INCREASING WORKLOAD AND CHANGING REFERRAL PATTERNS IN PEDIATRIC CARDIOLOGY OUTREACH CLINICS - IMPLICATIONS FOR CONSULTANT STAFFING

Objective-To assess the workload of, and referral patterns to, paediat ric cardiology outreach clinics to provide data for future planning. D esign-Descriptive study of outpatient attendance during 1991 and 1996. Setting-Five district general hospitals with unchanged local demograp hics and referral patterns during the study period. Methods-Postal, te lephone, and on site survey of clinic records and case notes. Results- The number of outpatients increased by 61%, with a consequent increase in the number of clinics held and patients seen in each clinic. The n umber of patients aged between 10 and 15 years doubled. Conclusion-The se data confirm the impression that demands for paediatric cardiology services are increasing. The increased need for attendance at outreach clinics has inevitable consequences for the clinical, teaching, and r esearch activities of specialists in tertiary centres. An increase in the number of paediatric cardiologists, or development of local expert ise (general paediatricians with an interest in cardiology), will be r equired. Furthermore, the increasingly large cohort of older teenagers and young adults with congenital heart disease underscores the need f or the development of specialist facilities.