PA45 Successful implementation of referral triage in a paediatric dermatology service

Abstract The demand for paediatric dermatology services has risen significantly in recent years across the UK, particularly following the COVID-19 pandemic. This has led to a sharp increase in waiting times, putting secondary care dermatology services under significant pressure. To address this challenge, our department implemented a triage system for paediatric dermatology referrals from primary care in January 2023. Referrals were received through the National Health Service Electronic Referral Service system. Enhanced triage was implemented with the aim of providing advice and guidance to general practitioners and primary care referrers to improve care delivered in the community and reduce pressure on the secondary care service. This was achieved by enhanced, consultant-delivered triage with management plans for common conditions, such as atopic dermatitis and acne. In total, 2028 referral triages were carried out between January 2023 and May 2024. The mean number of referrals triaged per month was 122 (range 99–146). Following triage, 1036 referrals (51.1%) were returned to primary care with clinical advice, effectively reducing the burden on clinic appointments. Overall, 1026 referrals (50.6%) were accepted and booked into clinic. These data suggest that triage of referrals from primary care can be an effective strategy for reducing pressures on clinic appointments and decreasing waiting times for secondary care paediatric dermatology. We propose that this model should be considered for national adoption to reduce pressure on paediatric dermatology services. Furthermore, the development of standardized managements plans for primary care practitioners may be of benefit and could be developed. Currently, management and referral guidance from the British Association of Dermatologists is primarily focused on treatment in adults. Extension of this guidance to include advice on management of common skin conditions such atopic dermatitis in a paediatric population may also be helpful and reduce the number of referrals from primary care.