Endocrine Abstracts

Inequalities due to poverty influences access to advanced technology and outcomes. The 2021-22 results of NPDA for our service, demonstrated that only 15% from most deprived families are using insulin pumps compared to 50% of Children and Young People (CYP) from least deprived areas. This improvement work was funded by the HNY ICB and the Children North East team provided the team training, conducted staff and user interviews and produced a comprehensive report which formed the basis for action plan for the team to address inequalities of care within the service. This improvement work was undertaken collaboratively through a programme of training, scoping, staff and user group consultations. The paediatric diabetes team implemented changes in 8 areas relating to access and care provision, including transport, technology, person centred care, appointments, food, prescriptions and additional costs/financing. This project had a positive impact on staff and their understanding of the challenges presented by poverty. It has challenged MDT members’ own bias, unconscious or otherwise, towards parents and families living in poverty. The positive impact of this improvement activity, along with other quality improvement initiatives within the paediatric diabetes team, was reflected in the 2022-23 NPDA data as below: 1. Improving equity of access to advanced technology for patients from more deprived and ethnic minority backgrounds. 39% of patients from most deprived background had access to insulin pump for 2022-23, compared to 15% in 2021-22. similarly, 60% of most deprived population is now using Continuous glucose monitoring devices, compared to 38% in 2021-22. 2. Excellent improvement in mean and median HbA1C for the patient cohort. The median HbA1C for our population for 2022-23 was 58 mmol/mol compared with 63 mmol/mol in 2021-22. This has moved our paediatric diabetes team from being a negative outlier on the national audit for past decade, to being one of the positive outliers. It is not easy to address all the inequalities within a system without significant investment. However the focused input by our team has led to a very positive outcome following this quality improvement activity.