P107 Exploring the perceptions of foundation Doctors’ ability to deal with the acutely unwell hepatology patient (AUHP)

<h3></h3> The Foundation Programme curriculum (1) outlines capabilities required of foundation doctors (FD) and is designed to consolidate skills and knowledge as a clinician. Ideally, these should be achieved during foundation rotations, but there are no specific specialties required. As a subspecialty of Gastroenterology, not studied until ST3, Hepatology exposure and teaching remains limited to FDs and data is lacking on the resources available to doctors below specialty training. This can result in FDs feeling less capable of managing hepatology patients compared to those with other gastrointestinal pathologies. Mortality from Liver disease has increased four-fold since 1970s, and patients presenting to A&amp;E with a primary diagnosis of liver disease has doubled over the last decade and by 22% in the last year (2, 3). Early specialist care is crucial. This work aims to quantitively evaluate the perception of EOE FDs’ ability to manage the AUHP. FD denotes FY1, FY2, Junior Clinical fellows and other doctors working below core trainee level. Through an anonymous Likert survey, trainees in EOE were asked about their confidence in managing the AUHP, whether they had access to a dedicated Hepatology team (separate to general Gastroenterology) in their Trust, if they used the British Society Gastroenterology (BSG) bundle when clerking and their opinion on whether there were sufficient dedicated curriculum competencies addressing management of the AUHP. Results from FDs in the EOE region from six Trusts (n=54) showed that only 11.1% felt confident managing the AULP. 46.3% of FDs were aware of their Trust having a dedicated Hepatology team where the majority at 51.8% stated it was difficult to contact the team. 70.4% of FDs felt there were not enough competencies to address the AUHP including ascitic taps and paracentesis. Lastly 70.4% reported that none of their simulation sessions had addressed the AUHP (figure 1). This data demonstrates a lack of confidence in FDs in managing the AUHP and a need for dedicated Hepatology teaching and inclusion on the curriculum. FDs make up a significant proportion of acute medical teams clerking these patients and Specialist review within 12–24 hours is paramount to ensure timely diagnosis and management. This is of particular importance as access to Liver Specialist Services nationwide is variable resulting in differences in the quality of care for this cohort (4). Formal didactic teaching supplemented by e-learning and simulation sessions could be developed to address these issues.