Endocrine Abstracts (2011) 27 OC5.3

Use of Peer review to help individual units and networks improve standards of care

Fiona Campbell1, Philip Holland1, James Heasman2 & Ruth Bridgeman2

1Leeds Teaching Hospital Trust, Leeds, UK; 2Cancer Peer Review Team, London, UK.

Background: A detailed assessment of children’s diabetes services across 21 units in the Y&H SHA identified a significant variation in care with the number of children with an HbA1c <7.5% ranging from 3 to 30%. This variation could not be explained by demographics or resource.

Methods: Agreement was obtained from three units in Yorkshire to pilot a Peer review visit in conjunction with the national Cancer Peer Review Team and too develop the methodology for Peer review of Children Diabetes services. All three teams were given appropriate support and asked to submit an annual report, operational policy and supporting documents in advance to a trained review team. The chief executive of the trust was informed and half a day was allocated for the visit.

Results: Three children’s diabetes services were visited over a 3 day period. I team was identified as the highest performing in the region and two teams who acknowledged they were struggling to improve services. The high performing team had clear governance structures with clear operational policies, downloaded all meters and pumps at the beginning of clinic, had 40% of patients on pumps and 100% on multiple insulin regimens. One of the two teams was identified as having major concerns over dietetic support which was highlighted to the chief executive; both teams had low levels on multiple insulin injections and pumps and had struggled to introduce these to the services due to workload. I team had significant level of deprivation. In neither team had the directorate clearly supported them to improve.

Conclusion: All teams acknowledged the importance of Peer review and felt that it had helped to structure their service and identify a way forward. Peer review is being planned for all services in Y&H region.

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