Diabetes is a progressive disease that affects approximately 14,000 people in the North Cheshire area alone.

Major landmark studies have shown that treatment targeted around the needs of individuals significantly reduces diabetic complications. We provide services at both Warrington and Halton hospitals and our philosophy is to support patients and health care professionals to manage care safely and effectively in both primary (community) and secondary (hospital) care. By helping you manage your diabetes we aim to prevent you needing to be admitted to hospital and ensure that all patients have support to manage diabetes at home or in the community where possible.

To achieve this aim, our team of diabetes specialist nurses deliver quality education for patients and other health care professionals. We also run clinics for complications caused by diabetes and do provide direct inpatient care if you do need to stay in hospital.

There are many different clinics and activities which take place within the Diabetes department at Warrington Hospital and at other locations within Warrington and Halton Hospitals NHS Foundation Trust sites, as well as at other locations such as; Warrington Wolves, Bath Street Clinic in Warrington and Halton hospital

As a diabetes team our ethos is to focus on the individual and their diabetes.  We try and do this as much as possible within the time frame of your appointment. With the exception of certain specialist clinics the time frames are structured as follows:-

New patient appointment – 30 minutes to 2 hours depending if you see all 3 team members

Follow-up appointment – 15 minutes

Nurse led Clinics – variable times

New patient clinics – When you are a newly referred to the diabetes service, usually by your GP or Practice Diabetes nurse, you will be seen in one of these clinics. These clinics take place at both Warrington and Halton outpatient departments. We generally plan for you to have 3 appointments within these clinics ( 1 new, 2 follow-up).These clinics are led by a Diabetes Consultant (+/-Diabetes specialist trainee) a Diabetes Specialist Nurse and a Specialist Diabetes Dietician. On your first visit you will usually see all three team members. If you need ongoing care, we try and transfer you to one of our specialist follow-up clinics; otherwise we aim to discharge you back to the care of your General Practitioner with a management plan in pace for you and your GP.

Diabetes Specialty  Clinics – These are all follow-up clinics and take place at both hospital sites.  More details are available within the relevant section on specialty clinics. They are led by a Diabetes Consultant. There is usually a Diabetes Specialist Nurse as well. Foot clinics would have a Podiatrist

Nurse Led Clinics- These clinics are Led by the Diabetes Specialist Nurses. Appointment times flex in accordance with the patient need in clinic. They take place at both Warrington and Halton Diabetes centres as well as specified clinics in the community.

Dietician Led Clinics - Our specialist diabetes dieticians work closely with the team. They are highly skilled in providing advice and support on particular nutritional aspects of diabetes care including Carbohydrate Counting, Weight Management and Coeliac disease for example. They run their own clinics where they can provide patient specific advice on dietary matters, as well as providing support to our clinics and educational courses.

When you are offered an appointment you will be seen in one the Outpatient Departments when our New Patient Clinics*are scheduled.

• Please book in at the reception desk/area, you will be asked to confirm your details.
• Before seeing the diabetes team, you will be seen by the clinic team. You should be weighed, your height measured and your blood pressure checked. You will be asked to do a finger-prick blood test which allows us to assess you HbA1c.

• You will be asked if you have brought a Urine Sample (please do and ask for a specimen pot for your next attendance). We test your urine to detect if very early changes are occurring in your kidney as a result of diabetes.

• Please bring your Blood glucose meter to clinic each and every time you attend. We have the facility to upload its data into our system. This helps us give the best advice we can for you to manage your diabetes.

• If you have the results of any recent Eye Screening or Foot screening appointments (done in the community), then please bring them with you.

• If there are specific aspects of your care you wish to discuss with the team, please bring this up in the appointment. We do our best to address the issues that matter to you.

• When you appointment is over, you may be asked to attend for further blood tests, if not, when you leave can you please confirm at the appointment desk that you have completed your appointment. We currently arrange follow-up electronically, but this may change.

• If you are unable to keep your clinic appointment, for whatever reason, please let us know. Either ring the hospital appointments number on (01925 662416) or the Diabetes Specialist Nurses on 01925 662179, (this is an answer phone but leave a message giving your name and message). We will be able to arrange another appointment but in the meantime the DSNs will contact you to check all is okay.

Clinic Schedules

We provide a mix of clinics on both hospital sites.  The only clinic provided exclusively at Warrington Hospital is the Medical Obstetrics Clinic, which is run in conjunction with the obstetricians within the Women’s’ Health department of the hospital.

