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New diabetes care standards introduced

Children and young people with diabetes should expect big improvement in care

Mark Gould

Monday, 02 April 2012

From today every child and young person with diabetes in England can expect an improvement in their level of care as a landmark funding agreement for paediatric diabetes services comes into force.

Set by paediatric doctors, nurses and commissioners, working in partnership with NHS Diabetes the Best Practice Tariff for Paediatric Diabetes sets out 13 mandatory care standards for paediatric diabetes service teams to meet.

Providers who can prove they meet these levels of care will qualify for greater funding. The Department of Health says services unable to achieve these standards will be supported to improve but face having their funding withdrawn if unable to reach the required level by April 2013.

The 13 standards of new Best Practice Tariff for Paediatric Diabetes include:

  • Every child or young person with diabetes will be cared for by a specialist team of health care professionals (consisting of a doctor, a nurse and a dietitian as a minimum) who have specific training in paediatric diabetes.
  • The doctor must be a consultant or speciality doctor with training as detailed by the British Society for Paediatric Endocrinology and Diabetes, the nurse must be a paediatric nurse with training in children’s diabetes as detailed by the Royal College of Nursing and the dietitian must be a paediatric dietitian with experience and/or training in diabetes. If the doctor is a Specialist Registrar who wants to specialise in paediatric diabetes, they must be supervised by the consultant or speciality doctor.
  • When a new diagnosis of diabetes is made in a child or young person, this must be discussed with a member of the specialist team within 24 hours of the diagnosis. The child or young person and their family must be seen by a senior member of the specialist team on the next working day.
  • Every child or young person with diabetes must be offered at least four clinic appointments a year with the doctor and specialist team.
  • The HbA1c (long term blood glucose measurement) must be checked at every clinic visit and the result available in clinic for the appointment. It is recommended that this is checked at least four times a year.

NHS Diabetes Paediatric Network Clinical Lead and Consultant in Paediatric Endocrinology and Diabetes, Dr Tabitha Randell, who led the initiative, said: “Our Paediatric Diabetes Networks have been working hard with the Department of Health’s PbR2 team over the past 18 months to ensure the introduction of our tariff.

“Looking to the long term, we hope the changes to the financial levers will lead to an improvement in the care and outcomes for children and young people with diabetes. This should then result in a reduction in costs to the service, in levels of emergency hospital admissions among children with type 1 diabetes, and in the incidence of life-changing, yet often preventable, complications associated with the condition.

Anna Morton, Director of NHS Diabetes, said: “Outcomes for children with diabetes in this country compare poorly to the rest of Europe. We will show that with a proper funding mechanism and access to expert support, providers can improve, and unacceptable variations in care can be addressed.  

“We are encouraging all paediatric providers, particularly those in poor performing areas, to engage with us to ensure our standards are met, and that every child, no matter where they live, receives the care and support they deserve.”

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