BSPED2014 Poster Presentations (1) (88 abstracts)
The effect of the introduction of best practice tariff for paediatric diabetes care on service provision and staffing in the West Midlands
Melanie Kershaw , Marie Atkins , Chizo Agwu , Alison Bone , Sabrina Brown , Jennie Brown , Frank Hinde , Kathryn McCrea , Raffeeq Parakkal , Ash Reynolds , John Scanlon , Gill Salt , Paitra Sparkes & Heather Stirling
West Midlands Paediatric Diabetes Network, West Midlands, UK.
Objectives: The Department of Health introduced a Best Practice Tariff (BPT) to finance Paediatric Diabetes Services in England, in response to variation in service provision and outcome. The tariff became mandatory in April 2013 and depends on achievement of 13 quality standards (QS). The West Midlands (WM) Region covers an area of 5020 square miles, where 2700 Children with Diabetes receive care from 15 Hospital Trusts who are members of the Regional Paediatric Diabetes Network (WMPDN). The WMPDN, works to ensure services are supported to achieve QS and undertook a regional peer review of diabetes care across the WM.
Aim: To determine the impact of BPT on compliance with the 13 QS and staffing of services.
Methods: A questionnaire survey was conducted of lead clinicians at each Trust pre and 6 months post BPT introduction to assess compliance with QS and determine staff ratios of Consultants, Diabetes Nurses (PDSNs), Dieticians and Psychologists.
Results: A 100% response rate was achieved. Less than 80% compliance with six of the QS was observed pre BPT; including an inability to:
i) offer four HbA1c measurements per year,
ii) discuss a newly diagnosed child with a senior diabetes team member within 24 h of diagnosis.
iii) offer at least eight additional contacts for every patient per year,
iv) offer an annual additional dietetic appointment,
v) provide 24 h advice to parents and health care professionals.
vi) offer annual screening.
6 months following BPT Trusts reporting compliance increased to over 80% for ten out of 13 QS. 8/15 Trusts comply with over 90% of QS, compared to 2/15 trusts pre BPT. There were significant improvements in staffing ratios of PDSNs, dieticians, and psychology provision.
Conclusions: Introduction of the Best Practice Tariff has facilitated investment in paediatric diabetes services in the WM improving staffing levels and compliance with QS.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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