P-119: Network-led implementation of hybrid closed-loop technology in paediatric diabetes: rapid, equitable scale-up across Yorkshire and Humber, UK
A Soni, E SavageAbstract
Introduction
Hybrid closed-loop (HCL) systems improve outcomes in type 1 diabetes, yet large-scale, equitable implementation remains challenging. Following NHS England’s 2023 strategy, we evaluated a network-led approach to rapid HCL adoption across a large paediatric population.
Objectives
To operationalise the NHS England 2023 strategy and NICE TA943 by supporting healthcare professionals to offer Hybrid-Closed Loop Technology to the 3419 children and young people receiving care from paediatric diabetes units across Yorkshire & Humber, UK
Methods
The Yorkshire and Humber Paediatric Diabetes Network (3 Integrated Care Boards; 1 regional network) coordinated implementation following NICE Technology Appraisal (TA943). Interventions included: (1) a region-wide virtual education programme to support HCL initiation; (2) structured optimisation sessions addressing sick-day management, exercise, and age-specific challenges; and (3) cross-centre workforce development via national study days. Uptake and equity were assessed using National Paediatric Diabetes Audit (NPDA) data.
Results
Nationally, NPDA 2024/25 reports 62% HCL uptake, with wide variation across systems (34–86%). Regional uptake in Yorkshire and Humber increased from 55.3% (Q1 2024/25) to 71.6% (Q4 2024/25), reaching 85% by Q1 2025/26 (+29.7% absolute increase). Most centres exceeded 70% adoption, with reduced inter-centre variation (34–86%). Regional uptake substantially exceeded the national average. Equity gaps were minimal, with similar uptake by deprivation (75% least vs 70% most deprived) and ethnicity (73.3% White vs 70.8% ethnic minority groups).
Conclusions
A coordinated, network-led implementation model enabled rapid, high, and equitable HCL adoption at scale, outperforming national benchmarks. Key drivers included standardised education, shared optimisation strategies, and cross-organisational collaboration. This model is transferable to other systems aiming to accelerate diabetes technology uptake while minimising inequalities.