ESPE Abstracts

Introduction: The BSPED Peer review programme was initiated in 2011 to provide a regular cycle of independent impartial professional assessment, against quality standards for Specialised Paediatric Endocrine Services (SPES) in the UK.¹ We present here an evaluation of the outcomes from the first review cycle completed in 2017.

Methods: We examined pre-review self-assessments (4–6 weeks before a site visit by the Peer Review team) and post-review questionnaires (at least 6 months after a review) completed by the SPES lead, and final Peer Review assessment reports completed by the BSPED Peer Reviewers from each SPES. The assessment reports showed whether standards were met or unmet.

Results: All 22 SPES (England 18, Scotland 2, Wales 1, Northern Ireland 1) accepted the invitation to be reviewed. The total population served (median 2.6 million; range 1–8 million) and number of annual consultations (median 1872; range 779–6738) per SPES varied considerably. The 22 SPES met a median 43 (range 30–49) of the 54 criteria in the UK standards¹. Adherence to the standards was suboptimal for the ‘availability of specialist psychology support’ (n=11), ‘telephone access to a paediatric endocrine specialist 24 hours a day’ (n=8), ‘appropriate facilities for adolescents’ (n=8) and ‘transition clinics’ (n=3). From the post-review questionnaire, 21 SPES found the review process useful in identifying developments and implementing quality improvements. However one SPES reported no impact from the peer review owing to lack of support from the hospital’s senior management team. This SPES served a total population of 2.5 million, met 33 of the 54 criteria and had a dedicated cohesive team working above their remunerated sessions. Although a major recommendation from the review conducted in 2013 was to secure funding for an additional paediatric endocrinologist to meet the criteria of one paediatric endocrinologist per 1 million population, this has not been achieved.

Conclusions: This BSPED Peer Review programme has contributed to promoting the quality of SPES and the care they provide for children and young people with endocrine disorders within the UK National Health Service. To enable appropriate action plans from the final report and recommendations, it is vital that these are presented to the medical and health care professionals of the SPES, but also to the hospital management and planning teams. Evidence and experience from this first cycle of SPES peer reviews will help refine future standards and reviews.

References: ¹BSPED. UK Standards for Paediatric Endocrinology, 2010. https://www.bsped.org.uk/media/1370/bspedpaediatricendocrinestandardsvs130710.pdf