by Project Leads – Professor Eleanor Scott and Professor Helen Murphy Professors of Diabetes and Maternal Health/Antenatal Care. A collaboration between: University of Leeds and University of East Anglia; NHS England Diabetes programme and NHS England Maternity programme; Diabetes Technology Network-UK (DTN-UK); Diabetes-UK; JDRF; National Pregnancy in Diabetes Audit (NPID); NHS Local Maternity Systems and NHS Diabetes in Pregnancy clinical teams across England
In our CONCEPTT trial we established that Continuous Glucose Monitoring (CGM) improved maternal glucose control and neonatal outcomes for pregnant women with Type 1 diabetes (T1D). Working with stakeholders across traditional boundaries we co-produced an implementation package delivering CGM to all pregnant women with T1D in England. To date, 98% of pregnant women with T1D have been offered CGM with no inequalities based on ethnicity or social deprivation. NPID data shows significant improvements in maternal glucose across pregnancy, and pre-term births, large-birthweight babies and neonatal care admissions have started to decline for the first time, saving the NHS ~£9.5 million/year.
"CONCEPTT-2-CARE was an excellent entry, with clear cost savings and it really looked at the national picture. It had well-articulated sustainability and is clearly replicable. The judges liked that it was open to all women, had a brilliant reach with informative user feedback. It was also impressive that other countries are now looking at replicating and genuinely has a commendable impact on diabetes care."
Intensive Support Package for Glucose Optimisation in Type 1 Diabetes During Pregnancy
by St Helens & Whiston Hospitals – Mersey & West Lancashire Teaching Hospitals NHS Trust
We recently introduced an intensive support package for pregnant women with Type 1 Diabetes. The package consists of a band 7 DSN dedicated to antenatal care, intensive band 7 dietetic input, weekly appointments, telephone support, longer appointment times, MDT meetings, mental health support, alongside provision of CGM. An audit was completed to establish if the package had increased the number of women achieving a 3rd trimester HbA1c of < 48mmol/mol and if it improved neonatal outcomes. Results show an increase in women achieving a 3rd trimester HbA1c of < 48, reduced number of babies with macrosomia or admitted to NNU at birth.
"St Helens & Whiston Hospitals have produced a project with a hollistic approach in a very deprived area that has literacy issues. The Quality and diversity section is very well done and the judges could see how this would be replicable in other areas. It is about the whole person and shows how a properly resourced service benefits outcomes."
Regional Peer Review in Kent and Medway Paediatric Diabetes Units: An Effective and Resource Efficient Model
by East Kent Hospitals University Found Trust
The four-paediatric diabetes units (PDUs) in Kent and Medway (Dartford, Medway, Maidstone & Tunbridge Wells, East Kent) piloted a regional peer review programme in 2021-22.
All four units responded positively to the reviews. One unit was required by the CYP diabetes network to provide an urgent action plan.
The review process delivered useful feedback within a reasonable resource commitment. The regional model simplified logistics of the review visits, promoted collaboration and allowed identification of regional themes. Oversight by the CYP diabetes network provided accountability for the PDUs following review.
The review process will be refined and repeated in 2-3 years.
"The judges liked the entry from East Kent Hospitals University Found Trust and could see the wider access dissemination opportunities. It is a well-rounded project and embodied the Type 1 Specialist Service category. It was very well-written and explained."
Enhancing Young Adult Services with Youth Work
Supporting people with diabetes to effectively self-manage their condition is key to reducing their psychological distress, improving self-management and achieving long-term health outcomes that benefit both the person living with diabetes and their wider healthcare and social systems. For vulnerable young people, the addition of youth work allows services to provide bespoke interventions that are tailored to the individual needs of young people, while working on a population level to increase education and management confidence through the use of resources that are developed for, and with, the young people who will use them.
"The judges liked what this project by BCUHB is doing by utilising youth workers, which was impressive. There is also important psychological support and it got individuals re-engaging in their diabetes care. It is important to have contact with this transition group and BCUHB provide a great service initiative with good qualitative detail."