Endocrine Abstracts

Objective: To describe the changes in out-of-hours emergency advice to families of children with diabetes over the last 15 years, the reasons for change and impact on hospital attendance.

The local emergency clinical helpline for children with diabetes (DiabNet) was discontinued in August 2015. We have looked at its service and how it informed the support we deliver today, especially out of hours advice provided currently by paediatric registrars.

Background: DiabNet was established in 2000 as a collaboration between three Scottish Health Boards: NHS Tayside, NHS Forth Valley and NHS Fife. This helpline was staffed by Paediatric Diabetes Specialist Nurses using shared protocols and guidelines and was initially open 24 hours a day, 7 days a week. Over the years, it evolved to offer a more tailored service, as changes in diabetes management led to families being better equipped to manage most situations.

Eventually, Diabnet helpline was discontinued as its usage decreased over the years. Families now contact the paediatric registrar on-call for emergency advice. To support this change, registrars were trained using interactive teaching sessions, flow charts on intranet and a call proforma to ensure a standard approach. Completed forms are used for audit and training purposes.

Results: There are 223 children with type 1 diabetes in NHS Tayside. There were approximately 120 calls to the helpline per year. 32 calls were made in NHS Tayside 2014-15 (< 1/week). 35 out of hours calls were logged in the 8 months since withdrawal of the DiabNet helpline, 3 of which resulted in admission.

Conclusion: Recommendations from NICE in 2015 suggest that 24 hour emergency advice be available to families of children with type 1 diabetes from “their diabetes team”. Few units would be able to support this and paediatric trainees have limited exposure to childhood diabetes. With our current approach, early results suggest that safe and effective advice can be provided by medical trainees with no increased rate of hospital attendance.