LAUSR

Background Children with cerebral palsy (CP) are recognised to have long-term morbidity. CPIPS (CP Integrated Pathway Scotland) standardises management and has been shown to reduce hip dislocation and surgical intervention. Benefits of this approach are 1)appropriate and evidence-based surveillance and 2)early referral to appropriate specialists. There are improved patient outcomes following CPIPS introduction, however limited studies reporting patient journey or financial healthcare outcome measures. Aims To report outcomes of the graded introduction of CPIPS, initially the ‘one stop’ MDT clinic. Methods Retrospective review of healthcare records of all children seen in CPIPS clinic (March-October 2017); reporting clinical and patient journey outcomes. Results 23 children have been seen in the CPIPS ‘one stop’ clinics; which include a community paediatrician, paediatric orthopaedic surgeon and physiotherapist. 17% (4/23) children had significant medication changes; such as starting muscle relaxants. 65% (15/23) children had subsequent list for specific specialist management, with 13% (2/15) recieving botulinum toxin injections and 87% (13/15) being listed for orthopaedic surgery. These children were previously seen separately by specialists therefore we estimate that 23 extra outpatient appointments are available. Single clinic attendance is beneficial for children (reduce time away from school) and families (reduced travel/missed work, parking expenses, inconvenience). Clinicians reported that shared decision making during the clinic facilitated 1)team learning 2)patient-centred holistic decision making taking into account family circumstances 3)facilitated subsequent treatments as relevant teams were present with the family to plan optimum interventions and timings. Conclusion We present initial outcome data from the CPIPS ‘one stop’ MDT clinics, which have demonstrated shared decision making, positive initial comments from both professionals and families; and a theoretical financial benefit with reduced clinic usage and probable shorter time to interventions. 65% of children were subsequently booked for specialist intervention, supporting the need for ‘red’ alerts prior to review, ensuring appropriate children are assessed. Further studies are needed to explore the clinical and patient journey outcomes in children with CP; alongside the outcomes following the introduction of CPIPS. Studies are needed to report holistic outcomes, including chronic medical conditions and the mental health to continue developing a service to support chronic, complex, and life-long conditions.