Endocrine Abstracts

Using nurse led clinics (including telephone and virtual reviews) in NHS Grampian to improve patient satisfaction following a diagnosis of hyperthyroidism.

Aims: To reduce waiting times for patients with hyperthyroidism, nurse led clinics were introduced. Telephone and virtual follow up reviews are offered after commencement of thyroid treatment (e.g. anti-thyroid medication or radioactive iodine (RAI)). Nurse-led thyroid clinics aim to improve the overall support the patient receives, complimenting rather than replacing existing medical thyroid clinics (which lack capacity).

What we have done: Nurse-led virtual clinics were initially established to facilitate follow up of post radioiodine patients. The virtual clinic then evolved to allow more patients to contact us and receive advice on their thyroid biochemistry in between clinic appointments. The virtual thyroid clinic allows remote review of thyroid biochemistry results and advises patients of any changes to their medication. Overall review and support are provided via e-mail and/or telephone. Nurse-led telephone clinics allowed review of thyroid biochemistry results and give guidance regarding their anti-thyroid medication. In addition, their overall health status would be reviewed including potential thyrotoxic symptoms. Follow up appointment and further thyroid blood testing would also be arranged. A structured formal clinic letter is sent to both the GP and patient.

Progress to this point: Thyroid Nurse led clinics have helped to reduce waiting review times for patients. Nurse thyroid appointments increased from 101 (Apr 2018 to March 2019) to 798 (April 2022 to March 2023). Medical thyroid return appointments dropped from 865 to 666 in the same time period. Patients appreciate the prompt service and primary care feels reassured that effective and timely thyroid clinic follow up is undertaken.

Discussion: We are pleased to share our experience of our very useable frameworks for both nurse telephone and nurse virtual thyroid clinic follow ups.