Warrington and Halton Teaching Hospitals NHS Foundation Trust (WHH) is leading the field in its efforts to tackle the number of children being admitted with type 1 diabetes-related complications.
The Trust’s Paediatric Diabetes Team have significantly reduced type 1 admission numbers as a result of several innovative initiatives, including being the first in the region to introduce a permanent diabetes youth worker following funding from the Diabetes Health Inequalities Programme.
Their Youth Service Project has since proven to be so successful, similar pilot schemes are now being rolled out nationally, with plans to extend the service to other long term health issues including respiratory conditions and epilepsy.
The work is linked to the NHS Long Term Plan which aims to reduce the variation in the quality of diabetes care services, as patients in deprived areas are more likely to have poor short and long term health outcomes.
Latest National Paediatric Diabetes Audit (NPDA) data has shown that 30.9 per cent of children and young people in Warrington and Halton with type 1 diabetes complications live in the most deprived areas, compared with the national average of 23.7 per cent.
The Trust’s ambition has been to achieve better outcomes by working more closely with Warrington and Halton families affected by the debilitating condition.
Type 1 diabetes causes the level of glucose (sugar) in a person’s blood to become too high. This happens when the body cannot produce enough of the hormone insulin, which controls blood glucose. The condition isn’t linked to age or being overweight (risk factors associated with type 2 diabetes).
Chloe Lloyd joined WHH as a youth worker in 2021, with an emphasis placed on supporting children who may have poorly controlled diabetes or additional needs. Her dedicated efforts have contributed to an increase in the number of children engaging with diabetes activities and family events, support groups, advocacy services and the Trust’s Youth Buddy Champion Programme.
In the 12-month period following Chloe’s appointment, the team saw a 50 per cent reduction in diabetes-related admissions and diabetic ketoacidosis – a serious and potentially life-threatening condition that can happen when a lack of insulin causes harmful substances called ketones to build up in the blood.
Chloe said: “Developing positive relationships with children and young people affected by diabetes does not happen overnight and is a process that takes time and commitment.
“At WHH we continue to work with patients to support them with their personal, social and emotional wellbeing, and help make positive changes to their quality of life.
“My role as a health-based youth worker supports the young person’s health condition by enhancing the healthcare experience and ensuring their voices are heard.”
Other improvements to the service in Warrington and Halton have been made by participating in the Diabetes Seamless Transition Programme with the North Coast Clinical Network, tailoring care to ensure
young people are fully supported when they move from paediatric to adult services.
WHH also has a transition nurse, Claire Hulmes, which is unique in this region. Claire helps patients to develop their independence and prepare them for early adulthood through a transition programme and community events.
Additionally, the Trust has seen an increase in the number of families using the latest ‘closed loop system’ technology to continually monitor glucose levels remotely. This has been bolstered by the introduction of evening technology awareness sessions and weekend clinics to provide further help and guidance.
As a result, the NPDA data (2021/22) highlighted that median HbA1C <58mmols levels – which are used to measure diabetes control in children and young people – were better at WHH than the regional and national averages (44.4 per cent at WHH vs 35.2 per cent regionally and 39.5 per cent nationally), putting it in the top three north west CYP units.
Dr Satish Hulikere, Clinical Director for Women’s and Children’s Health at the Trust, and North West Children and Young People’s Diabetes Lead for NHS England, is passionate about improving patient outcomes both here and more widely, not only within the NHS but further afield.
He said: “The youth service received extremely positive engagement and feedback from children, young people and families, and has been successful in providing evidence that a holistic approach to healthcare is vital for encouraging them to communicate effectively.
“It bridges the gap between young people and the clinical team, providing them with a non-judgmental approach and support to cope with everyday challenges, to achieve their goals and aspirations and to help them create the best possible pathway to their own future.
“We are now hoping to secure funding for other diabetes projects to allow the team to further its developmental work, focusing particularly on long term conditions and young people with mental health needs.”
For more information about type 1 diabetes visit the NHS website.
