Paediatric diabetes operational 1745.pdf - East Cheshire NHS Trust

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Membership Arrangements Members of the MDTCOREMEMBERTeam Member Role CoverSurendranChandrasekaranNicola BirtwistleGeorgina TimsonLead clinicianLead PDSNPaediatric DiabetesDieticianS Melanie Hodskinson Admin/secretarial supportall consultantsChildren’sCommunity TeamEXTENDEDDenise Baillie Paediatric ManagerDr WaiKaren Bliss/SteveDavisAdult DiabetologistLead Adult DSNsAdrianneSally ChartresDieticianPharmacistOutpatient ServicesThere is a weekly diabetes clinic on Monday afternoons between 14:00 – 18:00 in theChildren’s outpatient department at Macclesfield DGH for all young people with diabetes upto the age of 16 and for pump patients up to the age of 18. Appointments in the clinic arefor 20 minutes with all team members. If additional time is required with the PDSN ordietician a home visit or nurse led clinic appointment can be arranged outside normal clinictime.Transition clinics (Please see Transition policy)There is a monthly transition clinic, on the 4 th Wednesday of the month for patients fromages 16 to 18, attended by an adult diabetologist and PDSN. The young adult is seen eitherby the adult consultant/PDSN or both.Patients are referred to the transition clinic in school year 11 after their GCSE’s (age 16). Itis hoped that these appointments allow young people the opportunity of meeting the adultteam while still feeling supported by the paediatric team. At the discretion of the MDT itmay be decided that young people will remain with the paediatric service beyond year 12or that they will remain in the transition service for longer than 1 year. This is particularlyrelevant to young people who are attending the CDC and are still attending a special school.Insulin pump patients are referred at the age of 18 to Manchester Royal Infirmary withwhom theCYPD team has developed links. The PDSN aims to attend the first clinic appointment withChildren’s Diabetes MDT Operational Policy May 23, 2012 10
the patient.All ClinicsPatients are all invited by letter to the next outpatient appointment; this is arranged by theMDT at their previous appointment. It is the hospitals responsibility to ensure letters aresent confirming follow up appointment dates and times.At all clinics patients have near patient testing of their HbA1c, so that results are availableat the time of their consultation.The MDT ensures that patients are offered appointments at least every 3 months in linewith national guidelines. New patients are seen on a more regular basis initially dependenton need. We would also arrange earlier review for specific patients if required. This mayinclude patients who have recently changed insulin regime, are running high HbA1c or if acrisis has arisen as highlighted by the family themselves or a member of the MDT.Core members of the MDT will be present at all outpatient clinics and patients will haveaccess to a member of the MDT at all times.Should patients consistently not attend their appointments the DSN will contact thefamilies directly and letters will be sent to both the family and GP highlighting the nonattendanceand further planned course of action.At the beginning of each clinic all patients from clinic are discussed within the MDT. TheMDT will also discuss any other patients where issues have arisen and decisions arerequired.Inpatient careChildren and young people will be admitted to the paediatric ward if they require inpatientcare. Any child admitted with diabetes will be discussed with a member of the MDT andadvice will be given on management of their diabetes while in hospital. Any in patients willbe reviewed by a member of the MDT within 24 hours of admission to hospital unless theadmission is over a weekend. Out of hours the care of children with diabetes will bemanaged by the on call paediatric registrar and consultant. A member of the MDT will oftenbe available for advice if required.Advice on the management of new patients on those admitted with DKA as well as advicefor any children admitted as an emergency with a surgical problem can be found onstre@mline, the intranet and shared drive.Children who are admitted for routine surgery will have already been discussed with theMDT after the child has been seen in the surgical pre admission clinic. Any plans for achange in treatment prior to admission to hospital will have been discussed with the familyby the PDSN. A treatment plan for the admission will have been discussed by the MDT andthis will have been discussed with the nursing staff and documented in the patient’s’ notes.Guidelines for the management of diabetes during surgery are available on the intranet andshared drive.Children’s Diabetes MDT Operational Policy May 23, 2012 11
Page 1 and 2: Paediatric and Adolescent Diabetes
Page 3: Table of contentsIntroduction……
Page 6 and 7: Purpose of the MDTThe aim of the MD
Page 8 and 9: and their carers.• Contributing t
Page 12 and 13: The MDT MeetingsWeekly MeetingsWeek
Page 14 and 15: Patient InvolvementThere is an acti
Page 16 and 17: Adherence to GuidelinesThe MDT look
Page 18 and 19: Equality Analysis (Impact assessmen
Page 20 and 21: From the evidence available does th
Page 22: 7. Any actions identified: Have you

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