GIRFT diabetes report issues inpatient recommendations

Calls have been made to ensure all trusts have a dedicated multi-disciplinary team of specialist diabetes inpatient practitioners.

The Diabetes GIRFT Programme National Specialty Report has made a series of recommendations to improve diabetes care.

This is because more than 90 per cent of people with diabetes in hospital are admitted for non-diabetes related conditions such as pneumonia, fractures and elective surgical procedures.

Despite that, they are usually treated by staff across various surgical and medical disciplines, who may not be experienced in diabetes care.

The report authors said they found “variation in the quality and availability of targeted diabetes inpatient services”.

A quarter of hospitals do not have a single diabetes inpatient specialist nurse, and as people with diabetes tend to stay longer in hospital the report has made suggestions which have been drafted to tackle these issues.

It is hoped by introducing a multi-disciplinary team that hospitals will be able to target help for people who are having problems on admission, implement an efficient referral system for cases needing specialist input, raise awareness of inpatient diabetes harms and how to prevent them and also provide basic psychological support for patients experiencing stress.

The report has also suggested trusts should work towards providing a seven-day service with at least one MDiT team member, such as a specialist diabetes inpatient nurse, being made available for part of the day on Saturday and Sunday, The authors said meant that “urgent cases can be seen by a diabetes specialist within hours rather than days”.

This report comes at a time when the NHS has undergone profound changes in response to the COVID-19 pandemic

Getting It Right First Time (GIRFT) is an NHS improvement programme delivered in partnership with the Royal National Orthopaedic Hospital NHS Trust and this latest diabetes report was published to mark World Diabetes Day 2020.

Professor Tim Briggs, GIRFT’s Programme Chair said: “This report comes at a time when the NHS has undergone profound changes in response to the COVID-19 pandemic. The terrible and unprecedented events of 2020 – and the extraordinary response from everyone working in the NHS – add greater significance to GIRFT’s recommendations, giving many of them a new sense of urgency.

“Recommendations in this report, such as systems to support virtual clinics, can help the NHS as it faces the substantial challenge of recovering services while remaining ready for any future surges, by operating more effectively and safely than ever before.”

Commenting on diabetes inpatient care, the report states: “We heard on our GIRFT deep dives that some trusts’ inpatient teams required further development, which is supported by 2017 NaDia data showing: One in six hospitals in England did not have a multidisciplinary foot care team; A quarter of hospitals did not have a single diabetes inpatient specialist nurse.

“Transformation funding since 2017 will have improved these figures, and the NHS Long Term Plan commitment for universal coverage of multidisciplinary foot care teams and diabetes inpatient specialist nurses will improve this further. This is reflected in our GIRFT recommendation.”

To access the report, click here.