A new Diabetes UK review into diabetes inpatient care during COVID-19 has revealed that disruption to inpatient diabetes services created positive environments and opportunities for new ways of working and, in the minority, impacted on the quality of care clinicians felt they were able to deliver.
The report, Inpatient Diabetes Care during the COVID-19 pandemic, highlights the need to take account of the lessons learned during the first peak of COVID-19.
The COVID-19 pandemic has impacted the way care is delivered across the UK, so Diabetes UK needed to understand how inpatient care for people with diabetes had been affected. The charity interviewed healthcare professionals across the UK to find out about their experiences of delivering inpatient diabetes care during the first peak of the COVID-19 pandemic.
The findings showed that, while the pandemic has created disruption to inpatient diabetes services, many clinicians considered this disruption to have a positive impact in how agile the new environment was. However, some diabetes teams felt that their hospitals struggled as a result of the reorganisation of staff, which meant at times there was a lack of readily available diabetes expertise where needed.
These findings highlight the important role diabetes specialist teams play in meeting the needs of people with diabetes in hospital and in tackling the challenges the pandemic has brought with it.
As a result, the charity believes that the following recommendations are key to ensuring safe and effective inpatient diabetes care across the UK, and that they must be a priority when planning for winter:
- Maintaining or reinstating multi-disciplinary diabetes inpatient teams urgently. Diabetes inpatient teams must be deployed effectively to maximise their value and provide safe, effective care for people with diabetes.
- Involving diabetes specialist teams in the planning of the response to the next phases of the COVID-19 pandemic. Crucially, hospitals and local health systems must involve diabetes specialist teams in recovery phase and winter planning.
- Actioning the NHS Long Term Plan commitments to ensure universal coverage of diabetes specialist nurses. Access to Diabetes Inpatient Specialist Nurse teams must be a priority, for people with diabetes to be able to have the specialist support they need while in hospital.
- Maintaining technological advances or putting new systems in place where they have previously been unable to. Technology such as web-linked glucometers, ketone meters, electronic patient records, inpatient diabetes dashboards, and video call equipment were all deemed vital to providing care during the pandemic.
- With the NHS wanting to accelerate the return to near-normal levels of non-COVID health services, surgical care pathways for people with diabetes must be in place at all sites where surgery is carried out. These pathways must be appropriately resourced and created in collaboration with local diabetes inpatient teams.
- Prioritising the wellbeing of health care professionals to ensure there is time for rest and recovery. Hospitals and local health systems must ensure appropriate support and protection for staff physical and mental wellbeing.
Despite the challenges of providing care during the COVID-19 pandemic, the review also found that the last few months have presented opportunities for some teams to deliver inpatient services in ways they had always wanted to.
As reported by some clinicians, the ‘new normal’ for inpatient care should therefore not involve a move back to old ways of working, but instead be an opportunity for continued prioritisation and recognition of diabetes inpatient care as an integral, governance and safety-led component of hospital care.
Bridget Turner is Director of Policy Campaigns and Improvement at Diabetes UK. She said: “Hospitals and local health systems have been under enormous pressure recently, and diabetes was just one of the complex issues they had to navigate in a context that we had never seen before.
“However, adopting these recommendations and having the right workforce in place in the months to come will significantly reduce the strain on those fighting the pandemic from the front lines, and – crucially – help provide the level of care people with diabetes need to stay safe throughout and beyond the COVID-19 pandemic.”
Inpatient Diabetes Care during the COVID-19 pandemic was developed by speaking with 28 healthcare professionals and hospital teams from across the UK, including diabetes specialist teams. Sanofi has provided financial sponsorship to support Diabetes UK’s Improving Inpatient Care Programme, with the report being a part of the programme. Sanofi has no editorial control over the content or the delivery of the programme.