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2021 Quality in Care Awards recognise the transformation of services and care provision in response to the COVID-19 pandemic

Quality in Care (QiC) Diabetes recognises, rewards and shares innovative practice that demonstrates quality in diabetes management, education and services for people with diabetes and/or their families. COVID-19 has changed the way care is delivered to people with long-term conditions, and this is exemplified by the treatment of people with diabetes. This year’s QiC awards therefore focused on recognising the transformation of services and care provision which was undertaken in response to these unprecedented times. Here, we summarise the results, which were announced on Thursday 14th October, at Sanofi’s offices in Reading. For more information about QiC Diabetes, visit https://www.qualityincare.org/diabetes

Diabetes Collaborative Project of the Year

This award recognises the value of outstanding collaborative team achievements and contributions that help better prevent, diagnose or treat diabetes and support self-care management to improve the experience and outcomes for people with diabetes and/or their families/carers in response to the COVID-19 pandemic.

Winner

Diabetes 101: Creating a Community From a Crisis

Diabetes 101

The Diabetes 101 project is a virtual diabetes multidisciplinary team (MDT) service, set up on Twitter in March 2020 in response to the COVID-19 pandemic and the first national UK lockdown. At this time, people living with diabetes were extremely anxious. Misinformation was a problem, and capacity in specialist diabetes teams was overwhelmed.

The account disseminated reliable information, stability and support to people with diabetes. It was staffed voluntarily by 19 multidisciplinary healthcare professionals. The account has more than 6000 followers, with resources shared around the world. Novel formats of education delivery have been successfully trialled and a website has been developed.

Highly commended

The National Diabetes COVID-19 Response Group Collaborative

National Diabetes COVID-19 Response Group

The pandemic meant many diabetes staff were redeployed to support general inpatient care. Information from London and Italy suggested people with diabetes and COVID-19 infection had poorer outcomes, and that the infection might trigger new-onset diabetes. In response, the National Diabetes Inpatient COVID-19 Response Group was convened in the last week of March 2020. Its purpose was to maintain consistent support for people with diabetes and provide COVID-specific guidance for specialists and non-specialists. Specialists in diabetes, pharmacy and psychology, from all four UK nations, met weekly, or more often, to create a series of pragmatic guidance documents.

Finalist

A collaborative approach to insulin delegation: a pilot to drive system change on the background of the COVID 19 pandemic

By East Sussex Healthcare NHS Trust

The rising number of older, frail and comorbid people with diabetes requiring insulin therapy via community services has put additional pressure on overstretched community nursing workloads, especially during the pandemic. Therefore, appropriately trained and competency-assessed health support workers and healthcare assistants were identified to administer insulin to people with stable diabetes control. Joint working, led by East Sussex Healthcare NHS Trust with Sussex Community NHS foundation Trust, prior to the launch of the NHSE and NHSI framework, resulted in a draft guideline to enable these workers in residential/care homes to administer insulin using pens to adults with diabetes.

More information about the project can be found in issue 4 of this Journal.

Diabetes Education Programmes – People with Diabetes

This award recognises initiatives to educate and empower people with diabetes and their families/carers to self-manage and stay as healthy as possible in response to the COVID-19 pandemic.

Joint winner

The DESMOND Programme

Leicester Diabetes Centre

With face-to-face diabetes education on hold during the pandemic, the Diabetes Education and Self Management for Ongoing and Newly Diagnosed (DESMOND) team at Leicester Diabetes Centre took various actions. New materials relating to COVID-19, resilience and emotional wellbeing were added to MyDESMOND, ensuring fair access for all. Virtual delivery Packages were set up for all DESMOND modules. Guidance for educators was written and made available to all DESMOND teams. The DESMOND Academy was launched with virtual workshop support for existing educators, new educator training was redesigned, and quality assurance assessment methods were refined for virtual delivery.

