Diabetes: Children and Young Adults (CYA)

GIRFT is working with the NHS Diabetes Programme on a national review of services for children and young adults living with diabetes.

The 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 is on reducing health inequalities for CYA, including in access to technology, transition from paediatric to adult services and workforce.

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.

Dr Fulya Mehta

CYA diabetes clinical lead

Fulya is the clinical lead for the national children and young adult diabetes programme at NHS England. She is a paediatrician working in a large diabetes unit at Alder Hey Children’s Hospital in Liverpool, caring for over 500 children and young people with diabetes. Her areas of interest include improving transition and young adult diabetes care and improving access to diabetes treatment technology.

Dr Dita Aswani

CYA diabetes clinical advisor

Dita has been a consultant in paediatric diabetes since 2012. She was clinical lead of the Derbyshire Children’s Hospital Service and vice-chair of the East Midlands CYP Diabetes Network from 2015 until 2021, when she joined Sheffield Children’s Hospital to additionally specialise in children’s obesity and complications from excess weight.

She was a Diabetes UK clinical champion between 2021-23, and an experienced peer reviewer for the Royal College of Paediatrics and Child Health (RCPCH) National Diabetes Quality Programme.

Dita holds a number of roles in paediatric diabetes and obesity. She sits on the National Paediatric Diabetes Audit (NPDA) methodology and dataset group, NICE committees for diabetes (NG18) and weight management (NG10182), and the Quality Standards Committee for obesity. She is a member of RCPCH Health Improvement Committee as assistant officer for nutrition and obesity, and represents the College on the National Child Measurement Programme (NCMP) board.

She is an NHSE regional clinical lead for children and young adults’ diabetes, has been on the editorial board of the RightCare toolkit for CYA diabetes and T2 e-lfh learning package. She is on the oversight board for Digibete, and has been a clinical lead for the YoungType2 platform. She is also a clinical co-investigator on the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research (HSDR) funded ENHANCE study – evaluating the NHSE complications from excess weight clinics.

Practical steps for improving care and support for children and young adults living with diabetes

Practical steps to help ensure that every child and young adult living with diabetes in England receives high-quality care and support, regardless of where they live, are outlined in the GIRFT’s national report for diabetes: children and young adults (CYA).

The report offers the most comprehensive national picture to date of how diabetes services for CYA aged 0-25 are organised, how care and outcomes vary, and what systems can do to adopt best practice and deliver equitable, modern care. It brings together the findings from a far-reaching national review of all 42 Integrated Care Boards (ICBs); a joint initiative between GIRFT and the NHS Diabetes Programme. 

CYA Diabetes Academy Resources

Ethnic variation in length of stay for diabetes emergencies>

Reducing emergency admissions in young adults with diabetes >

Increasing CYP diabetes technology use by utilising an Urdu family support worker >

Reducing DNA rates for new patients and minimising follow-up waiting times at Mersey & West Lancashire Teaching Hospitals NHST >

Tackling inequalities to accessing diabetes technology across North East and North Cumbria >

Seamless transition clinic : supporting young adults with diabetes at Mersey & West Lancashire Teaching Hospitals NHST >

National paediatric diabetes audit care completion at George Eliot Hospital NHST >

Enhanced accessibility and support for young adults with diabetes at Mersey & West Lancashire Teaching Hospitals NHST >

Mental health screening of young adults with diabetes at Mersey & West Lancashire Teaching Hospitals NHST >

Promoting personalised care through pre-clinic questionnaire at Mersey & West Lancashire Teaching Hospitals NHST >

South Yorkshire ICB approach to improve care for people with early-onset Type 2 diabetes (EOT2D) through targeted support >

CYP Diabetes Team start all CYP with new T1 diabetes on hybrid closed loop at diagnosis >

Improved outcomes for young people aged 16-25 with type 1 diabetes in Sheffield – a collaboration between adult and paediatric services >

Improving equity and outcomes through a high-throughput hybrid closed loop initiation pathway >

Removing the barriers in hybrid closed loop approval for high-risk young people with type 1 diabetes >

The Effect of a Dedicated Diabetes Young People’s Service on Hybrid Closed Loop >