P316 Treatment plans in gastroenterology via the advice and guidance service are an effective means of managing patients in primary care

IntroductionOur gastroenterology department offer an advice and guidance (A&G) service which acts as the interface between primary care and gastroenterology/endoscopy for all referrals other than those meeting two-week wait criteria. There is insufficient capacity to see all patients referred in a clinic.On average, 366 referrals are received through A&G per month (4400 per year). 10 hours of consultant time are allocated per week. Referrals are processed within 48 hours via a dedicated app. Approximately 25% of patients are booked directly to the appropriate clinic, 35% triaged direct to endoscopy and 20% are offered a treatment plan. 20% of referrals are invalid or redirected. Treatment plans offer advice for the GP and patient, e.g., advice on further investigations in primary care or symptom management. We assessed whether treatment plans are an effective means of managing patients in primary care or whether this process simply delays review in secondary care.MethodsWe reviewed a sample of 100 patients who were offered a treatment plan in 2019 and a further group from 2021. We categorised each treatment plan based on sub-speciality (hepatology or non-hepatology). We then reviewed the outcome of each treatment plan to see whether a) the patient was managed entirely via the treatment plan b) the patient was re-referred to gastroenterology within 1 year of the treatment plan or c) the patient was referred to another specialty for the same problem within 1 year of the treatment plan.ResultsThere were a similar proportion of hepatology treatment plans each year - 34 and 26%. Table 1 shows the outcomes of the patients who received a treatment plan by year.Abstract P316 Table 1Outcome of patients receiving a treatment plan by year 2019 (n=100) 2021 (n=100) Managed via treatment plan alone 70 81 Re-referred to gastroenterology within 1 year 22 16 Referred to another speciality within 1 year 8 3 In 2019, of the 22 patients who were re-referred within 1 year of their treatment plan, 18 required a gastroenterology clinic appointment. 1 was managed via a further treatment plan only and 3 via outpatient investigations only. Similarly in 2021, of the 16 patients who were re-referred, 10 required a gastroenterology clinic appointment. 3 were managed via a further treatment plan only and 3 via outpatient investigations only.ConclusionsTreatment plans for patients referred via A&G are an effective, time efficient means of managing patients. For the majority, further se