Endocrine Abstracts

Introduction: The provision of out-of-hours (OOH) care for hospital inpatients is currently a hot political topic with aspirations for ‘seven day working’ and earlier specialist involvement. Care for patients with diabetes or endocrine problems OOH (which accounts for 75% of each week) is variable and often falls as a default to the general medical team. Our centre (over 1000 beds, all major specialities) has, for many years, provided a 24/7 service for GPs and hospital inpatients in our trust and beyond. This non-resident rota is manned by ‘out of programme’ specialist registrars with consultant support. Patients can be reviewed in person if required and routine ward rounds are conducted on weekends and bank holidays. To the best of our knowledge there is no published data defining the extent to which diabetes or endocrine problems are encountered OOH.

Methods: Prospective data collection regarding all OOH activity (defined as 1700–0900 h weekdays and all day on weekends and bank holidays) for 1 month (May 2015).

Results: 224 OOH clinical interactions occurred during the study period of which 87% occurred on weekends or bank holidays and 81% resulted in a physical review of the patient. There were forty-eight new referrals. The majority were about inpatients within the trust (77%); the remainder related to calls from GPs (13%), patients at home (6%) and other hospitals (4%). Referrals were evenly split overall between diabetes (48%) and endocrinology (52%) with hyperglycaemia and hyponatraemia being the most common reasons for referral respectively. The largest referrer was acute medicine (40%) followed by GP (13%), oncology (10%), and ED (8%).

Discussion: Diabetes and endocrine problems frequently arise OOH and the availability of round the clock specialist advice is well utilised across a range of referring specialities. We would hope, although cannot prove, that our earlier involvement in patient care improves outcome, facilitates earlier discharge and enables admission avoidance if appropriate – all key performance metrics.