BSPED2025 Poster Presentations Diabetes 6 (10 abstracts)
Audit of a multidisciplinary annual review clinic for children and young people with diabetes mellitus
Yunzila Mirza 1 , Benjamin G. Fisher 1 , Jennifer Ashford 1 , Nazia Bhatti 1 , Lisa Cooper 1 , Jenny Lee 1 , Eilidh Nicol 1 , Natalie Schillaci 1 , Charlotte Claydon 2 , Ajay Thankamony 1 , Sandra Walton-Betancourth 1 , A. Emile J. Hendriks 1,3 & M. Loredana Marcovecchio 1,3
1Department of Paediatric Diabetes and Endocrinology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom; 2Department of Internal Medicine, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom; 3Department of Paediatrics, University of Cambridge, Cambridge, United Kingdom
Background: NICE guidance recommends that children and young people (CYP) with type 1 diabetes (T1D) have structured, annual reviews (ARs), including checks of glycaemic control and growth, and screening for comorbidities and complications. At Cambridge University Hospitals the paediatric diabetes AR clinic for CYP aged <16 years runs weekly, supported by a multidisciplinary team (MDT) of doctors and diabetes educators, with input from dietitians and clinical psychologists as required. In 2023, a quality improvement project was initiated to optimise adherence to screening guidelines, standardise the MDT approach, and improve CYP/carers and staff satisfaction with the clinic.
Objectives: This audit aimed to evaluate and improve: adherence to NICE guideline NG18; compliance with departmental standards, including timing of reviews; MDT member satisfaction; and CYP and family understanding of, and satisfaction with, the AR clinic.
Methods: Changes introduced in 2023 included: standardising clinic administration; introducing templates and checklists to cover all recommended AR assessments and improve consultation structure; involving clinical psychologists in the clinic; increasing staff awareness of dietetic referral criteria; and providing written information to CYP and families. Data sources comprised the National Paediatric Diabetes Audit, retrospective reviews of CYP’s medical notes, an online staff survey, and a CYP/carer survey.
Results: Between 2023 and 2025, significant improvements were seen in the proportion of CYP having foot assessments (78% to 93%), lipid measurements (78% to 91%), psychology questionnaire (PI-ED) completion (74% to 100%), and smoking status documentation (73% to 99%). However, recording of retinal screening results worsened (87% to 66%) and measurement of albumin-creatinine ratio was persistently low (76-77%). In 2025 there was higher staff satisfaction regarding clinic structure, appointment length, understanding of MDT roles, and awareness of referral pathways for dietetic and psychological services. Data from the CYP/carer survey are awaited.
Conclusion: This local audit demonstrates that targeted quality improvement strategies - particularly the use of templates/checklists, enhanced MDT collaboration, and standardised processes - can improve adherence to national and departmental standards, staff satisfaction, and clinical assessments in a paediatric diabetes AR clinic. Ongoing evaluation, including CYP/carer feedback, will be key to guiding further improvements and ensuring long-term sustainability.
Volume 111
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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