Endocrine Abstracts

Objectives: Best practice tariff guidelines recommend that paediatric patients with diabetes should have a minimum of four MDT clinic appointments, and an additional eight contacts with the diabetes service per year. This audit compares performance in a DGH against these recommendations. It seeks to determine whether there is a correlation between amount of contact with the service and average HbA1c level.

Methods: Analysis of a database recording contacts with a total of 159 children between April 2014 and March 2015.

Results: Of the 159 patients, 21 (13%) were newly diagnosed, 19 (12%) were transitioning to adult services, and one had care shared with another hospital. These were analysed separately. For the remaining children the median total number of contacts per year was 23. The median number of MDT contacts was 4/year, and of additional contacts was 18.5/year. Additional contacts included telephone calls, texts, school visits and home visits. 93% of these children were offered at least four MDT appointments per year, 100% were offered at least eight additional contacts with the service, and 100% had a total of at least 12 contacts. The median HbA1c was 61 mmol/mol and 35% of patients had HbA1c <58 mmol/mol (i.e. good control). There was no correlation between median HbA1c and total number of contacts per year (P=0.18).

Conclusions/recommendations: Compliance with best practice tariff guidelines was achieved in the majority of cases, although 7% were offered less than four MDT clinic appointments per year. In addition patients received on average 11 more contacts per year than the minimum requirement (these were mostly ‘additional contacts’). There was no correlation between average HbA1c level and number of contacts per year. More comprehensive routine data collection will allow further analysis of the contacts taking place to ensure quality as well as quantity.