Joint winner

Providing structured education programmes virtually during COVID-19 pandemic

York and Scarborough Teaching Hospitals NHS Foundation Trust

Good2Go is a structured education course for people with type 2 diabetes. It has been running in person since 2010. The aspiration was to offer Good2Go in different formats, to make it more accessible, as working-age participants represented a large proportion of non-attendees.

The pandemic pushed the move to a virtual platform; however, the goal was to offer a portfolio of structured education options for different needs and preferences. Two solutions are now provided: a virtual webinar, delivered in the daytime or evening, or a workbook with one-to-one Q&A sessions for those without internet access. Video clips are also available.

Highly commended

Gloucestershire community diabetes education team

Gloucestershire Health and Care NHS Foundation Trust

The Diabetes Education Service was suspended in March 2020 to support the COVID-19 response, so the team proactively created a new online programme, using Microsoft Teams, to provide diabetes education. The six-part online course runs across multiple days/times of the week, including morning, afternoon and evening, to ensure flexibility for users.

The course covers diabetes management, the importance of looking after mental health and wellbeing, understanding goal-setting to encourage motivation in challenging times, and the importance of staying physically active during lockdown. The information provided accounts for psychological, physical and learning difficulties, cultural differences and other long-term health conditions.

Finalist

Remote education during the pandemic – the roll-out of a new bolus calculator app

Paediatric Diabetes Team, Royal United Hospital Bath NHS Trust

Three challenges had to be overcome: the pandemic necessitated changes to face-to-face and group education; the Expert meter, popular for accurate bolus calculations, was being phased out; and more FreeStyle Libre users wanted to use a scanned value in a bolus calculator. MyLife was identified as the most suitable bolus calculator app. The diabetes team, patients and families were educated in setup via new training resources. IT and poverty challenges were overcome to ensure accessibility. Then ward staff were trained to enable the initiation of MyLife at diagnosis. Learnings and training resources were shared with the South West CYP Diabetes Network.

Finalist

Cooking in a virtual world: How Cook and Eat adapted during the COVID-19 pandemic

Royal Devon and  Exeter Foundation NHS Trust

Cook and Eat is an established level 3 carbohydrate education programme for children and young people (CYP) at Exeter Children and Young Person’s Diabetes Service. It changed from an annual face-to-face session (for under-16s) to virtual sessions (offered to all) during the pandemic.

The CYP cook a recipe at home with a parent or carer. Each recipe is designed to be easy to follow and uses inexpensive and accessible ingredients. The carbohydrate counting process is explained and the CYP are encouraged to do it independently. The main aim is to create a fun, engaging and collaborative environment for supporting carbohydrate counting.

More information on this project can be found in Diabetes Care for Children & Young People.

Type 1 Specialist Service

This category recognises initiatives that deliver specialist support for people with type 1 diabetes, and have demonstrated a positive impact on the diagnosis and management of type 1 diabetes and associated secondary complications in response to the COVID-19 pandemic.

Winner

DigiBete App

DigiBete and Leeds Children’s Hospital Diabetes Team

DigiBete is a multi-award-winning digital web platform and app for the type 1 diabetes community, codesigned by patients, parents and the Leeds Children’s Hospital Paediatric Diabetes Team. The DigiBete.org web platform, and the subsequent nationwide app launch in 2020, provide free access to clinically approved education and training resources to support young people with type 1 diabetes, their families and communities. It has enabled rapid, direct digital communication between registered patients and individual teams during the pandemic.

The app launched regionally in October 2019, and nationally in June 2020, in response to the pandemic, with funding from NHS England.

Commended

Transforming the CHFT Children’s Diabetes Team

Calderdale and Huddersfield NHS Foundation Trust

In order to continue supporting and educating its children and young people during the pandemic, the CHFT paediatric diabetes team analysed every process for patients and considered how to deliver it virtually. Every method of communication was used, including social media and the DigiBete app, to provide patients with up-to-date advice, support and guidance. Virtual clinics were set up using Microsoft Teams to ensure patients could be seen safely. Despite 50% of the nursing workforce being redeployed internally, the transition to virtual diabetes management was successful.

