G343 The influence of parental screen time and attitudes on screen use in preschool children attending a developmental clinic

Abstract

In contrast, Endocrine, Diabetes and CFS/ME clinics showed a much higher proportion of patients from more affluent backgroundsperhaps reflecting a larger proportion of these patients who live outside our local area. Further research will now be conducted to determine the extent to which these findings may also reflect unmet need and difficulty in accessing more specialist clinics for families living in more deprived areas.Background Intensive early neurorehabilitation is required after severe Acquired Brain Injury (ABI), usually necessitating inpatient care. Adult in-patient Specialist Neurorehabilitation services have been commissioned by NHS England since 2013, but there is no consistent provision and standard for specialist neurorehabilitation services for children. Aims To survey arrangements for ABI children requiring inpatient neurorehabilitation across England. Methods A questionnaire was sent to Lead Clinicians at all paediatric Regional Neuroscience Centres (RNSC) and two stand-alone specialist neurorehabilitation units in England.Centres were asked about neurorehabilitation clinical practice and demographic details of in-patients treated 2012-2015.Results 17 centres responded, 15 RNSC, 2 stand-alone units. Only 29% had neurorehabilitation funding arrangements separate to acute neurology/neurosurgery tariffs. Only 10% had ring-fenced neurorehabilitation beds. Total patients receiving in-patient neurorehabilitation were estimated at 1589 over 3 years (mean/year=530). Numbers increased over time (464 (2012/13); 530 (2013/14); 595 (2014/15)). Estimated mean number of patients treated per centre/year=40 (range 2-98). 18% of centres accepted external neurorehabilitation referrals, 82% did not. 47% had a process for care transfer from ? A3B2 re 3,j?>acute services to neurorehabilitation, 53% did not. Proportion of total neurorehabilitation in-patients classed as severe ranged from 25%-90%. 6% of centres reported having >7 neurorehabilitation in-patients at any time; 41% 2-7; 41%<2. Length of neurorehabilitation stay ranged from 7-375 days. Percentage of cases with distance from centre to home >45 min by road ranged from 3%-100%. Many centres reported staffing deficiencies; 40% had protected time for multi-disciplinary team (MDT) meetings for all members, 20% for some, 40% for none. 86% of MDTs included non-NHS funded members. Most patients were discharged from RNSCs to home, but some were discharged as in-patients to district hospitals or specialist neurorehabilitation unit. Conclusions Considerable neurorehabilitation in-patient activity is taking place in RNSCs, despite general absence of secure funding or dedicated beds. Inter-centre variations in funding,