NPC Archive Item: Improving emergency and inpatient care for people with diabetes

NOTE – This is an archive post from the NPC and has not been updated since first publication. Therefore, some hyperlinks may no longer be working.

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What is the background to this?
Released by the National Diabetes Support Team in April 2008, ‘Improving emergency and inpatient care for people with diabetes’ is the report of a working party of representatives of the inpatient and emergency care community, in partnership with the National Institute for Innovation and Improvement. It’s chapters include a focus on preventing diabetes admissions through education, approaches to improvement, clinical pathways and commissioning opportunities. As stated in the forward of the report, with an estimated 2.35 million people with diabetes in England, and the number diagnosed increasing by about 1,300 each week1, the healthcare challenges encompass all elements of healthcare provision, including public health, primary and specialist care, ambulance services, and commissioners.

Medicines Management is an integral part of the care provided for people with diabetes. However, when you consider that 20% of those people only sometimes, or rarely can take their medication as they wish2, then it is essential that the providers and commissioners of medicines management services consider how they can contribute to improving care for this vulnerable group.

The report highlights several areas where improving medicines management services for patients with diabetes could support their care and/or prevent admission to, or attendance at, hospital including:

  • Proactive intervention for high-risk groups, e.g. recurrent hypo- or hyperglycaemia in younger people which could indicate problems with managing an insulin regime
  • Supporting the appropriate self-management of medicines for inpatients
  • Providing training to ward staff on the different effects of different medication and achieving steady and safe blood glucose levels

However, the report does not specifically highlight the inclusion of a member of the pharmacy team in multidisciplinary diabetes specialist teams.

How does this relate to other publications or evidence?

This publication relates directly to the standards set out in the National Diabetes Framework (NSF)3.

The Diabetes Commissioning Toolkit4 includes sections on assessing healthcare needs to support commissioning, and outlines the core elements of care that a high-quality diabetes service should include.

The Pharmacy White Paper, Pharmacy in England: Building on strengths – delivering the future5, sets out a vision for building on the strengths of pharmacy as part of an overall strategy to ensure safe, effective, fairer and more personalised patient care.

Prescribing and medicines management teams should review the recommendations in this report and support their implementation through the inclusion of medicines management services in care plans and clinical pathways

Item details
Improving emergency and inpatient care for people with diabetes can be accessed here.

1Quality & Outcomes Framework statistics
2Healthcare Commission,National Survey of People with Diabetes, 2007
3The National Diabetes Framework, Department of Health, 2003
4The Diabetes Commissioning Toolkit, Department of Health, 2006
5The Pharmacy White Paper, Pharmacy in England: Building on strengths – delivering the future, Department of Health, 2008

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