We aim to provide equity of care across the two sites.

The benefit you can gain from coming to Clinic will be greatly improved if you bring your Blood Glucose meter with you and any information you have about recent eye screening or foot screening appointments.”

Warrington Clinics*

Halton clinics are shown below

Halton Clinics*

New Patient Diabetes Clinics

This is the way all patients will become involved with the Diabetes Care Team.

In general terms, this clinic aims to give you 3 appointments over a period of 4 months. This allows a rapid assessment of your needs to take place and a treatment plan to address the areas suggested put in place and subsequently reviewed.

In this clinic, in most cases, you will see a Diabetes Consultant, a Diabetes Specialist Nurse and a Specialist Diabetes Dietician. This will definitely occur on your first visit, and may be with one, two or all three members of the team on subsequent visits. Please be aware of this and allow enough time for this in your attendance at clinic.

At the third clinic visit , we will discuss with you  if you will benefit from continued input in one of the Diabetes Specialty Clinics, or whether your care can be continued in the community by you, your GP and the practice nurse. We do, of course, take your personal wishes into account when making this decision. Please feel free to discuss this with us at the time.

Diabetes Specialty Clinic

These clinics are focused on a particular aspect of, or problems with your diabetes care. These clinics run on both hospital sites apart from the Joint Medical Obstetrics Clinic, which only runs at Warrington Hospital.

Insulin Pump Clinics

Clinic schedule

• Halton Hospital - Monthly  - First Friday(am) - Dr Simon Saunders + Carol Leach
• Warrington Hospital -Monthly - First Monday (am) - Dr Paula Chattington+ Carol Leach
•  

The Insulin Pump Clinics are run by a Diabetes Consultant and our Insulin Pump diabetes Nurse.

Twenty (20) minute appointment times are scheduled in this clinic to allow a full discussion of the issues related to the pump and your diabetes. We encourage you to upload your pump and meter data before your clinic appointment so this information can be reviewed before your appointment and allow a thorough review to occur. If you require information on how to do this please contact our Pump specialist nurse email : carol.leach@nhs.net  These clinics have the support of the specialist diabetes dietician where required.

Young Person Diabetes Clinics

Clinic schedule

• Halton Hospital -Monthly - First Thursday (am) -Dr Simon Saunders+ DSN
• Warrington Hospital-Monthly - Second Monday (am)  - Dr Paula Chattington+ DSN

The Young Person Diabetes Clinics are run by a Diabetes Consultant and our Young Adult Diabetes nurse.

The Young Person Diabetes Clinic concentrates on a population of patients usually aged between 18-25yrs old*. These clinics take over former paediatric diabetes patients who have recently transitioned to the adult service or patients who are newly diagnosed between the ages stated. Appointments tend to be slightly longer to accommodate concerns of the young adult. Parents of the young adult are welcome to attend the clinic at the wish of the patient. We encourage you to upload your meter data before your clinic appointment so this information can be reviewed before your appointment and allow a thorough review to occur.

If you require information on how to do this please contact our specialist nurse email : (given in clinic)  These clinics have the support of the specialist diabetes dietician where required.

We also offer our My Diabetes education programmes for patients to help you manage your diabetes:

Type 1 diabetes

MyDiabetes is a 3 session face to face group course for people with type 1 diabetes who want to learn how to self manage their diabetes.  Where people with Type 1 diabetes are taught to match their insulin dose to their chosen food intake on a meal by meal basis. MyDiabetes provides 7.5 hours of structured group education and is delivered by specially trained diabetes specialist nurses and dieticians, to groups of between 10-14 people over a 3 week period on an outpatient basis. It is an evidence-based, evaluated, professionally delivered, quality assured, peer reviewed and audited education package for Type 1 diabetes.

Type 2 diabetes

MyDiabetes is a 3 session face to face group course for people with type 2 diabetes who want to learn how to self manage their diabetes. They are taught to be more aware of the affects of their food choices will have with this medications and lifestyle. MyDiabetes provides 7.5 hours of structured group education and is delieverd by specially trained diabetes specialist nurses and dietiticians, to groups of between 10-14 people over a 3 week period on an outpatient basis. This supports self care. People can self register for this programme. For further information contact:

Warrington 01925 251417

Email: gaynor.carr@bridgewater.nhs.uk

Warrington Hospital

The diabetes centre is situated on the first floor of the hospital in the Appleton Wing where it meets the Burtonwood Wing. It is open from Monday to Friday 9.00 – 5.00 pm daily. The diabetes specialist nurses run nurse led clinics from the centre and there is a podiatry (foot specialist) led foot clinic three times per week for any patient with diabetes who has been referred with an acute foot problem.

