Assessment of current practice of paediatric respiratory and allergy teams in Cambridge University Hospital during the COVID-19 pandemic era and optimisation of the service

Abstract

Introduction: The paediatric respiratory and allergy teams in Cambridge Hospital see patients with atopic and overlapping conditions, thus increasing travel for patients and hospital footfall. It is a tertiary reference hospital covering East England. Assessment of practice and changes of the service, in view of COVID-19 pandemic.

Method: Retrospective assessment of patients: a) referred between the specialties (1/4/19- 31/3/20), investigations booked (lung function, skin prick testing, specific IgE, peak flow, inhaler and nasal spray technique) and patient flow. b) currently being seen by both teams (1/4/18-31/3/20).

Results: a)13 patients identified; 10 from respiratory to allergy. 62 days delay between referral and review by secondary team. Referral reasons to allergy: food/drug allergy, asthma, allergic rhinitis/conjunctivitis and from respiratory: asthma, cough, wheeze. In 10, there was no overlap in the investigations. 3 patients were discharged after one review. b) 98 patients being seen by respiratory and allergy. Some overlap between investigations in both clinics. 54% attended the A&E, for an allergy or respiratory reason and 36 had subsequent admission. 79% on inhaled corticosteroids, 51% on montelukast, 42% on LABA, 39% on nasal steroids. 69/98 had one appointment with allergy and 77 had 2 or more with respiratory. 2 month wait from referral.

Outcome: Improved communication between the teams, establishment of joint MDT and clinics every 6 months. In the current COVID -19 pandemic, this will improve patient experience/adherence from MDT approach, reduce hospital footprint and increase clinic attendance.