A panel of leading experts have been brought together in a bid to enhance diabetes care and the quality of life residents with diabetes living in care homes have in the future.
The main aim of the National Advisory Panel for Care Home Diabetes is to produce a Strategic Document of Diabetes Care that will provide recommendations focussing on producing the highest possible standards of diabetes care.
Once agreed, the recommendations will be submitted for public consultation, and then with the proper support, rolled out across care homes with the intention to improve standards of diabetes care which will ultimately enhance the well-being, quality of life, and clinical outcomes of all residents with diabetes.
The work of the panel is our best opportunity to make a difference and to enhance diabetes care and bring about sustained benefits Professor Alan Sinclair
Sound and effective communication
The strategic document will reflect the importance of sound and effective communication channels between residents and families, care homes, community nursing and diabetes services, primary care, acute hospital services, eye specialist and optometry care services, nutritional and podiatry services, and the social services sector.
Chaired by Professor Alan Sinclair of King’s College, the multiagency panel consists of senior clinicians and representatives of the key diabetes organisations including Diabetes UK, the Association of British Clinical Diabetologists (ABCD), the Primary Care Diabetes Society (PCDA), and the Joint British Diabetes Societies for Inpatient Care (JBDS-IP), and the Older Peoples Diabetes Network (OPDN).
There will also be input from the United Kingdom Clinical Pharmacy Association (UKCPA), the Royal College of General Practitioners, Care England, Hallmark Care Homes, Public Health England, Association of Directors of Adult Social Services, British Dietetic Association, as well as other invited experts including commissioners.(see table 1). It is also hoped that we will see representation from the British Dietetic Association, Association for Clinical Biochemistry and Laboratory Medicine, and representation at a national level from a Podiatrists organisation..
Professor Sinclair, who has had extensive involvement in care home diabetes and will be leading the project, said: “It has taken the COVID-19 pandemic, which has taken a major toll on the care home resident population with diabetes, to highlight their vulnerability and to expose significant shortfalls in how we best manage this condition in these settings.
“The work of the panel is our best opportunity to make a difference and to enhance diabetes care and bring about sustained benefits. We hope that our recommendations will receive the appropriate amount of funding to develop new services and we trust in those making these decisions.”
The Strategic document will provide a set of recommendations that all stakeholders will be asked to endorse. The relevant elements to be addressed are listed in Table 1:
|Philosophical Framework for the Project||1|
|Ethics and equity of care, access to services, principles of shared decision-making, and any related ethnicity issues||2|
|Training& Education of Care Staff and related competencies||3|
|Care Home Assessment Procedures and Assessment Schedules: (a)Safe transfer during transitional care; (b) Admission Assessments; (c) Ongoing key assessments for diabetes, frailty, cognitive impairment; depressive disorder; (d) vaccination schedules; (e) exercise and nutrition schedules;||4|
|Acute illness protocols plus (a) Infection management including Covid-19 (b) hospital admission criteria; (c) clinical biochemistry and haematology services||5|
|Systems enhancement and use of technology including data collection, storage and safe sharing, resident’s plans and case records||6|
|Individualised management schedules including (a) Oral glucose-lowering and targets; (b) Injectable therapies; (c) metabolic targets and ranges||7|
|Hypoglycaemia, Foot Disease, Eye Services, and Hospital Admission Avoidance||8|
|Type 1 diabetes – special features||9|
|Effective Liaison and Communication with (a) Primary Care; (b) Community nursing service and foot local protection service; (c) Adult Social Services||10|
|Diabetes Care (Operational Policy) for Care Homes to include risk-minimisation policy, audit schedules, and preventative care||11|
|Public Health Liaison and CQC involvement/oversight||12|
|End of Life Care including advance care planning||13|
Please note that a recent ABCD webinar on care home diabetes was delivered by Professor Sinclair and can be accessed here.
Other domains of interest are likely to emerge as the work of the Panel develops momentum. All members have been issued with a Briefing Document which sets the scope of the work to be undertaken and the timelines involved. It is the intention of the Panel to deliver a completed Strategy document by May 2021.
National Advisory Panel – Care Home Diabetes: Stakeholders/Members
|Professor Alan Sinclair (Chair)||King’s College, London and Foundation for Diabetes Research in Older People|
|David Jones||Diabetes UK|
|Prof Mike Sampson||Norfolk and Norwich University Hospitals NHS Foundation Trust and JBDS-IP|
|Dr Umesh Dashora||East Sussex Healthcare NHS Trust and JBDS-IP|
|Dr Philip Newland-Jones||University Hospitals Southampton NHS Foundation Trust and UKCPA|
|Dr Susannah Rowles||ABCD and Pennine Acute Hospitals NHS Trust|
|Dr Belinda Allan||Hull and East Yorkshire Hospitals NHS Trust and JBDS-IP|
|Dr Kath Higgins||University Hospitals of Leicester NHS Trust and JBDS-IP|
|Dr David Strain||University of Exeter Med School|
|Nneka Agbasi||Trend Diabetes|
|Prof Gerry Rayman||East Suffolk and North Essex NHS Foundation Trust and JBDS-IP|
|Prof Angus Forbes||King’s College, London|
|Dr Clare Hambling||Primary Care Diabetes Society (PCDS)|
|Dr Ahmed Abdelhafiz||Rotherham NHS Foundation Trust and OPDN|
|Professor Martin Green, OBE||Care England|
|Julie Rayner||Hallmark Care Homes|
|Dr Sandip Ghosh||University Hospitals Birmingham NHS Foundation Trust and JBDS-IP|
|Dr Susan Manley||University of Birmingham and JBDS-IP|
|Dr Jason Cheung||Norfolk and Norwich University Hospitals NHS Foundation Trust and JBDS-IP|
|Dr Gurpreet Kaur||NHS Sandwell & West Birmingham CCG – Commissioner|
|Dr Daniel Flanagan||University Hospitals Plymouth NHS Trust and JBDS-IP|
|Dr Amar Puttanna||Sandwell and West Birmingham Hospitals NHS Trust|
|Philip Ivory||Lay member and person advocate|
|Dr Julia Platts||Cardiff and Vale University Health Board, Wales|
|Dr Erwin Castro||East Sussex Healthcare NHS Trust and JBDS-IP|
|Dr Masud Haq||Maidstone and Tunbridge Wells NHS Trust and JBDS-IP|
|Dr Parijat De||Sandwell & West Birmingham NHS trust/JBDS-IP|
|Dr Kevin Fernando||Royal College of General Practitioners, RCGP|
|Dr Ellis Friedman||Public Health England (PHE)|
|James Bullion||ADASS – Director, Association of Directors of Adult Social Services|
|Professor Peter Scanlon||Gloucestershire Hospitals NHS Foundation Trust|