P-269: Equity of care leading to improved diabetes related outcomes in a teaching hospital setting
S Gupta, J Hoyle, S Goodwin, E Savage, K Ward, L NicollAbstract
Introduction
Paediatric diabetes unit at Hull, UK looks after 250 children and young people (CYP) with diabetes. Inequalities due to poverty relating to access to advanced technology was reflected in our outcome measures (median HbA1C below national figures). Our outcomes in terms of HbA1C and 6 key health checks were consistently below national mean since 2011.
Objectives
To improve our outcomes relating to HbA1C and care processes for CYP with diabetes. To address equity of access to technology for CYP from most deprived background.
Methods
Since January 2020, the service actively engaged in quality improvement initiatives. The regional network board meetings and NPDA audit formed the basis for our team’s engagement with service managers and commissioning body, Integrated Care Board (ICB), which helped us implement our improvement ideas. Children North East, a charity based in Newcastle, provided the team training, conducted staff and user interviews and produced a comprehensive report which formed the basis for action plan for the team to address inequalities of care within the service.
Results
The paediatric diabetes team implemented changes in 8 areas relating to access and care provision. The uptake of advanced technology improved universally among CYP in our patients, irrespective of their deprivation index. The 2024-25 NPDA data show that 89% of patients from most deprived background now have access to insulin pump for 2022-23, compared to 15% in 2021-22. The median HbA1C for our population for 2024-25 was 54 mmol/mol compared with 63 mmol/mol in 2021-22, moving our paediatric diabetes team to becoming a positive outlier.
Conclusions
The positive impact of this improvement activity, along with other quality improvement initiatives within the paediatric diabetes team, was reflected in the latest NPDA data which showed the median HbA1C of our unit to be among the best in the country.