Summary

In 2014 the team introduced a joint multi-disciplinary clinic consisting of the paediatric diabetes team, a gastroenterology clinician and specialist dietetic colleagues with knowledge and experience of both chronic conditions. These clinics have allowed the elimination of clinical care variability and equity factors and also to reduce the frequency of speciality clinics visits for children and families (reducing cost, travel time and parents taking time off from work and reduction in the time for children away from their educational setting). The programme amalgamated the investigations required to minimise venesection and reduce costs of multiple blood tests, creating more hospital follow-up appointment spaces for children requiring specialist gastroenterology and dietetic expertise. Feedback from parents, carers and young people was positive. 

Results

School staff have valued this structured education and the time and diabetes team resources have been used effectively to cover a wide range of topics to a large number of school staff which would be otherwise unachievable in the time period of one day.

Challenge

The number of CYP with diabetes is increasing, and smaller teams are struggling to provide one-to-one support for individual schools with pupils with diabetes. Schools without previous diabetes awareness have poor knowledge and significant anxieties around managing a child with diabetes following a new diagnosis or an intake of a child with established diabetes. 

Objectives

To provide school staff with an awareness of all stakeholders’ responsibilities for managing a CYP with diabetes in school; the difference between Type 1 and 2 diabetes; causes, signs and symptoms; treatment options; how to manage acute complications; and a basic understanding of the practicalities of insulin administration and blood glucose/ketone monitoring.

Solution

To date the team has run a pilot diabetes awareness day at Birmingham Children’s Hospital, attended by 50 school staff delegates from within the Birmingham area, and a further study day that was open to school staff from across the WM region and which attracted over 50 schools, represented by 86 individual staff members and supported by diabetes team members from 4 regional centres and Birmingham Medical Needs in Schools Service. The programme provides a package of PowerPoint presentations on each of the agenda topics, learning outcomes for delegates, all of the administrative documentation including sample promotion flyers, certificates, evaluation forms and booking forms. This is to ensure that teams hosting the day are required to do minimal administrative tasks and teaching preparation before the day, leaving them free to continue with clinical duties. Any school within the region can send members of staff to any of the study days rather than having to wait for a local date. The dates are advertised via the diabetes team, Birmingham Medical Needs in Schools Service, the LEA’s, individual families and is also supported by the WM Parent Representatives for the network who promote it via social media. These study days are sponsored by members of the diabetes industry to keep costs to a minimum and have so far allowed no attendance fee to be incurred by the individual schools.

Learnings

With the introduction of the new National CYP Diabetes Website these resources could become easily available to anyone in the National Network who wishes to use the resources as they can download all resources to hold their own event. The steering group believe that this programme can be delivered by any team nationally with minimal need for training and/or explanation in to its use thus minimising development, planning provision and evaluation time. Raising awareness of diabetes with school staff, and improving their knowledge and confidence around diabetes can only enhance the experience of families with CYP with diabetes when they are dealing with the anxieties of a new diagnosis or a start/change in school/teacher. Parental confidence in the school’s capabilities to care for their child throughout the school day is fundamental in both the emotional wellbeing and physical health of the child and parent.

Evaluation