Summary
Children and young people (CYP) with diabetes spend one third of their life in school, often being cared for by staff with limited diabetes knowledge. In 2024, DigiBete launched diabetesinschools.org – comprehensive, interactive online training for school staff. It was created in collaboration with healthcare professionals (HCPs), young people and major diabetes charities, Breakthrough T1D and Diabetes UK. It has provided national consistency in schools training, is time efficient for HCPs, providing prior knowledge to complement in-person practical skills training. It is used alongside a digital healthcare plan, which all CYP need in school.
Innovation/Novel approach to an existing problem
More is expected of school staff than ever before, and a lack of understanding or training in diabetes care can create tension between staff and families. Health needs in school must be addressed to keep children safe. Poor school support can result in a change of school and disruption to education. Some parents reduce or give up employment opportunities due to lack of confidence in school care. School training is relentless and time consuming for HCPs and patients. In early 2024, representatives from DigiBete, Children and Young People's Diabetes Network (NCYPDN), HCPs, Together Type 1 (Diabetes UK) and Breakthrough T1D examined an existing schools e-learning package (from NCYPDN and JDRF, now Breakthrough T1D) with a view to updating it. The programme lacked content in certain areas, including modern diabetes technology and the emotional burden of diabetes. The In School Study of 2023 reported the unmet needs of young people who emphasised feelings of diabetes stigma. This study aimed to provide an evidence base for essential modules in the updated training. As a respected digital brand sponsored by the NHS, DigiBete, in collaboration with the trusted stakeholders listed, CYP with diabetes, parents and school staff, created comprehensive online training for school staff. This can be completed at a time convenient to them, ideally ahead of in-person practical skills training from an HCP. Divided into content appropriate for primary and secondary ages, it is in module format and includes contributions from all HCP groups, school staff, parents and CYP, to ensure their lived experience is heard. The training is in multimedia format to make it engaging, combining animated content, instructional videos of real HCPs and CYP recounting their experiences, with an assessment of knowledge for staff at the end. Content reflects both the physical and emotional impact of living with diabetes. Pilot testing took place in mid-2024, with amendments made and reviewed by a digital safety officer (to meet digital safety standard DCB0129) before launch. The national roll-out in September 2024 provided consistency and updated training to reflect current UK diabetes practice including hybrid closed loop (HCL) and continuous glucose monitoring (CGM) therapy. This new diabetesinschools.org training supercedes the previous training. Other schools resources are also available to download via this platform. The online training for schools complements the existing digital healthcare plan available for all families to use for children in school. All CYP in school should have a individual healthcare plan, which needs updating annually, agreed with CYP and family, HCP and school.
Equality, Diversity and Variation
The training is accessible to all school staff nationwide at no cost to the school or local diabetes services. This reduces variation in schools training provided by HCPs across the country and allows all services to be more time efficient, as school staff are more prepared ahead of any individual training. There are different training options for primary and secondary school staff, reflecting the different needs of younger vs older children. The site features CYP from different ethnicities; it is provided in English as most school staff have language skills at a suitable level. Much of the content is visual and auditory with a written transcript available. Feedback from school staff completing the training is from all areas of England, Wales and Scotland, showing wide reach.
Impact to Patient Care
Including the voice and experience of children with diabetes in school has represented them, and given school staff more insight into the practical and emotional challenges of living with diabetes. The training advocates for CYP whose needs can be ignored in school. It also explains the need for technology in school. The training empowers school staff with the knowledge and tools they need to truly support students, ensuring they feel safe, and thrive academically, socially and emotionally.
Results
The training was funded by a non-restrictive educational grant from Sanofi UK, Breakthrough T1D and Diabetes UK. This enabled content creation that is available free to all users and all children's diabetes services. A total of 55,000 active users have visited the platform, using all the pages. In total, 20,145 people have registered for courses on the platform; 12,781 different schools have registered; 19,625 people have started the courses; 14,786 people have completed the courses; 14,356 people have completed the assessment and got a certificate. Assessment pass rate is 80% with an average score of 91.76%. The practical training takes about an hour. This is more time efficient for HCPs and easier to arrange with school staff, who have already completed the online training, often in smaller chunks of time at their convenience. Freeing up nursing time has enabled a refocus on HCL rollout in paediatrics.
User Feedback
Optional feedback was collected by anonymous survey after completing the assessment at the end of training. A total of 3,104 people completed the primary school assessment and provided questionnaire feedback: 92% said they strongly agree/agree with the statement "I feel more confident managing diabetes completing this course”. A total of 1,637 people completed the secondary school assessment and provided questionnaire feedback: 91% said they strongly agree/agree with the statement "I feel more confident managing diabetes completing this course”. The same survey asked for any potential improvements or gaps in knowledge to focus further development.
