Diabetic children miss out on hospital checks

Paediatric endocrinology clinics have a  non-attendance rate of 11.4% in the south west of the UK. The majority of these patients have diabetes.

Children who did not attend were more likely to  come  from families living in areas of high deprivation and to have a child protection alert in their hospital records.

In 60% of the cases, the GP was not informed that the child had not appeared, so they were not in a position to follow the child up themselves. Some of the children were sent other appointments, some were given an open attendance appointment and some were discharged.

About half of the children were eventually seen within a year and a third attended A and E. Almost a quarter went back to see the GP and half of these were re-referred.

My comments: In my own practice I am aware that a minority of parents are very poor at attending diabetic clinics with their children. We are always informed and keep out an eye for opportunistic intervention when the child attends for another matter. Our hospital has a good nurse liaison service and they do their best to keep a dialogue open with the parents and visit at home. Sometimes lack of money for bus fares is given as an issue. Sometimes work commitments or having to make arrangements to look after other children in the family is the reason. For one reason or another, the child’s diabetes management does not have the priority that it is given in other homes, and that doesn’t work out well on the long term.

Reported in BMJ 24th June 2017 by Ingrid Torjesen BMJ 2017;357:j2983