mean age (years) Number of Patients Mean Index of Multiple Deprivation rank (1= most deprived, 32,844= least deprived) Percentage of patients in least deprived quintile Percentage of patients in most deprived quintile Allergy 4.66 4088 10,719 3.57% 36.91% Asthma 7.54 796 9327 2.14% 41.08% CFS/ME 14.66 1630 18,274 26.20% 14.66% Diabetes 11.17 663 18,369 24.13% 13.42% Endocrine 13.61 4538 15,254 15.93% 22.17% Epilepsy 7.92 865 10,864 4.97% 36.99% General Paediatrics 5.73 9846 10,132 3.04% 39.15% Rapid Access 4.05 9714 9706 2.28% 39.53% ConclusionsThe 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.