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Endocrine Abstracts (2014) 36 D1.1 | DOI: 10.1530/endoabs.36.D1.1

University College London, London, UK.


Paediatric diabetes is essentially a hospital based service with opportunities for care delivery in settings such as the home, school and community based organisations. The delivery of care (as defined in part by HbA1c) varies throughout the UK. Factors influencing this include varying staffing levels and skill sets along with social deprivation and ethnic diversity and attaining a standard of equitable care is a major challenge. The fundamental issue is not whether care is delivered centrally or not but whether that care is of value to the patient. This means moving from a supply driven health care system organised around what physicians do to a patient-centred system organised around what patients need. To achieve this organisation into integrated practice units (IPU) of about 500 patients is a proven way to improve outcomes. An IPU is patient centric and results driven, focused on best way to deliver care using interdisciplinary groups, manages information, integrates decisions, and ensures continuity, is responsible for the whole cycle of care even if other entities are involved and the staff work exclusively in diabetes. The benefits for the patient are a partnership of excellence serving them, care delivered using state-of-art facilities and technologies, expertise always available when needed by the patient or their family, continuity of care and scale that allows development of dedicated teams rather than part time practitioners with shorter wait times and convenient booked appointments. For the clinical service common management allows for unified process of care, shared staff training developing skilled teams, strong governance, efficient division of labour, more rapid evolution and deployment of effective techniques and care plans. The scale allows for richer feedback and support, better flexibility, and efficiencies in scheduling. Finally for commissioners there are economies of scale in terms of best practice tariff and procurement, high patient value a rapidly responsive system to needs of patients and families with rapid implementation of advances in clinical management.

Volume 36

42nd Meeting of the British Society for Paediatric Endocrinology and Diabetes

British Society for Paediatric Endocrinology and Diabetes 

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