Diabetes Digital Monitoring: Building Back Better to Support Nursing Teams, Reduce Healthcare Inequalities & Empower Patients
By University Hospitals Coventry & Warwickshire NHS Trust
Inpatient flash glucose digital diabetes monitoring has been implemented across the NHS Trust.
This approach was designed in response to COVID-19 and achieved across a tertiary hospital, with
devices offered to 350+ patients at the pandemic peak. The innovation allows closer monitoring of
glycaemic control for at-risk patients with diabetes and COVID-19, empowers patients to manage
their sugar levels, reduces inequalities in access to diabetes technology, supports overworked ward
nursing teams and reduces exposure of staff to COVID-19. Patient and staff feedback was positive.
"The judges agreed that this entry was admirable as it seemed really simple when first read, but is easily scalable and leaves you thinking 'why has no-one done this before?'. The project was clearly impressively organised and coordinated, with evaluation very well planned. It achieved an impressive amount, including low-cost online training, improved patient comfort (feedback like patients not having to be 'manhandled' for finger pricks or woken up during the night) and empowerment, while reducing pressure on scarce nursing time and reducing risks of exposure. It was also impressively cost-effective. With regional dissemination and ongoing funding already in place and clear plans laid out for further national and international reach, this project, born out of a clearly identified need during a pandemic, also makes a strong case for reducing the existing digital divide. The judges look forward to hearing about future developments and achievements of this impressive work."
Validation and feasibility of a postal system for remote monitoring of HbA1c
By East Suffolk and North Essex NHS Foundation Trust Ipswich Hospital
Haemoglobin A1c (HbA1c) measurement is important for monitoring glycaemic control in
people with diabetes (PWD) but, during the COVID-19 pandemic, access to an up-to-date HbA1c
measurement for PWD was challenging. An innovative and cost effective at-home capillary blood
collection system was needed, which was accurate, reliable and user friendly for patients. After
development and validation, 286 postal HbA1c kits were sent to PWD in October-December 2020.
The return rate was 87%. Subsequently the project has been integrated successfully into the
diabetes service and 905 kits have been sent to PWD, with an encouraging return rate of 80%.
"This is a great example of a project implemented during COVID restrictions, but has ongoing value even after restrictions have been lifted. It is mainly feasible in specialist teams who have existing equipment for HbA1c testing, although this may mean that seeing people face-to-face (typically more complex) is preferable. Impressive validation work. It has excellent clinician feedback with evidence of sustainability."
The only DSN in the Village
By Medway NHS Foundation Trust
Diabetes care in Medway was improved by providing specialist care within the GP surgery. This
reduced waiting times for appointments, duplication, and delays to prescriptions, speeded
referrals, and improved communication between services. A diabetes specialist nurse (DSN)
was seconded from secondary care into a primary care network as a pilot project for two
years. The main requirement was to assess patients with HbA1c above 75 mmol/mol. Within 12
months the HbA1c of 159 patients was reduced by between 9-95 mmol/mol, and at 18 months
the DSN had reduced the overall HbA1c by 9 mmol/mol per patient across nine practices.
"The judges liked the idea behind this entry from Medway NHS Foundation Trust, which showed a great amount of work done primarily by one person. It was phenomenal and reached a lot of people, plus offering education for the staff. It was innovative and worked. "