Endocrine Abstracts

The NHS is an evolving organisation facing huge challenges (bed pressures, lack of workforce/specialists, outpatient waiting lists etc.) while still striving to provide best possible patient care. Our Endocrine Specialist Nurses (ESNs) are an integral part of endocrine services in creating an individualised, smooth patient pathway. They are a link between endocrinologist, patients and community services to ensure high quality care for all. A dedicated ESN clinic with direct access to endocrinologist was set up to provide ongoing care for patients with thyrotoxicosis after their initial endocrine consultant appointment. The aim was to ensure blood tests, medication titration and patient education were provided in a timely manner. We reviewed the clinical journey of 8 patients diagnosed with thyrotoxicosis. Initial free T4 ranged from 25 to 100 pmol/l (normal 11.9 to 21.6 pmol/l) and all TSH levels were <0.01 mU/l (normal 0.27 to 4.2 mU/l). All patients were commenced on oral Carbimazole with daily doses ranging from 5 mg to 60 mg. Patients were seen between 2 to 4 times by ESNs. It took 6 to 14 weeks (mean of 8.75 weeks) to achieve an acceptable thyroid results. 3 patients had a near normal free T4 of 8.5 to 9.35 pmol/l. 5 patients achieved a normal free T4 between 15.8 to 20.8 pmol/l. (with a mean free T4 of 14.8 pmol/l). The ESN endocrine clinic has enabled us to:

• increase outpatient consultant appointment capacity by reducing the number of endocrine clinic follow up visits.

• provide greater patient satisfaction due to direct access to ESNs.

• reduced the burden on hospital, community phlebotomy services.

• improved patient care by providing relevant blood tests, education and ensuring medication compliance.