Diabetes Education Programmes – Healthcare Professionals

This award recognises initiatives for the educational needs of healthcare professionals to advance skills and knowledge to support effective and efficient management of people with diabetes in response to the COVID-19 pandemic.

Winner

Delivering online competency-based training for the CamAPS FX hybrid closed-loop insulin delivery system

Cambridge Diabetes Education Programme

CamDiab commercially launched the CamAPS FX system in the UK in March 2020, after years of research at the University of Cambridge to develop the advanced closed-loop algorithm. This initiative delivered competency-based training, improving competency, confidence and troubleshooting ability, using a digital, blended learning approach for a wide range of CamAPS FX hybrid closed-loop users.

Finalist

ACADEMY

Diabetes Technology Network

Academy is an interactive, free-to-access, online education platform, developed by clinical leaders in the Diabetes Technology Network, in conjunction with Glooko, to improve access to technology across the country and provide training for healthcare professionals. It provides high quality, CPD-accredited and NHS England-endorsed training on diabetes technologies. It aims to reduce inequality in access to technology by providing education in bite-sized chunks that individuals can undertake at their own pace. Primarily aimed at specialist teams, it is also also available to community and primary care teams. The platform contains 58 topics with 368 micro-learning videos, spanning a total of 27 hours of content.

Finalist

Remote DAFNE HCP training

National DAFNE Programme – Northumbria Healthcare NHS Foundation Trust

The pandemic meant that Dose Adjustment For Normal Eating (DAFNE) patient courses and healthcare professional training had to move away from face-to-face courses. A Remote DAFNE patient course was created (April–July 2020). It comprised a five-week blend of self-directed online learning and structured virtual group sessions, facilitated by a DAFNE educator. Existing educators were trained via a virtual conversion course, developed in parallel to the Remote DAFNE course. It has been delivered to 303 educators. The Remote DAFNE Educator Programme and Remote DAFNE Doctor Programme were produced to replace in-person workshops.

Equality and Diversity – Reducing Variation of Care and Outcomes particularly as it relates to Socioeconomic, Cultural or Racial Determinants

This category recognises initiatives for people with diabetes and their families and/or carers that illustrate one or more of the eight urgent actions required to tackle health inequalities. These were outlined in the latest phase of COVID-19 response and recovery that have been identified by the NHS national advisory group of leaders from within and beyond the NHS:

  • Protect the most vulnerable from COVID-19.
  • Restore NHS services inclusively.
  • Develop digitally enabled care pathways in ways which increase inclusion.
  • Accelerate preventative programmes which proactively engage those at risk of poor health outcomes.
  • Particularly support those who suffer mental ill health.
  • Strengthen leadership and accountability.
  • Ensure datasets are complete and timely.
  • Collaborate locally in planning and delivering action.

Winner

An evaluation of group educational sessions for people with type 2 diabetes on insulin amongst Black, Asian and other ethnic minority communities

London North West University Healthcare NHS Trust

This project evaluated group sessions for Black, Asian and other ethnic minority communities with type 2 diabetes on insulin at GP practices and the Brent Diabetes Service. It explored whether giving groups of people with similar culture and languages the opportunity to discuss managing their diabetes while on insulin, in conjunction with specific foods relating to their culture, could improve their glycaemic control. It also worked with healthcare professionals in primary care to support people with diabetes, carers and families, as people registered with type 2 diabetes differed in culture, food and languages spoken.

Patient Care Pathway, Secondary and Community

This category recognises innovative patient care pathway initiatives in response to COVID-19 based on patient needs and goals with demonstrable results of improved quality and delivery of effective integrated services that are based in the community and/or in hospital.

