ESPE Abstracts

Background: The Best Practice Tariff (BPT) was introduced in England in 2011–2012 to improve paediatric diabetes care. An enhanced amount is paid based on the attainment of 14 standards.

Objective and hypotheses: We describe the experience of a District General Hospital working with the new Tariff, including the structural changes and the effect on diabetic control.

Method: We observed the changes to the local service since the introduction of the BPT. We analysed unit-wide HbA1c data. We conducted a retrospective audit examining specific cohorts of patients. Group A were children diagnosed 2008–2009; we collected data from this group between April 2010–March 2011 (pre-BPT), and April 2014–March 2015 (post-BPT). Group B were children diagnosed 2012–2013; we collected data from this group between April 2014 and March 2015 (post-BPT).

Results: The funding received per patient per year has increased to £2988. This has enabled the diabetes team to expand to include an extra dietician, family support worker and shortly a clinical psychologist. The average HbA1c within the unit has fallen. Within the audit cohorts, there were 19 children in group A and 32 in group B. Post-BPT all children were offered four multi-disciplinary team (MDT) appointments and 69% had another eight contacts through the year. Pre-BPT only 74% were offered four MDT appointments and none had a further eight contacts in the year. The average HbA1c increased in group A despite the introduction of the BPT (8.64% pre-BPT, 9.18% post-BPT). However, the average HbA1c in newly diagnosed patients fell following introduction of the BPT (8.36% in Group B post-BPT vs 8.64% in Group A pre-BPT).

Conclusion: The introduction of the BPT has increased the funding and improved the care that we deliver to our children. This is demonstrated in the reduction in HbA1c across the unit, and in newly diagnosed children.