The Challenge

 

Children and Young People with Diabetes should expect to have access to the best clinical care that empowers them to manage their condition on a day-to-day basis. This care should extend beyond hospital settings, to ensure children and young people with diabetes can lead their daily life at school and at home in a way that is clinically optimal and personally and psychologically right for them.

Marked improvements in outcomes have occurred in centres around the world over the past 10 to 20 years, but the National Paediatric Diabetes Audit for England and Wales shows that our outcomes have remained largely unchanged. We know change is possible and that we can obtain the results that we are seeking through the re-design of our services.

In 2009, 10 regional Paediatric Diabetes Networks were set up across England with support from NHS Diabetes. Wales has also recently joined as the 11th network. Together they form the National Children and Young People's (CYP) Diabetes Network. This CYP Diabetes Network is led by Dr. Fiona Campbell, Consultant Paediatric Diabetologist, Leeds Children's Hospital. Each regional network has a Clinical Lead and a Paediatric Network Co-ordinator (PNC0) plus experts working in frontline diabetes services, parents and young people, all relevant stakeholders such as members of the Strategic Clinical Networks, commissioners and charities. The purpose of the network is to engage with young people and parents to promote innovative and proactive approaches to the re-design of services to improve the quality and cost effectiveness of diabetes services. The networks also help to identify and establish best practice, follow current and agreed guidance and protocols, and share tools/resources.

The membership of the regional networks recognise that to achieve good experiences of care and better outcomes for children with diabetes, the services that they provide should be designed around the needs of those children and their families. Obviously, any newly designed service cannot exist in isolation from the wider political, social and economic environment of the present day. Resources need to be used wisely to create safe and sustainable services for the future.

The driving force behind the development of any service improvement plan would be to strive for continuous improvements driven by innovation, evaluation and the desire for continuous life-long learning.

The National Paediatric Diabetes Service Improvement Delivery Plan 2013-2018 was designed to provide a framework to help improve the quality of planning, commissioning, delivery and regulation of services in order to achieve better outcomes for children and young people with diabetes and their family. It was written to be in keeping with the three phases of diabetes as a long-term condition - the initial phase (development of the condition), a review phase (living with the condition) and a transition phase (moving on to adult services). There are 13 work streams addressing these phases and collectively they are attempting to reduce unnecessary future morbidity or mortality associated with living with diabetes.

Prior to writing the Service Improvement Delivery Plan, the National Paediatric Diabetes Network examined where the current system of diabetes care needed improvements.

By considering the journey that the individual child and family made through the services in a life-course, condition specific pathway, we could identify current deficiencies in service provision. We concluded that our focus in the future should be much more on encouraging partnership working and good communication between clinical practitioners, young people and families. We also wanted to ensure that we were involved in getting evidence into practice and bringing together and strengthening the teams that deliver the care.

At this time of austerity and major systems reform in the NHS it has never been more important that planners and commissioners of services; providers and their regulators; public, private and community sectors; families, practitioners and any community members, all work together to align services, to improve the health of Children and Young People with Diabetes and help them lead lives free from the complications of this long-term condition. With this in mind National CYP Diabetes Network plan to review, update and relaunch the CYP Diabetes Service Improvent Plan with an increased emphasis on improving outcomes.