A rheumatology team at University College London Hospitals is leading a project to understand the reasons that young people miss their hospital appointments and find ways to avoid this.
The team noticed that there was a particularly high rate of non-attendance for clinic appointments within their service, with between 10 and 15 per cent of children and young people missing them. This affected the quality of care the team was able to provide, but also cost money and affected staff morale.
Rheumatologists, Dr Aicha Bouraoui and Professor Debajit Sen won a Health Foundation grant and launched the ‘Pathway to Equity’ programme with a focus on adolescent and young adult rheumatology and paediatric outpatient services.
The programme aimed to identify who is most at risk of non-attendance, and also understand the reasons for this and what the service can do to help.
A data prediction model which could proactively identify patients at risk of non-attendance established that deprivation and distance from hospital are the two main drivers of clinic non-attendance.
The team carried out interviews with young patients and their guardians, and then invited a group of young people to an engagement event at the hospital.
The team also visited local secondary schools, where clinical staff worked with a group of students on health inequalities, barriers to attending hospital appointments and how to rebuild young people’s trust in the NHS.
30 young people volunteered to continue to work on the programme as Quality Improvement community partners.
Following the research, the team has introduced steps to help improve attendance and address health inequalities. This includes continuing to identify and proactively telephone patients at risk of clinic non-attendance and employing a peer support coordinator to support young people with care navigation.
The team will also be providing travel guidance for staff to support patients travelling to hospital and working with health champions in schools to set up a ‘health space’ and providing peer support on health promotion supported by teachers and NHS professionals.
Dr Aicha Bouraoui, rheumatology consultant and Pathway to Equity programme lead, said: “Non-attendance is a long-standing issue for the NHS, and we wanted to truly understand the reasons amongst young rheumatology patients behind this. I have loved working with both the clinical team and the young people themselves to tease out some of the issues and work together to find solutions to non-attendance.
“The Pathway to Equity programme has demonstrated that collaboration between health systems and educational institutions is a key to transforming the lives of our future generations.”
