Endocrine Abstracts

Following approval of NHS England Equitable Funding we recruited one WTE Family Support Worker and 0.2 WTE Specialist Dietitian, from April 2023 to March 2024. These resources were utilised to support advanced diabetes technology use in Rotherham’s most deprived population and support best outcomes. Additionally our focus was to maintain the improvements in glucose management, beyond onboarding. The workforce standards for children and young people’s diabetes services were published in February 2024, 10 months into the project, which recommended the minimum staffing levels based on caseload numbers, and supports the requirement for one WTE Support worker and additional Dietitian time for the Rotherham caseload. Key FSW roles included: planning and initiation of the technology start pathways; signposting/demonstrating technology resources and equipment; supporting families and CYP to connect technologies to data platforms and provide ongoing technology trouble shooting advice; reviewing ‘Time in Range’ (TIR) data to highlight those CYP requiring earlier intervention than their planned appointments; providing individual support to struggling CYP and their families and those not engaging with the service; preparing data and information for clinic reviews. The FSW continues to allow capacity for the PDSNs to focus on new technology starts, clinical support and reviews. The additional Specialist Dietitian role included: contact with all CYP and families prior to HCL starts with a full dietary and carbohydrate counting review; production of a simple leaflet ’Getting the Most out of Your HCL’; additional dietetic appointments for those with deteriorating TIR or requiring additional advice; support and guidance to FSW and data collection/report updates.

Results: 70 CYP have started HCL since July 2023. HbA1c data available for 49 of the CYP before starting HCL: Mean 59.3 mmol/mol. and median 59 mmol/mol and 3 months after starting HCL: Mean 51.4 mmol/mol. and median 51 mmol/mol. 29 CYP with HbA1c data at 6-10 months after HCL: Mean 50.9 mmol/mol.; Median 48 mmol/mol. This project demonstrates the value and importance of skill mix in a CYP Diabetes Team and the quantitative and qualitative benefits of ongoing support for CYP and their families, in high deprivation, to implement advanced technology.