Diabetes
The GIRFT diabetes workstream is focused on helping people with diabetes and their clinicians to better manage the condition and reduce avoidable harms.
The 2020 national report focuses on improving services for people with type 1 diabetes, and improving inpatient care and foot care for everyone living with diabetes.
Data-driven insight provided by the GIRFT programme’s methodology is helping to tackle one of the biggest health issues in the UK; it is estimated that more than 4.7 million people are living with diabetes and the number is growing, with diagnoses more than doubling in the last 20 years.
- Diabetes Clinical Leads
Professor Gerry Rayman MBE
Joint diabetes clinical lead
In addition to his GIRFT role, Professor Rayman has also been the national clinical lead for diabetes inpatient care and foot disease at NHS Diabetes and is the lead and innovator of the National Inpatient Diabetes Audit (NaDIA). He has also been chief medical advisor to Diabetes UK and is a past president of the endocrine and diabetes section of the Royal Society of Medicine. He is also Chair of Diabetes UK’s clinical study group for acute diabetes care.
With colleagues in the East Suffolk and Ipswich CCG, he was instrumental in developing the Integrated Diabetes Service in 2014, which has been a major success in improving the diabetes services for local people and recognised by a Healthcare Transformation Award for innovation in diabetes care (2016).
He has also developed the Diabetes Inpatient Care and Education (DICE) programme, which has significantly improved inpatient care at Ipswich Hospital and has won several awards including an HSJ Patient Safety Award in 2012.
He is clinical lead of Diabetes UK’s inpatient programme and co-author of Diabetes UK’s report Making Hospitals Safe for People with Diabetes.
Professor Partha Kar OBE
Joint diabetes clinical lead
Professor Kar is the NHS England GIRFT Type 1 diabetes and technology lead. He also holds a full time job as a consultant in Portsmouth.
Among his work, he has helped enable access to freestyle libre in the NHS, as well as ensuring continuous glucose monitoring (CGM) will be available for all Type 1 diabetes patients in pregnancy from 2020.
He has also led on developing the Language Matters document along with the Type 1 diabetes information portal on NHS Choices.
Locally, he helped develop the Super Six Diabetes model of care, adopted by many areas within the NHS, and is the co-creator of TAD talks (Talking About Diabetes) and the Type 1 Diabetes comic (Origins) – while also involved in setting up a Type 1 Diabetes information portal (T1resources.uk) and Type 1 diabetes: Rise of the Machines – looking at DIY technology.
Other work has involved negotiating changes to GP contracts based on frailty and revised diabetes targets, developing a virtual reality programme to improve hospital safety and starting work on increased mental health access for diabetes patients across the NHS.
Associated projects
- Improving perioperative pathways of people with diabetes – the GIRFT-led programme Improving the Perioperative Pathways of People with Diabetes (IP3D) is successfully helping to reduce complications for people with diabetes and the time they stay in hospital, through the use of a Perioperative Diabetes Specialist Nurse (PeriopDSN) to offer support and education to staff and patients, and a Diabetes Perioperative Passport, given to patients before surgery to help them prepare.
GIRFT programme for improving insulin management in the community
GIRFT’s quality improvement initiative aiming to improve insulin management in the community for patients living with diabetes – at the same time as offering a more efficient service for the NHS – is now being rolled out nationally.
Following an initial pilot of the GIRFT Community and District Nurse Insulin Programme (CADNIP), 20 Integrated Care Boards (ICBs) are now on board to take part in the scale-up of the initiative. An inaugural meeting was held in early December to present the background to the study and get feedback on the plans for data collection, implementation and evaluation.
CADNIP empowers community and district nurses to optimise glycaemic control through collaboration with community diabetes specialist nurses (cDSNs), helping to improve patient safety and reduce hospital admissions.
- Supporting national diabetes campaigns –Insulin Safety Week provided GIRFT with a valuable opportunity to promote best practice around the safe administration of insulin. In 2022, GIRFT produced some original assets, including an animation video, to encourage NHS trusts to adopt robust self-administration policies to support patient-safety and reduce unnecessary insulin errors.
- Developing simple self-care information for diabetic patients waiting for surgery – in 2021 GIRFT worked with a clinical team to produce a self-care digital leaflet for diabetic patients. The leaflet provided simple and straightforward clinical advice to support people with diabetes to stay safe at home while waiting for surgery or further investigative treatment.
- Summary of National Report Findings
Specialist inpatient teams recommended for every trust to help prevent errors and protect patients
Every hospital should have a specialist team dedicated to caring for inpatients with diabetes to help ensure their safety, according to a new national report.
Up to 20% of all hospital beds are occupied by patients with diabetes, although the vast majority (92%) are admitted for other conditions and illnesses. The report from the Getting It Right First Time (GIRFT) programme, published on the eve of World Diabetes Day (14 November, 2020), outlines how uncoordinated inpatient diabetes care and insufficient specialist staffing can result in complications for some patients, which lead to them staying longer in hospital or put them at higher risk of mortality.
- Diabetes emergency surgery pathway videos
The Diabetes Emergency Surgery Pathway, was developed as part of the Improving the Perioperative Pathways of People with Diabetes (IP3D) program. It is a set of resources and guidelines to improve care for surgical patients with diabetes, particularly in emergency settings as they await surgery.
Watch the video guides below, tailored for:
- Anaesthetists
- Emergency department
- Surgical doctors
- Surgical ward nurses
- Theatre staff
Anaesthetists
Emergency department
Surgical ward nurses
Surgical doctors
Theatre staff
Find out more about GIRFT’s data-led approach and best practice resources:
- Diabetes National Report
In November 2020, GIRFT published its national speciality report for diabetes:
Click above to view the pdf report
- Diabetes Report Video
Watch the video about the Diabetes report…
Click above to play the diabetes national report video
- Diabetes News
Diabetes Academy Resources
- Pathways
Diabetes Emergency Surgery Pathway >
Hyperglycaemia: Initial management of hyperglycaemia in adults in the emergency department >
Hypoglycaemia: Management of patients admitted with hypoglycaemia >
Foot problem: Management of patients presenting to the emergency department with a foot problem >
Interactive pathways for diabetes (plus safety checklist) >
Hypoglycaemia: Admit, observe or discharge – decision support tool >
Discharge support tool for new diagnosis of diabetes >
Discharge support tool for pre-existing diagnosis of diabetes >
- Guidance