Endocrine Abstracts

Enhanced community care (ECC) for type 2 diabetes mellitus (T2DM) is a new initiative in Ireland. ECC involves episodic community-based consultant-led multidisciplinary care that supports general practitioner (GP)-delivered chronic disease management (CDM, available to patients with a medical or GP visit card). The Dublin North West (DNW) hub was the first fully operational hub. This study focuses on its inaugural year of activity. The study goals were to report on hub referral patterns, the characteristics of the patients referred, rates of eligibility for CDM and the impact of hub activity on acute hospital waiting lists. A retrospective analysis of patient charts and hospital databases was conducted for all patients referred to the DNW hub between March 2023-2024. Of the 204 referrals received 67% of patients were re-directed from acute hospital waiting lists, 22% were referred by GP’s and the majority of other referrals were internal from other sources within the hub. The average wait time to be seen was 8.57 weeks and 19.6% of patients failed to attend their initial appointment. Of those patients who attended, 44% were female and 56% were male with an average age 56.2 years, and only 46% were eligible for CDM. The numbers of patients waiting for a diabetes appointment in Connolly Hospital decreased by 61% over the time period, with the average waiting time decreasing from 11 to 5 months. The study offers novel insights into community hub-delivered T2DM care in Ireland. It demonstrates a clear reduction in waiting times for the acute hospital diabetes clinic and faster access to specialist diabetes care. The greatest source of referral was the hospital waiting lists. Notably, a significant number of patients did not have eligibility for CDM which may over time lead to patients with uncomplicated T2DM remaining within acute hospital clinics for financial reasons.