Endocrine Abstracts

Introduction: 25 314 children and young people <18 years with diabetes in England and Wales have been looked after in 178 paediatric diabetic units (PDUs) across the country. In 2012–2013, BPT has been introduced with 13 mandatory requested criteria, one of them is; each patient should have an annual assessment as to whether input to their care by a clinical psychology input is needed, and access to psychological support as appropriate. Therefore we aimed to study the impact of this criterion on PDUs.

Methodology: Online survey was cascaded to diabetic lead consultants via diabetic network managers. Data collected in Spring 2014 and analysed in Summer 2014.

Results: Fifty eight units responded across England. They serve 9817 diabetic children. 51 were district hospitals (88%) and seven tertiary centres (12%). Ratio of a psychologist to diabetic children ranged from 0 to 1:350. Median ratio of psychologist to diabetic children was 1:130 in district hospitals and 1:100 in tertiary centres. 14 PDUs (13 district hospitals) have not had psychological assessment for all their diabetic children. Other 40 PDUs have been referring to psychological services; majority (54%) were referring more than 2 years ago, 34% between 1 and 2 years ago and 11% started referring just over last year. Most of units (67%) were referring to Children and Adolescents Mental Health Services mainly when problems arise. Since introduction of BPT, 91% of PDUs have made some change to their provided service, either by recruiting new psychologists to their teams (48%) or increasing the sessions of psychologists (43%). Psychological assessment at time of diagnosis has raised from 18.9 to 58% before and after BPT respectively, so the routine/annual assessment from 10.3 to 55.1%.

Conclusion: Majority of units either recruited new psychologists or increased sessions following BPT. More impact on district hospitals compared to tertiary centres. The psychological support is going to be provided more at diagnosis and annually.