Paediatric diabetes operational 1745.pdf - East Cheshire NHS Trust

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