1326 Cardiology clinics during pandemic – call for a uniform response!

BackgroundDuring the current pandemic with Covid-19, face to face cardiology clinics were put on hold during national lockdowns. Consequently, there were increased waiting times and back log of paediatric cardiology outpatient numbers. It is currently not known as to what effect this has had on children awaiting cardiology services and whether there have been any adverse effects with the appointments being postponed. Feedback from paediatricians with cardiology expertise (PEC) would be an important exercise to learn how we have coped with outpatient cardiology work in the current pandemic and how we could prepare for the future.ObjectivesTo get feedback from PECs about their current joint clinic backlog and their experiences how they have managed to provide cardiology services over the past 1 yearMethodsSurveys were sent to group of Paediatricians with special expertise in cardiology group via link for preset questionnaire.Results44 PECs responded to the survey. A range between 0–16 outreach clinics were cancelled during the current pandemic with the average being 5 clinics per PEC. About 40% of the respondents had around 50 patients awaiting appointments as a result of backlog whereas 27% had between 100–400 patients on their list. A wide variety of methods were used from seeing only the urgent patients, vetting each patient and prioritising the list, continuing with remote clinics etc. but around 18% of the respondents felt that they are struggling with their workload. Some PECs have increased their PEC cardiac clinics to cope with the increased numbers. Reassuringly 90% of the respondents did not see any increase in complaints or unexpected patient deterioration due to delayed reviews. 45% of the respondents felt that 10% of their outpatient work could be done remotely whereas 37% felt that 20–50% of their work could be completed remotely. 95% of the PECs did not see any of their cardiac patients deteriorating secondary to Covid infections and most of the respondents agreed with the RCPCH guidance of clinically extremely vulnerable group in regards to classification of children with complex congenital heart disease. Most PECs wore standard PPE (surgical mask & plastic apron) during echocardiography.ConclusionsThe current pandemic has thrown in some unexpected challenges on how we deliver the paediatric cardiology services. There were great variations on how different professionals managed their work during this period. Reassuringly no increase in complaints or sudden unexpected deterioration were reported which is likely to be due to the painstaking vetting, prioritisation and diligent overview amongst our colleagues. Having a joint statement from specialist groups would be helpful in future to ensure uniformity of services and safeguarding of professionals from medico-legal challenges. There are some aspects of our work which can be delivered remotely and we need to study the pros and cons of this approach.