Type 1 Diabetes 1 Outcome : Strategy for Insulin Implementation Guidelines (Type 1) 1.1 Establish an agreed local policy for Insulin Administration on the outcome of the final NICE guidelines (currently out to consultation). NICE (June 15) Current guidelines are available and are based on a personalised approach. The majority of patients will receive basal bolus regimens based on insulin analogues; will be reviewed following launch of NICE guidelines. December 2015 Specialist team 2 Outcome : Recording and monitoring of 2.1 Recording data within out of hours and emergency admissions of patients in relation to glycemic control for and reporting purposes. Scottish Diabetes Survey HbA1c recorded routinely at clinics (including Paediatrics). 100% of the population reported. Various Clinical Staff 2.2 Establishing education sessions for young people with Type 1 diabetes, including the use of social media. SIGN – Education delivered individually at diagnosis and through annual reviews. DUK and JDRF education days are held for families. Pump update evening also organised for families. Transition group sessions have been offered to those in the 15-16yrs bracket, however uptake was very poor. All Paediatric Team. Person-Centred Care 1 Outcome : Self-Improvement & Educational Strategies 1.1 Roll out Type 1 Educational Resources Online SIGN 1 structured education programme runs weekly at Raigmore, provided by a specialist team of staff. This Specialist Teams
Equality of Access 1 Outcome : Enhancing access to services across all ruralities 1.1 Clinic set up and patient awareness. Availability of virtual clinics has been set up to allow patients who are unable to travel to access allocated time with an appropriate clinician. There are podiatry clinics held remotely where patients Experiencing foot problems may be seen nearer to home. The podiatrists working in the localities have competencies related to Podiatry Competency Framework for Integrated Diabetic Foot Care (TREIPoD 2012) and have easy access To diabetes specialist podiatrists and the MDT when necessary. Podiatry services operate a self referral system making access easier for patients. Paediatric Team: Use of face to face peripheral clinics are presently meeting the needs of our (North) population. All specialist Teams. Sandra Jones (Podiatry) Paediatric Team 1.2 Monitoring of DNA/CNA’s. Community DSN’s work in collaboration with general Practitioner staff to follow up people who persistently DNA or cancel appointments in order to ascertain continuity of care may have been affected. Paediatric Team: Telephone and text reminders are sent to those who regularly cancel or DNA. Community DSNs Paediatric Team
1.3 Use of digital technology for reporting purposes and exploration of additional telehealth opportunities where available. Local drive to facilitate the use of reporting mechanisms available in the SCI Diabetes system. The local SCI D Facilitator has been working with community staff to establish new query building tools to help identify people at risk in the care pathway. There is also a project underway to establish Consultation by “text” techniques. DSNs at who provide insulin service are also holding video conferencing clinics to ensure access to appropriate health care professionals. Paediatric Team: A monthly audit of HbA1c across the Population, shared across the team. Inclusion in the Scottish Centre Comparative audit through SSG. Various Personnel Local DSNs Paediatric Team Supporting & Developing Staff 1 Outcome : Ensure staff have access to educational resources and training 1.1 Availability of Registered Nurse Courses Education for registered nurses is up and running locally. Education for 25 nurses is provided on a monthly basis. Lorna Grant Alison 1.2 CPR Course on Learnpro CPR is available at . aspx?ReturnUrl=%2flms%2fuser level%2fwelcome.aspx CPR awareness sessions are being delivered at hospital sites across NHSH. This should be completed by October 2016. However, it is understood that promotion of CPR will need to be continuous. A member of the diabetes Sandra Jones