P92 Implementation of physiotherapy led paediatric respiratory clinics

Introduction The adult BTS bronchiectasis guidelines recommend patients have access to a physiotherapist to teach airway clearance, and that this is reviewed every 3 months (Hill et al 2019). While there are no guidelines for children, Chang et al(2018) reports that mild Bronchiectasis in children can be reversed if treated early enough. Although airway clearance is paramount in bronchiectasis, respiratory physiotherapy service provision for children with non-cystic fibrosis bronchiectasis is variable across UK centers. Often these children are seen in general respiratory clinics by a single clinician. We describe the outcomes of a novel pathway-based respiratory physiotherapist clinic for children with non-cystic fibrosis bronchiectasis at a tertiary Children’s Hospital in the UK. Method A physiotherapy led clinic was established to run twice a week, with follow ups based on a scoring of low/medium/high priority. Prospective data collected between September 2012 and September 2013 is compared to data collected one year after implementing the new clinic, between April 2017 and April 2018. Data for clinic utilization, demographic information and waiting times was collected and analysed. Results 157% increase in children seen in the clinic, from 90 up to 231 72% increase in children seen with Bronchiectasis, from 36 to 62 82% of new patients are now given a review within 3 months, this was previously only 5% Slot utilisation has improved by 17%, meaning there are fewer DNA’s. Discharges increased from 27 to 42 patients Positive feedback has been received from families Conclusion Patients requiring airway clearance were seen in a physiotherapy led clinic in a timely fashion and follow up was based on a priority scoring system. This approach has streamlined the care of children and young people with a variety of respiratory conditions, especially those with suspected or confirmed bronchiectasis. Regular access to appropriate airway clearance minimises the number of exacerbations (BTS 2019). This prevents further damage, optimises lung development and as a result less medical intervention is needed (Chang et al 2018). References Chang A, Bush A and Grimwood K. Bronchiectasis in children: diagnosis and treatment. The Lancet 2018;392(10150);pp. 866–879 Hill A, et al. 2019. BRITISH THORACIC SOCIETY GUIDELINE FOR BRONCHIECTASIS IN ADULTS. Thorax, [Online]. 74/1, 1–69. Available at: https://www.brit-thoracic.org.uk/quality-improvement/[Accessed 30 September 2019].