Developing a National Paediatric Diabetes Plan: What are the key issues for education? Dr. Sheridan Waldron HCP Education Lead for Children and Young people with Diabetes Hosted by Diabetes UK

Why do we need a national plan? ‘To develop a care model for children and young people with diabetes that enables consistent care, high standards, equal access, no matter where it is delivered’

8.7% Median HbA1c by audit year 8.7% 8.8%

Atlas of Variation 2.6 fold variation among PCTs in % of CYP admitted to hospital for DKA 2.4 fold variation between PCTs in % of CYP with most recent HbA1c measurement 10% or less

What are the key issues ? - provide consistent care - high standards - equal access - all parts of the country

‘Join us on our journey’ Study Health Care Professional Education & Training Structured education for CYP & families Psychological support Transition Young adult diabetes care Staffing levels Clinic Annual assessment and monitoring of complications 24 hr on-call provision Record keeping GP and public awareness of Type 1 diabetes Care provision and Type 1 diabetes education within schools Funded and supported by

HCP Training R&D / Yorks Register Diabetes in CYP CYP/Families Self Management Education Paed ND Audit (RCPCH) (data driven outcomes) Patient Reported Experience Measure (PREM) Annual Report Transitional Care Operational Service Delivery (Best Practice Tariff, effective commissioning ) Guidelines & Standards Peer Review Partnerships (Industry/DUK/JDRF/CWD) Innovation (adoption of technology) In Patient Management Prevention (Type II, DKA) SAFEEFFECTIVEEFFICIENT SUSTAINABLE 5 year Paediatric Diabetes Strategy Improving Outcomes National Paediatric Diabetes Network Driver for service improvement

NHS Diabetes National Paediatric Diabetes Service Improvement Delivery Plan Sections Section 5 Health Care Professional Training Section 6 Education for CYP & Families

Section 5: Standardised, Accredited & Structured Education for Health Care Professionals Academic Courses Birmingham Children’s Hospital (Degree level) York University (9 days at Masters level) - & Insulin Pump Course - & Transition (NEW) Sheffield Hallam (5 days) - Teaching Skills Course Leeds Metropolitan University – Full Masters: Advanced Diabetes Educator (NEW) Warwick University (Masters level) – & Psychosocial Module (NEW)

Developing a career pathway for Health Care Professionals ‘Generalist’ – ward staff, Band 5? ‘Specialist’ – Band 6 & 7? ‘Advanced Practitioner’ – Band 7 & 8a?

Section 5: Standardised, Accredited & Structured Education for Health Care Professionals  E-Learning of Level 1 (Basic Awareness) & Portfolio for Life Long Learning & Register of certificated HCPs

E-Learning Sections 1. Aetiology, Epidemiology and Diagnosis 2. Phases of type 1 Diabetes 3. Other Types of Diabetes 4. Insulin Therapy 5. Complications of Diabetes - Acute Identification and treatment of hypoglycaemia - Hyperglycaemia and Diabetic Ketoacidosis (DKA) - Chronic Eye complications - Nephropathy - Neuropathy, Macrovascular and Dental disease 6. Defining the Multi-disciplinary Team and Delivery of Ambulatory Services 7. Education of Children and Young People and Carers 8. Nutrition 9. Management of Physical Activity and Exercise 10. Monitoring of Diabetes and Screening for Associated Conditions 11. Psychological Aspects 12. Surgery, Fasting and Sick Day Rules 13. Young People and Transition to Adult Care 14. Vision of the Future for Children’s Diabetes Services

Ambition All members of the MDT in England to complete the E-learning module

DIABETES UK 2014 LIVERPOOL THURSDAY 6 TH MARCH PAEDIATRIC CPD CERTIFICATE & CME Children and Young People with Diabetes

Section 6: Structured Patient Education: Best Practice Tariff ‘ The diabetes team should offer a structured education programme at diagnosis and with updates as needed, aimed at the age and understanding of the young person and their family’ Onset of DM Continuum of self-management education paediatric long term care Young adults & long term care Improving outcomes & decrease complications Standardise education programme & resources at diagnosis Age & maturity appropriate CYP & families Self-management by adolescents transfer Emerging adulthood Primary Metabolic Memory

8 Randomised Controlled Trials 6 reported Education for Children & Young People & their families Future guidance for Structured Patient Education at Diagnosis & Transition

Diabetes Care for Children & Young People