GIRFT and NHS Diabetes Programme launch new specialty review into services for children and young adults living with diabetes

A national review of services for children and young adults living with diabetes is about to begin, in a joint initiative between the Getting It Right First Time (GIRFT) team and the NHS Diabetes Programme. The new workstream aims to tackle variation in care and outcomes between and within Integrated Care Systems (ICSs) in England, working to identify challenges and opportunities, and developing recommendations for improvement. A particular focus will be on workforce and on reducing health inequalities for children and young adults (CYA), including in access to technology, transition from paediatric to adult services. The work will be led by Fulya Mehta, NHS England’s National Clinical Lead for Diabetes in Children and Young People and a consultant in paediatric diabetes at Alder Hey Children’s Hospital in Liverpool, and recruitment is underway for a GIRFT CYA diabetes advisor to support delivery of the workstream.

“Reducing variation across health systems is a national priority and one of the key areas of focus for the children and young adults diabetes programme. We are confident this partnership approach between GIRFT and the NHS Diabetes programme can support systems to identify opportunities to improve care and outcomes in this area, with its focus on tackling health inequalities, supporting equitable access to treatment technology and improving transition and young adult care for young people living with diabetes.”

GIRFT’s national report for diabetes (2020) highlighted variation in the provision of transition services to help young people living with diabetes move out of paediatric and into adult care. This can result in young adults losing touch with their type 1 diabetes service, resulting in poorer outcomes such as completion of care processes and achievement of the HbA1c treatment target, as well as a higher rate of admissions for 19 to 25-year-olds as a result of diabetic ketoacidosis (DKA).

In addition, data from national audits shows that completion of key health checks, achievement of treatment targets and uptake of technology between paediatric diabetes units (PDUs) varies within and between regions.

The new GIRFT/NHS Diabetes Programme ‘gateway’ reviews will cover care for those up to the age of 25, and will bring together colleagues from paediatric, young adult and adult services with Integrated Care Board (ICB) commissioning leads and key decision makers for discussions about local challenges and how they might be overcome, based on a core set of data and metrics.

A GIRFT questionnaire will be circulated to all units and ICBs in advance of each visit. Following an initial pilot phase, the full programme of GIRFT gateway reviews is expected to begin in Spring 2024.

“One of the key focus areas of delivery of care in type 1 diabetes is enabling all children to have access to Hybrid Closed Loop (HCL) technology. This workstream will be pivotal to this work, ensuring this happens irrespective of deprivation, ethnicity, or postcode.”

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