Endocrine Abstracts

Background: Screening for Congenital hypothyroidism is part of National New-born screening program. Each District General Hospital is required to have a Congenital Hypothyroidism Service with a Lead Paediatrician and a Deputy to provide seamless service to babies with suspected congenital hypothyroidism and their families. National guidelines and service standards exist to guide setup, operation and auditing of this service.

Aim: We aim to benchmark the performance of our congenital hypothyroidism service against local and national guidelines.

Materials and methods: We studied timeliness of organising physical review, blood tests, scans, initiation of treatment and follow up of these patients. We planned it as a retrospective audit including all patients referred with suspected congenital hypothyroidism between 2002 and 2018. The list of patients was cross-checked with Regional Screening Laboratory to ensure all cases were included. The data was collected from hospital notes and laboratory system computers using a standardised pro forma. Results were analysed and presented in graphical form.

Results: Total 38 cases were identified. In 100% cases, contact with family was made within 48 h of receiving notification from screening laboratory. All patients were seen and started on treatment if required within 48 h of notification (66% seen on the same day and 34% seen on the next day). The starting dose of levothyroxine was correct as per guidelines in 100% of the cases. The future clinic follow-up scheduling did not conform to the national guidance. This was felt to be secondary to reduced capacity in out-patients clinic. However, 100% of these patients had blood tests done and dose change actioned on telephone.

Conclusion: Overall, our service achieved excellent performance in initial workup and initiation of treatment of all cases. However, future follow up scheduling needs improvement. This is one area where the concept of Virtual Clinic can deliver good results. The local team is in discussion with the Trust to pilot Video clinics in this service.