Winner

Diabetes Digital Monitoring: building back better to support nursing teams, reduce healthcare inequalities and empower patients

University Hospitals Coventry and Warwickshire NHS Trust

Inpatient flash glucose digital diabetes monitoring has been implemented across the NHS Trust. This approach was designed in response to COVID-19 and achieved across a tertiary hospital, with devices offered to 350+ patients at the pandemic peak. The innovation allows closer monitoring of glycaemic control for at-risk patients with diabetes and COVID-19, empowers patients to manage their glucose levels, reduces inequalities in access to diabetes technology, supports overworked ward nursing teams and reduces exposure of staff to COVID-19. Patient and staff feedback was positive.

Commended

Validation and feasibility of a postal system for remote monitoring of HbA1c

East Suffolk and North Essex NHS Foundation Trust Ipswich Hospital

HbA1c measurement is important for monitoring glycaemic control in people with diabetes but, during the pandemic, access to an up-to-date HbA1c measurement was limited. An innovative and cost-effective, at-home capillary blood collection system was needed that was accurate, reliable and user-friendly for patients.

After development and validation, 286 postal HbA1c kits were sent to people with diabetes in October–December 2020. The return rate was 87%. Subsequently, the project has been integrated successfully into the diabetes service and 905 kits have been sent to patients, with an encouraging return rate of 80%.

Finalist

The only DSN in the Village

Medway NHS Foundation Trust

Diabetes care in Medway was improved by providing specialist care within the GP surgery. This reduced waiting times for appointments, duplication and delays to prescriptions, speeded up referrals and improved communication between services. A diabetes specialist nurse (DSN) was seconded from secondary care into a primary care network as a pilot project for two years. The main requirement was to assess patients with HbA1c above 75 mmol/mol.

Within 12 months, the HbA1c of 159 patients was reduced by between 9 and 95 mmol/mol, and at 18 months the DSN had reduced the average HbA1c by 9 mmol/mol across nine practices.

Mind and Body Healthy Together – Emotional Wellbeing Programmes for People with Diabetes

This category recognises initiatives that deliver emotional wellbeing support for children, young people, emerging adults and adults with diabetes of all ages and/or their families and carers in response to the COVID-19 pandemic.

Commended

Keeping young people connected during COVID-19: Adapting the Tree of Life group to run online

University College London Hospitals NHS Foundation Trust

The pandemic disrupted the lives of young people living with type 1 diabetes, with limited or no face-to-face contact with healthcare teams. The Tree of Life groups had been run in person at UCLH since 2010, helping young people to develop positive views of themselves, connect with others and improve diabetes management (see articles in issue 6:1 and issue 8:2 of Diabetes Care for Children & Young People).

The groups were adapted to be delivered online, focusing on fun and creative ways of connecting young people with each other. Between July 2020 and June 2021, three Tree of Life groups, one “Peer Trainer” event and a professional training event were held virtually.

Diabetes Professional of the Year

This award recognises diabetes healthcare professionals based in the UK or Ireland who have succeeded in raising standards of care over and above their day-to-day role in response to the COVID-19 pandemic. The judges look for evidence of changes in practice in 2020, initiated and led by the nominee, demonstrating positive outcomes in care and clear benefits for diabetes service users and/or their families and carers.

Winner

Dr Philip Newland-Jones

Dr Newland-Jones is the Clinical Director for the University Hospital Southampton inpatient diabetes and endocrine team. He is the first consultant pharmacist in this organisation to be a clinical director. He has been incredibly supportive to all staff members throughout the whole COVID-19 period, enabling them to switch to a seven-day clinical inpatient service during the second wave. He was involved in the Diabetes 101 project and helped to write the diabetes COVID guidance that is now used on a daily basis within the organisation.

Dr Newland-Jones is an inspirational leader and always goes that extra distance to ensure the team is well informed and supported. He is well respected for his work at a local and national level and always has time to check in on each member of the team. His colleagues say: “We are so lucky to have Phil within our team; he has really ensured that we have become a close-knit, cohesive group who often meet socially outside of work, further enhancing the team.”

