Portsmouth Diabetes team identified inequity of care for diabetic inpatients as only a small percentage of those requiring specialist input were being referred.
To address this issue a new service was developed which allowed all patients with diabetes to be reviewed by a member of the specialist team.
This DIPPS service resulted in a number of improvements against performance indicators including reduction in length of stay, readmission rates, sepsis and intravenous insulin use. The service is currently being extended to include all surgical specialities as well as the initial four pilot areas.
Around 18 per cent of inpatients at Portsmouth Hospitals NHS Trust (PHT) have diabetes. Quality and experience audits revealed poor diabetes management and experience with worse outcomes for diabetic patients admitted for primary reasons other than their diabetes.
Patients with diabetes are twice as likely to be admitted to hospital and have lengths of stay twice that of non-diabetic patients and higher complication rates (NSF diabetes 2001).
Before November 2008 the diabetes team at PHT offered inpatient contact only in response to ward requests but only 10 per cent of patients with known diabetes in hospital were referred to the diabetes specialist team (DST) regarding their diabetes management, even if in difficulty and then generally too late to make a significant difference to their admission care.
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