Endocrine Abstracts (2008) 17 S11

Diabetes care: first steps in crossing the quality chasm

P Hindmarsh

Institute of Child Health, London, UK.

As medical science and technology have advanced health care delivery particularly in diabetes has struggled to provide consistent high quality care. The document ‘Making every child and young person with diabetes matter’ provides the overarching direction in which health care should move. The challenge now is to execute the task at the regional and local levels. Diabetes is a classic chronic disease that requires continuous monitoring/input, involves different specialities and a high level of patient/parent involvement. Although the complexity is acknowledged in practice there is little evidence that health care systems really understand these complexities and tend to go on providing the same kind of care that was delivered 10–20 years ago without the benefit of complete and holistic information. Service provision in the United Kingdom still lags behind Europe, is prone to widespread inconsistencies in care delivery and outcomes and remains firmly medico-centric despite clear evidence that this approach is less than helpful. The Health care offered for children and adolescents with diabetes has safety and quality problems because the system that is utilised is largely outmoded. The poor design sets the workforce up to struggle or fail regardless of how hard they try. If we wish to advance the cause for Paediatric and adolescent diabetes then system redesign is essential and this will be the focus of this presentation.

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