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1789 Changes to the community child health services for children and adolescents with ADHD in the UK during the COVID-19 pandemic

Background ADHD is the most commonly diagnosed neurobehavioural disorders among children and young people (CYP). Given that patients with ADHD are already experiencing significant functional impairment in several domains, they are particularly vulnerable to the distress caused by the COVID-19 pandemic and social distancing measures. It is therefore important to understand changes and helpful adaptations to the ADHD service provision during the pandemic in order to learn lesson that could be applied during preparations for any future pandemic or further lockdowns. Objectives We aimed to ascertain how clinicians have adapted their practices in response to the pandemic and their awareness of Covid-19-related professional guidelines in the management of CYP with ADHD. Methods An online custom-designed questionnaire was approved by the Executive committee members of the National ADHD Network, George-Still Forum (GSF) and emailed to all the delegates who have attended the latest GSF annual scientific meeting. Results Sixty-two of the 100 eligible respondents completed the survey (53 online and 9 as email attachments). Two thirds of the respondents were seeing 76% to 100% of their followup (FU) patients remotely, of which 98% involved telephone calls. Almost half of the clinicians (47%) were not offering clinic appointments for new referrals. About a quarter of the respondents (24%) were able to obtain patients' Blood Pressure and Pulse, and growth measurements in accordance with the NICE recommendations. Locations for obtaining the physical measurements for patients with ADHD included specialist health centres (25%), GP surgery or other primary care locations (10%) and homes (13%). Forty-two percent of respondents worked from home, 43% used video calls and 75% were able to signpost patients with ADHD and their families to various online resources for selfhelp and non-pharmacological behaviour management strategies. Thirty-eight percent of the respondents reported being redeployed to other high-demand clinical areas during the pandemic including the acute general paediatrics (19%), statutory safeguarding work (6%) and adult medical care (2%). In relation to awareness of professional guidelines, 32% of the respondents were aware of the general Covid-19 recommendations from the RCPCH and 33% knew about the European ADHD Guidance Group (EAGG) Covid-19 recommendations for the management of CYP with ADHD. However, 8% of the clinicians indicated no awareness of any Covid-19 specific guidance. Conclusions Clinicians made several modifications in order to maintain ADHD services during the pandemic. The changes included massive increase in telephone and video consultation to limit direct clinician contacts. Only about a third of clinicians were aware of pandemic-specific guidelines.