PTH-53 Evaluating the effect of covid on an Upper GI Two Week Wait pathway

IntroductionThe covid-19 pandemic has necessitated a change in how healthcare provision is delivered. As such there has been an almost instantaneous transition from face-to-face doctor-patient consultations to the use of tele-medicine. The aim of this study was to evaluate outcomes from referrals via the upper gastrointestinal two week wait pathway (UGI TWW) made by GPs using telephone assessment during the covid era.MethodsThis was a retrospective database review of all patients referred via the UGI TWW pathway between 1st March 2019 - 28 Feb 2020 pre-covid (PC) and during the covid era (CE) during 1st March 2020 - 28 Feb 2021.All referrals received by Imperial Healthcare trust were included in this study. The standardised referral proforma was reviewed to determine patient characteristics and symptoms. Investigations undertaken and subsequent diagnoses were recorded.ResultsA total of 153 referrals were included in this study, 83 PC and 70 during CE.GP consultations PC were conducted in over 95% of patients, compared to 16% in CE, where the remaining 84% were handled virtually or by telephone. PC the average age of patients referred was 66 (range 34-92) with a M:F ratio of 0.77:1, this compared to CE 60 which was a significant difference (p value =0.025226) (range 19-86) with a M:F ratio of 0.79:1. Language based demographic data showed patients coded as having a non-english primary language made up 21.69% of the pre-covid cohort and 25.71% of patients in the covid era cohort.When the outcomes of investigations were examined, we found that GI cancer was found in 4% PC compared to 13% CE. The diagnosis of benign pathologies was 86% PC compared to 41% CE (p value < 0.00001 which is significant), while no pathology was detected in 10% PC compared to 39% CE (p value = 0.000022 which is significant). 6% were unknown as these patients were either referred to their local hospitals or we lost follow up.Abtract PTH-53 Figure 1Breakdown of diagnosis[Figure omitted. See PDF]ConclusionGP telephone consultation for upper gastrointestinal symptoms results did not result in a change to the rate of cancer detection. It was however noted that a greater proportion of patients with no pathology underwent investigation.