Diabetes Workstream - Getting It Right First Time

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.

Professor Gerry Rayman MBE

Joint Diabetes Clinical Lead

Consultant physician at the Diabetes and Endocrine Centre and Diabetes Research Unit at East Suffolk and North Essex NHS Foundation Trust

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

Consultant in diabetes and endocrinology at Portsmouth Hospitals NHS Trust and NHS National Specialty Adviser for diabetes and obesity

Professor Kar is the National Specialty Adviser for diabetes and obesity with NHS England. 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.

Useful information

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.

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.

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.