Endocrine Abstracts (2011) 27 P65

Assessment of standards of care in children's diabetes services across Yorkshire and Humber SHA

Philip Holland1, Katie Harron2, Fiona Campbell1 & Roger Parslow2

1Leeds Teaching Hospitals Trust, Yorkshire, UK; 2University of Leeds, Yorkshire, UK.

Background: A children’s diabetes network was established in late 2008 across the Y&H SHA. Following agreement from all units over 2009/10 it identified outcome measures and established policies leading to 2011 being a ‘Year of Action’ to produce significant improvement in services.

Methods: All units were required to submit annually to the NDA and to complete an extended version of the 2008 Diabetes UK questionnaire on staffing. Data from the 2008/9 and 2009/10 NDA, together with the Staffing Survey and the established paediatric register were independently analysed by the Paediatric Epidemiology Unit University of Leeds. A resource score was developed based on recommended staffing levels.

Results: Details from 21 units and 2421 children with diabetes were collected. No unit achieved maximum resource score of 15 (mean 9.1 range 6.5–12). There was no significant difference in resources across units but outcomes varied significantly with the number of children with HbA1c <7.5% ranging from 3 to 30%.

HbA1c was adversely influenced by: i) age at diagnosis: with each additional year of age at diagnosis resulting in an increase of 0.01–0.02; ii) duration of diabetes: with each additional year resulting in a 0.12 increase and iii) deprivation: with a 0.78 increase from the least to most deprived in HbA1c.

Units with better outcomes and higher % of HbA1c <7.5% had better control from diagnosis and higher % on MDI/pumps although there was a wide range across units.

Conclusion: Although there is a significant issue of resource across all units, there was a wide variation in outcome between units. The Y&H SHA Project Board are embarking on a ‘Peer review’ programme to help units learn from each other and identify ways forward to improve diabetes services.

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