Diabetes care areas - click here to navigate to care area page
- Cardiovascular care
- Children and young people
- Diagnosis and ongoing care
- Emotional and psychological support
- End of life
- Equality in diabetes
- Prevention and risk management
- Eye services
- Emergency and inpatient
- Kidney care
- Mental health and learning difficulties
- Neuropathy care
- Services for older people
- User involvement
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Inpatient and emergency
This page is aimed at commissioners and providers of diabetes care. It brings together guidance, policy, commissioning guides, links to care pathways and examples of how inpatient and emergency care can be improved for people with diabetes.
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.
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.
Inpatient and emergency resource list
- An 'Evaluation of the first national Hypo Awareness Week' has been published by NHS Diabetes to highlight key learning from the pioneering national campaign.
- Emergency care referral pathway survey for Hypoglycaemia (Acute/Community Trusts & PCT/CCGs)
- Prevention of hospital acquired foot ulcers
- NHS Diabetes guidance featured in renowned journal
- Audit to Action: How could a network approach support diabetes teams to make change happen? Dec 2012 (PDF 963.9KB)
- The management of the hyperosmolar hyperglycaemic state (HHS) in adults with diabetes, August 2012, JBDS 06 (PDF 3.2MB) / JBDS guidance on management of the hyperosmolar hyperglycaemic state (HHS) in adults with diabetes, August 2012 (PDF 175.8KB)
- Glycaemic management during the inpatient enteral feeding of stroke patients with diabetes, June 2012, JBDS 05 (PDF 3.5MB)
- Mortality among inpatients with diabetes - Key findings for England, May 2012 (PDF 499.9KB)
- Self-management of diabetes in hospital, March 2012, JDBS 04 (PDF 2.6MB)
- 2010 Dietitian Workforce Survey Report, March 2012 (PDF 2.5MB)
- Inpatient Care for People with Diabetes: The Economic Case for Change, Nov 2011 (PDF 10.5MB)
- Inpatient Care for People with Diabetes: The Economic Case for Change Factsheet, Nov 2011 (PDF 150.4KB)
- Avoiding admissions and improving inpatient care - sucess stories
- Diabetes Inpatient Specialist Nurse (DISN) Group - join the group to share ideas, best practice and offer peer support.
Inpatient network E-bulletins
- August 2012 - Register now for our annual conference
- July 2012 - NHS
Diabetes Inpatient Network
- February 2012 (Word 405.5KB)