Halton General Hospital

The diabetes nurses office is on the ground floor of Halton General Hospital next to the ECG department. This provides diabetes specialist nurse led clinics and a rapid access clinic – held weekly for any patient to self refer if you need advice and support.

Consultants

Dr Paula Chattington - Clinical Lead for Diabetes + Endocrinology, Consultant Physician in Diabetes+ Endocrinology.

Sub specialty interests

Dr Chattington has specific interests in Diabetes of Young Adults and does the transitional care from paediatric diabetes for Warrington. She also runs a dedicated insulin pump service for Warrington patients. She leads on the Pre-conception and pregnancy care for patients with diabetes in conjunction with the Obstetrics team. Her general interests include endocrine or general medical conditions and Type 1 Diabetes. Within Endocrinology she has interests in Thyroid Dysfunction, Pituitary disease and adrenal failure.

Dr Simon Saunders - Consultant Physician in Diabetes and Endocrinology.

Sub specialty interests

Dr Saunders has a particular interest in Type 1 Diabetes and runs the Young Adults/Transition service at Halton hospital. He is also keen on the integration of technology such as Insulin pumps and CGMS and monitoring into routine diabetes care. He has a particular interest in Sports and Exercise in Diabetes, particularly with keen amateur and semi-professional/professional athletes and is looking to run a separate diabetes and exercise clinic in the near future. Within endocrinology he is interested in Thyroid Dysfunction.

Dr Vineeth Chikthimmah - Consultant Physician in Diabetes and Endocrinology.

Sub specialty interests

Dr Chikthimmah has sub-specialty interests in Diabetic Foot Ulcers & Neuropathy care and leads the diabetes foot team, running clinics at Halton and Warrington. He also has interested in Complex Type 1 & 2 Diabetes as well as erectile dysfunction and men’s health in diabetes. Within endocrinology he has broad interests in Thyroid, Parathyroid, Adrenal and Pituitary disorders as well as Male Hypogonadism.

Dr Rahul Yadav - Consultant Physician in Diabetes, Endocrinology and General Medicine.

Sub specialty interests

Dr Yadav leads and is developing the Bone metabolism(osteoporosis) service as well as being interested in lipid metabolism and cardiovascular risk management in Diabetes and other Endocrine conditions. He is also interested in Obesity management. Dr Yadav is also the lead within the team for clinical research in diabetes and is involved in a number of trials.

Dr Mahmud Ahmad - Consultant Physician Diabetes and Endocrinology/Acute Medicine

Dr Ahmad joined our team in 2019. He trained extensively in the Mersey Area. He has sub-speciality interests in Insulin pump management, the care of young adults and Diabetes and pregnancy. He undertakes clinics at Warrington Hospital outpatients department. He also undertakes an Acute medicine role and is part of the team seen on the Acute Medical Unit.

Specialist Nurses

• Lesley Mills - Diabetes Nurse Consultant and Queen's Nurse
• Jane Stamper - Diabetes Specialist Nurse
• Sue McDonagh - Diabetes Specialist Nurse
• Sharon Fisher - Diabetes Specialist Nurse
• Carol Leach - Pump Speciliast Nurse
• Janet Tasker - Diabetes Specialist Nurse
• Kiera Rimmer - Diabetes Specialist Nurse

Community Diabetes Nurses

Barbara Lovelady - Diabetes Specialist Nurse

Liz Atkins - Diabetes Specialist Nurse

Diabetes Educator

Ben Thompson

All our diabetes nurses are independent prescribers who are very experienced in the management of all types of diabetes. Within the team, some of the nurses sub-specialise in the management of specific diabetes patients. However they all cover complex diabetes clinics and help manage the inpatients within the hospital who have diabetes related issues.

Most patients are referred from their GP to the service. The service provides fast access for first appointments through the see and sort clinics. Patients are then offered access to the right clinics for their specific requirements.

Diabetes Centre 
Appleton Wing First Floor 
Warrington Hospital
Warrington 
Cheshire 
WA5 1QG

Telephone1:
01925 662416