P73 The patient experience of a new ‘referral’ pathway for liver disease in the Somerset Liver Improvement Project

<h3>Introduction</h3> The Somerset Liver Improvement Project uses unique software to identify patients at risk of undiagnosed liver disease by analysing trends in prior blood tests. This is outside the traditional pathway in the UK of patient referral to secondary care. We intended to contact patients directly rather than waiting for a referral from their General Practitioner. The aim of this part of the project was to maximise patient engagement and understand emotional responses within the new pathway, ensuring that unnecessary anxiety was minimised. <h3>Method</h3> Our public and patient reference group (PPRG) were consulted in a workshop and followed by an iterative process to co-design communication materials, an invitation letter and information leaflet. PPRG members were asked via a structured questionnaire to a) predict emotional responses, b) determine whether sufficient information had been relayed and c) provide insight into the format and style of the material. Real world letters were developed and sent to patients in the post inviting them to book a clinical review. Patients who attended clinic were sent a feedback form incorporating the same structured questions, along with an opportunity for bespoke feedback. <h3>Results</h3> The PPRG preferred the initial communication to be via letter as opposed to email, phone or text. All wanted a formal letter style. Most felt a clinic appointment via phone or face to face of equal value. Of 66 patients subsequently called to clinic, 31completed feedback forms. The overall experience rated 4.8 out of 5. Patients on average scored 4.3 out of 5 for clarity of the information received on initial contact. After reading the invite letter the emotional descriptive words which scored the highest were ‘Interested’, ‘Grateful’, ‘Supported’ and ‘Concerned’. Patients scored ‘Supported’, ‘Grateful’, ‘Interested’ and ‘Relieved’ the highest after a clinical encounter. <h3>Conclusion</h3> New referral pathways which communicate with patients outside of traditional approaches need to consider the emotional impact on patients to avoid doing any harm. Public and patient involvement in developing communication materials was effective, with patients engaging positively with this programme of work. Patients found it acceptable to be contacted directly without the need for a primary care referral. Many extremely positive free text comments emphasised the perceived benefit of proactive preventative medicine.