Endocrine Abstracts

Introduction: The prevalence of diabetes continues to rise worldwide placing an increasing burden on the national health service. In 2012 a national Best Practice Tariff (BPT) was introduced in the UK and a National Peer Review Quality Assurance Programme was developed to drive improvements in diabetes care for children and young people. Our national audit from 2010 to 2018 aims to explore trends in paediatric diabetic care within the North West Diabetes Network and assess the impact of national quality initiatives.

Method: Data was collected from a regional survey in 2010, 2014 and 2018 from each of the 24 paediatric diabetes units (PDU) in the UK north west region for staffing levels. HbA1c outcomes were extracted from the National Paediatric Diabetic Audit (NDPA) for 2010–2019. We compared staffing levels with mean HbA1c and percentage of patients with HbA1C <58 mmol/mol in 2010, 2014 and 2019. Data was analysed using SPSS 24.0 statistical package.

Results: There was a significant increase in staffing levels for dedicated admin staff (P <0.01), consultants (P= 0.05), dieticians (P<0.01), specialist diabetes nursing staff (P<0.01) and psychologists (P<0.01) across the network from 2010 to 2014 following BPT. However, between 2014 to 2019, there was only a significant increase in staffing for administrative support (P=0.04). The mean HbA1C from PDUs and percentage of patients with HbA1C <58 mmol/mol were significantly improved between 2010 to 2014 but not from 2014 to 2018.

Conclusion: There had been a significant increase in staffing following BPT in multidisciplinary diabetes teams across PDUs between 2010 and 2014 with similar improvements seen in HbA1c outcomes. However, between 2014 and 2019, staffing was only significantly increased for administrative support while mean HbA1c were not significantly improved. The audit shows that the driving force to produce better health outcomes does not solely depend on staffing levels of PDUs. In 2019, a UK National Quality Improvement Collaborative Programme was developed to support PDUs to transform their service using proven quality improvement methodologies. Tracking of national quality indicators and surveillance of staffing levels are essential in further understanding the role that quality initiatives play in driving better outcomes for diabetes care.