Endocrine Abstracts

Background: The merging of hospital trusts resulted in 2 Paediatric Diabetes services within one Trust, but within separate networks. Care was not equitable between the 2, with inequitable staffing, difficulty in recruitment and low use of diabetes technology. An organisational change process in December 2022, highlighted the need for one merged diabetes service, with the Paediatric Diabetes Nursing and Administration Service working cross-site. The combined patient caseload was approximately 450. There were no additional finances available.

Methods: Professionals from the MDT on both sites held organisational meetings to agree a joint purpose, pathways and workforce. This required a change in the structure of the nursing and administration team, with the addition of a band 4 educator and band 8 paediatric diabetes nurse practitioner. Improving access to diabetes technology at one site was identified as a priority.

Results: Following the service restructure, staff retention improved and vacancies were quickly filled. Services were aligned across site including clinics and escalation processes. Pathways and Guidelines were merged. Access to technology has improved. Derby insulin pump use is up to 63% from 49% (95% of these pump patients are on Hybrid closed loop HCL). Burton pump use is up to 50% from 21% (87% of these are HCL). The 2 services are now within the same diabetes network.

Conclusion: Utilising best practice from each site and implementing this through a new staffing model capitalised on the high standards of each service and successfully delivered this through cross site working. A quality improvement approach enabled decisions to be made and changes implemented quickly.