The team from the North East of England beat strong competition to win the Nursing Times’ ‘HRH The King’s Award for Integrated Approaches to Care’ which recognises pioneering nurses who work in partnership with colleagues and other organisations to improve the quality of life and independence for patients by supporting them to self-manage their long-term condition.
Newcastle’s award-winning project ‘Addressing barriers to successful diabetes transition in children and young people’ impressed the Nursing Times judges with its remarkable results.
This initiative, which addresses barriers to successful diabetes transition in children and young people, has patients at its heart. The team’s evident passion and professionalism shone through and was inspiring.
Nursing Times Awards Judges
Improving the experience for young adults
The idea for the victorious scheme came about when clinicians noticed a growing number of young adults no longer attending diabetes appointments after moving into adult services.
They were also concerned to see an increase in admission to hospital with diabetic keto-acidosis (DKA) – a serious complication of diabetes which can lead to dangerously high blood glucose levels.
Emily Dodgson, diabetes educator for Newcastle’s Diabetes Transition Service explains “We are very proud of our service caring for around 300 young people aged 16 to 25 with type 1 diabetes, and constantly look at ways to improve their experience.
“When we reviewed data a couple of years ago we could see that whilst 70% of young people attended our clinics at the Great North Children’s Hospital, this dropped to almost half with only 36% attending during their first year in young adult services.
“Furthermore, 38 patients during the same period had been admitted to hospital with DKA, most of whom were from areas we would describe as more deprived that others.”
Dr Nicky Leech, a consultant specialising in adult diabetic medicine adds: “We know that diabetes outcomes are affected by the ability to live well due to the level of deprivation they experience. For young people in particular these are linked to employment and income, their living environment and difficulties accessing housing and associated services.
“These inevitably have an impact on health so when a young person has a chronic, life-long condition such as diabetes, how they manage it when transitioning into adulthood can make all the difference between keeping well or finding themselves in a serious and even life-threatening situation.”
The team decided to take action and approached NHS England who were looking for applications around the country from NHS services seeking to improve diabetes related transition and young adult outcomes.
Listen to Newcastle’s award winning team
Overcoming barriers
Dr Dan Schenk, consultant paediatrician and clinical lead for Newcastle’s children and young people’s diabetes team explains “We developed a project utilising the strong collaboration that already existed between children’s and adult diabetes services here in Newcastle.
“Using feedback from service users, Youth Focus North East and North England’s Young Person’s Advisory Group, also known as YPAGne, our vision was to attempt to overcome the barriers that were getting in the way of young people successfully managing their diabetes.
“One of the key aims of the project was to address difficult yet fundamental challenges, such as young people who have not attended clinic for a long time or where there are significant social or financial barriers.”
They created a new ‘super group’ of professionals including a specialist diabetes nurse and nurse educator as well as a clinical psychologist and youth worker, all working alongside diabetes consultants specialising in both paediatric and adult care.
Diabetes educator Emily adds “We made a start by arranging for diabetes nurse educators to make home visits in an effort to explain the importance of keeping clinic appointments. However, it became clear that there were several non-clinical factors affecting our patients’ lives and that we needed to provide a much wider range of easy to access support.”
Carly Blagojevic, a nurse specialist in children and young people’s diabetes continues “The inclusion of a nurse dedicated specifically to provide education and training was very important, as well as psychological input to help the team develop a personalised approach for each patient, offering early support where needed.
“We also found engaging experienced youth workers hugely beneficial as they can help with a wide range of non-clinical issues such as providing employment, benefit and housing advice, as well as aiding attendance at clinics and offering peers support.”
A multi-professional clinic dedicated to students with diabetes was introduced at Newcastle University as well as keeping in touch with patients via text messaging.
The initiative has been extremely successful with the team particularly delighted to see a consequent reduction in blood sugar levels with the associated risk of diabetes complications, as well as a noticeable decline in DKA related hospital admissions.
“Remarkable results”
The Nursing Times Awards’ judges were impressed by how this initiative prioritises young adults, breaking down barriers and achieving remarkable results, including reduced admissions.
They said: “This initiative, which addresses barriers to successful diabetes transition in children and young people, has patients at its heart.
“It aims to enhance the management and outcomes for young people aged 16 to 25 with diabetes by tackling social deprivation, improving transition support, and expanding access through flexible clinic options, a university-based clinic and a multidisciplinary / keyworker programme.
“The project’s integration of health, social services and education sets a new standard for collaborative, patient-centred care and promises wide transferability.”
The judges added that the team’s evident passion and professionalism shone through and was inspiring.
Ian Joy, Executive Director of Nursing adds “I’m delighted to see this team’s determination and hard work recognised by this prestigious, national award.
“As an organisation, we are committed to ensuring our staff feel supported and have the autonomy to creatively influence how care can be better delivered to improve clinical outcomes.
This award-winning initiative clearly demonstrates nursing leadership at its best, and how active engagement and collaborative working can successfully influence and shape the provision of high quality patient care.
Ian Joy, Executive Director of Nursing
“The whole team should, quite rightly, feel very proud – congratulations!”
Dr Dita Aswani, a consultant paediatrician specialising in diabetes and NHS England regional clinical lead for North East & Yorkshire’s Children and Young Adults Diabetes Programme says: “Newcastle’s application to NHS England for pilot funding to improve their transition and young adult services was one amongst many within the region. However, what clearly stood out was how well the team had understood their population’s vulnerabilities.
“They endeavoured to develop an innovative model to improve access and engagement by involving the right professional support to individualise care to suit the needs of 16-25 year olds.
Their application was a superb example of collaborative and compassionate patient-centred care to provide equity. This award is testament to the passion and hard work they have put into this initiative, and the success achieved as a result.
Dr Dita Aswani, NHS England regional clinical lead for North East & Yorkshire’s Children and Young Adults Diabetes Programme
Importance of collaborative working
Of winning this award Emily and colleague Danielle say “We are both so proud and honoured to see the hard work of our entire diabetes transition team recognised in such a special way.
“We are all passionate about the importance of collaborative working and strive to improve diabetes outcomes and smooth the path for transition from paediatric to adult services for our young people.
“This NHS pilot introduced the role of the diabetes nurse educator role, which has provided an exciting opportunity which we hope to develop and grow.
“Yet we could never have achieved this without the contribution from our transition clinical psychologist, youth worker, our paediatric and adult diabetes consultants and support from our paediatric and adult diabetes teams.
“We have so much more to achieve and hearing the judges’ quotes that our work as a team has set a new standard for care, drives us further to push for ever more successful outcomes for the young people we care for”.
