P108 Biologics polyclinic is an efficient and safe way to support a biologics service

Abstract

Traditional follow-up models typically involve twice-yearly reviews for patients on novel therapies. With increasing numbers of patients established on treatments, services face growing pressure on capacity. Innovative approaches are needed to maintain high standards of care. A consultant-nurse-led multidisciplinary biologic telephone clinic was set up to improve patient safety and service efficiency. Records of patients established on biologics, without serious comorbidities, were evaluated to identify those suitable for a two-clinic pilot. A nurse consultant supervised dermatology trainees, nurses and healthcare assistants, using a checklist to carry out telephone consultations. In total, 98 patients were assessed by telephone in two 4-hour clinics. Of these, 88 (90%) patients met the criteria for safe prescribing and were given prescriptions with review planned in 1 year, with a patient-initiated follow-up option for earlier review if needed. Eight were assessed as needing face-to-face review and two asked to be seen face to face. No safety concerns arose. Patient feedback was positive. The service has 1235 patients with inflammatory skin disease on novel therapies. Excluding 223 started on treatment in the last year, 1012 patients are suitable for this once-yearly telephone, polyclinic service. Previous practice was to have one face-to-face and one telephone clinic per year, so this model applied to 90% of patients could potentially save over 900 follow-up appointments yearly. Freeing up follow-up appointments creates clinic capacity, with health benefits for those waiting. Operational challenges included staffing coordination, resource allocation and booking. Benefits were a reduction in patients lost to follow-up, safety protocol checklists, timely prescribing and enhanced patient satisfaction. The pilot supported the initiation of these clinics on a weekly basis. The 2020 guidelines for biologics recommend 6-monthly follow-up monitoring and do not reflect current real-world safety data supporting the move to ‘living guidelines’ by the BAD guideline group.