ESPE Abstracts

Background: Type 1 diabetes mellitus (T1DM) continues to pose serious health risks with devastating long-term complications. UK management and control of T1DM in children and young people (CYP) remains amongst the poorest in Europe and significant variations in diabetes health outcomes are evident. In 2012–13 a Best Practice Tariff (BPT) for paediatric diabetes care was introduced and a National Peer Review Quality Assurance programme (DQuINS) developed. Both were developed to drive improvements in paediatric diabetes care.

Objective and hypotheses: To explore trends in paediatric diabetes care within the CYP North West Diabetes Network, UK and to assess the impact of national initiatives on health outcomes.

Method: Data was collected from each paediatric diabetes unit (PDU) in the region and extracted from the National Paediatric Diabetic Audit (NDPA) from 2010 to 2014. We compared staffing before and after the national initiatives, and values for mean HbA1C and percentage of patients with HbA1C <58 mmol/mol. Data was analysed using paired student T-tests.

Results: Data was received from all 28 PDUs for staffing levels before and after BPT and DQuINs. There was a significant increase in admin staff (P<0.001), consultants (P=0.03), dieticians (P<0.01), specialist diabetes nurses (P<0.01) and psychologists (P=0.01) across the network. Data was extracted from the NPDA for the years 2010–11, 2011–12, 2012–13 and 2013–14. There was statistically significant improvement in percentage of HbA1C <58 mmol/mol when compared for each successive year to 2010–11. The mean HbA1C was significantly improved for each year compared to 2010–11 prior to the national initiatives

Conclusion: There have been significant increases in staffing dedicated to the care of children with diabetes across the North West UK following DQuINS and BPT, as well as significant improvement seen in HbA1c. Set standards for paediatric diabetes care and appropriate staffing levels are critical to delivering good service and improving health outcomes.