Endocrine Abstracts

Childhood cancer survivors are a growing population. Lifelong endocrine follow up is essential for brain tumour and bone marrow transplant survivors who received radiotherapy. Patients attending the ‘late effects’ clinic have investigations coordinated with an annual appointment including endocrine bloods, urine protein:creatinine ratio, blood pressure and weight. The Covid-19 pandemic necessitated appointments to be telephone. Patients were asked to arrange their annual investigations via the GP surgery in conjunction with their appointment. In 2020, 24 patients received a telephone appointment, with 9 face to face prior to lockdown. 55% of patients had bloods taken in conjunction with the consultation. In 2021, 47 patients received a telephone appointment and 55% of patients had bloods taken in conjunction with the consultation. In 2019 prior to the pandemic, 33 patients were seen for a face to face appointment and 97% of them had bloods taken in conjunction with the consultation. Patients who attended face to face in 2019 had their urine protein;creatinine ratio taken at their appointment. In 2020 60% of patients had their urine checked remotely, and in 2021 it was 50%. In 2019 prior to the pandemic, 13% of appointments were not attended, which reduced to 4% in 2021 when appointments were telephone. Telephone appointments increased patient attendance but remote investigations were less successful in spite of communication with the GP surgery and patient. The NHS England Outpatient Recovery and Transformation Programme aims to offer appointments by telephone or video call and the ‘late effects’ service would benefit from this approach to improve attendance. However, more work is needed to implement the NHS long term plan and further service improvement to streamline this for childhood cancer survivors being seen in the ‘late effects’ service.