Patient Care Pathway – Children, Young People and Emerging Adults

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Introducing dedicated annual review clinics for children with T1DM

by Paediatric Diabetes Team, Gloucestershire Hospitals NHS Foundation Trust

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In 2014 the diabetes multidisciplinary team at Gloucestershire Royal Hospital Foundation Trust introduced a dedicated annual review clinic for children over the age of eight with type 1 diabetes. It involves a three-hour afternoon clinic visit, retinal screening and an onsite nurse-led phlebotomy service. Children are offered their consultant appointment, foot check, retinopathy screening and annual review bloods. They are also encouraged to participate, alongside other patients and families, in structured education sessions delivered by specialist nurses and diabetes dieticians. The sessions have evolved in response to ideas, experiences and questions from patients and their families - who have indicated they value the service highly.

Judges comment:

"Excellent aims and planning, particularly regarding the content and style of education based on user views and acknowledging that parents and young people have different opinions. This is a solid initiative in service redesign for young people and has also improved glycaemic control, thus preventing further complications."


Diabetes transition from paediatrics to adult services

by Isle of Wight NHS Trust

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Isle of Wight NHS Trust patients transitioning from paediatric to adult diabetes services were largely lost to follow-up and many found the process intimidating. The healthcare professionals now work together as a multi-disciplinary team to ensure the transition is a smooth, planned and supported process at an age-appropriate time. Joint transition clinics with the PDSN and adult DSN are provided, allowing young adults transitioning to meet the DSN to discuss any issues or concerns they have regarding the process. The young adult is communicated with as an equal and information is shared to enable an informed decision. Six months after transition young adults are invited to meet the consultant in a joint clinic with the DSN. Since this process began in 2010, 94% of young adults have successfully transitioned.

Judges comment:

"This is a good transition model and great to see the patient “in the driver’s seat” when planning the service, as well as consulting young adults who had already been through the process. The audit results were very impressive."


Diabetes services for adolescents and young adults – transition and beyond

by ENHIDE (East and North Herts Institute of Diabetes and Endocrinology) – East and North Herts NHS Trust

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Collaborative working between paediatric and adult diabetes services remains fragmentary and successful transfer onto adult diabetes services is an exception. To combat this East and North Herts NHS Trust used two under-resourced teams in separate acute Trusts to create a unified model of transitional care for young patients aged 16-19 in a single Trust, whose diabetes information systems capture both out-patient and emergency hospital activity. The service’s evolution has taken over 20 years, but has demonstrably improved health outcomes into adulthood. A telehealth project will utilise text and Skype technology and be led by a young persons’ worker and Diabetes Specialist Nurse.

Judges comment:

"This is a great initiative focusing on a complex area of care. It is  a strong example of adopting best practice, showed good collaborative work and has been well-evaluated."

Quality In Care Diabetes

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  • 2023 KEY DATES
  • Open for Entry:
    Thursday 27 April 2023
  • Entry Deadline:
    Friday 7 July 2023
  • Judging Day:
    Tuesday 8 September 2023
  • Awards Ceremony:
    Thursday 12 October 2023