The challenge

People with diabetes account for 15 per cent of inpatients in England – and over one third experience at least one medication error while in hospital. Patients with diabetes admitted for routine surgery stay on average 2.6 days longer than those without.  It is estimated that prolonged stays in hospital among people with diabetes result in about 80,000 bed days per year.

How is NHS Diabetes supporting you?

NHS Diabetes is at the forefront of service improvement in diabetes inpatient care. We are supporting better inpatient care and reduced length of stay and preparation for discharge, with a focus on health economic analysis to highlight excess spend on diabetes inpatient care.

Our work includes:

• The National Diabetes Inpatient Audit has been a major success, providing the evidence for improvements to diabetes care all over England. The survey is a snapshot audit of inpatient diabetes care. It was launched by NHS Diabetes and is now managed by the NHS Information Centre
• Building on the pioneering National Diabetes Inpatient Audit, NHS Diabetes is continuing to drive up quality in diabetes hospital care by launching the new National Inpatient Network.
• A commissioning guide (PDF 295KB) for inpatient diabetes care has also been published by NHS Diabetes. The guide includes an intervention map detailing all of the elements needed for the service as well as a contracting framework and service specification template. It supports our commissioning approach which offers a step-by-step guide in how to deliver high quality, efficient and cost effective diabetes services.

Emergency care

Hypoglycaemia, like many of the complications of diabetes is potentially avoidable.

We know that a severe hypo predisposes the person to further events unless the cause is identified. NICE Quality Standards for adults with diabetes no. 13 states that ‘people with diabetes who have experienced hypoglycaemia requiring medical attention are referred to a specialist diabetes team’

Some areas such as Yorkshire and the Humber and East of England have well established referral pathways between the ambulance trust and local specialist diabetes service.

Hypo survey coming soon

Currently there is no routine collection of data on the numbers of people with diabetes who experience a severe hypoglycaemic event requiring medical attention. Data from ambulance trusts in England show that ambulance call-outs to people with diabetes experiencing a severe hypo results in 25-40 per cent being transported to hospital. The rest are treated and left once the ambulance crews are satisfied the person is safe. Audits of this process involving all 12 ambulance trusts in England, suggest that there are approximately 3,800 events each month.

NHS Diabetes wants to know how other PCTs and ambulance trusts manage people with diabetes following the initial treatment of a severe hypo in the community. A link to a survey will be posted on this website shortly.