This report found that, overall, services continue to provide comprehensive care despite increasing workforce pressures. It also found that all Paediatric Diabetes Units (PDUs) provided structured education, and almost all delivered a transition clinic, and provided 24/7 out-of-hours support.
Better staffed services tended to achieve better outcomes
However, with a 20% growth in the number of children and young people (CYP) receiving care in England and Wales since 2017/18, its findings highlight a number of challenges. Staffing levels per 100 patients have generally fallen, vacancies have increased, and most services remain below recommended workforce standards. Better staffed services tended to achieve better outcomes, including lower HbA1c levels and higher uptake of hybrid closed loop technology.
More specifically, this report found that:
- Fewer patients are offered four annual appointments and staffing has not kept pace with growing patient numbers, leaving most PDUs operating below recommended workforce standards.
- CYP with diabetes are more likely to have a child protection plan or be a child in care. However, fewer PDUs have protected time for safeguarding and almost all did not have a dedicated social worker.
- Most PDUs are screening for emotional wellbeing but only a quarter screen for eating disorders. Most PDUs have a psychologist in post but many do not offer the recommended interventions.
In addition, this report found that levels of funding were also associated with outcomes. Fewer PDUs are receiving the national funding rate to cover a full year of care for a CYP with diabetes, while a quarter of PDUs are delivering tertiary care, requiring further funding.
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