Outstanding Educator in Diabetes

Supported by the Primary Care Diabetes Society (PCDS), this award is presented to an individual who is based in the UK or Ireland and has delivered excellence in education in response to the COVID-19 pandemic in a specialist or community setting: whether through developing innovative teaching tools or courses; providing mentorship for other educators; or delivering and promoting externally developed training. He or she will have a clear patient focus and be seen as a champion for education in his or her area.

Joint winner

Dr Rebecca Thomas

Rebecca Thomas has been nominated for her willingness to go above and beyond in supporting and educating people living with diabetes. She has done this though her voluntary work with the Diabetes 101 team and the DSN Forum UK. Her strong social media presence has been used to reach out and help people with diabetes when they have asked, to help translate the complex eye screening and eye clinic letters that often cause anxiety and fear into a patient-friendly language.

Becky has also designed many diabetes-related retinopathy infographics and also in relation to COVID-19 and the restart of screening and what this means for people with diabetes. She also designed and presented at the Diabetes 101 Downloaded conference, which was specifically for people with diabetes. Her talk was titled “The Eyes Have it” and it focused on demystifying the letters and numbers on eye screening results letters into an understandable format. She also explained the data around retinopathy to help people understand more about the risks and the screening journey that they undertake. Becky does a lot of this extra work in her own time, voluntarily.

Joint winner

Sally Woolgar

Sally Woolgar has worked in adult type 1 diabetes for over 20 years, the last seven as the lead trainer for the national DAFNE team, making a prolonged and significant contribution to patient care. Over the last 15 months Sally has led on the creation, piloting and refinement of a remote and online patient course and associated healthcare professional training. Her work has ensured that patients and professionals can continue to access DAFNE training and, importantly, enabled seven new DAFNE centres to be trained during the pandemic, further increasing access to DAFNE courses for people with diabetes.

NHS England Outstanding Contribution for Services in Diabetes

This award recognises an individual for their sterling work to improve diabetes care. NHS England are always grateful for the efforts the whole diabetes community puts forward to improve care, and this award recognises one individual for their efforts during this year.

Winner

Dr Shivani Misra

Dr Misra is a Consultant in Metabolic Medicine and Diabetes at Imperial College Healthcare NHS Trust, and an Honorary Research Fellow within Imperial College London. She is an NIHR Clinical Champion in Diabetes Stratified Medicine and has been awarded a Future Leaders Mentorship Awarded from the European Federation for the Study of Diabetes (2017). Dr Misra also leads the MY DIABETES study, which recruits at over 40 sites around England and phenotypes young-onset diabetes in different ethnic groups. This outstanding work is why she has been recognised in 2021.

NHS Wales Outstanding Contribution for Services in Diabetes

NHS Wales is very fortunate to have many dedicated and enthusiastic healthcare professionals who have championed and progressed diabetes service development. It is a pleasure to have this award to recognise and celebrate this dedication and outstanding achievement.

Winner

Chris Cottrell-Morgan

Chris is a Diabetes Specialist Nurse who has worked in both the acute sector and the community for many years. She has been one of Wales’ leading nurses and a founder member of the Wales Academy of Nurses in Diabetes. Chris has worked on numerous projects such as Think Glucose, education, COVID Guidelines and care homes.

The People’s Award

This award is presented to someone who is based in the UK or Ireland and is not a healthcare professional. Instead, it will go to an individual such as a carer, volunteer, a person with diabetes, diabetes blogger and/or writer, a family member – anyone that you think deserves this recognition.

Winner

Chris Bright

Sheffield Children’s NHS Foundation Trust

Chris Bright has been instrumental in keeping spirits up, providing emotional and uplifting support for people with diabetes and also using social media to spread positive initiatives during a very uncertain time. Chris could not run any The Diabetes Football Community (TDFC) sessions in person and so prioritised maximising the use of a TDFC WhatsApp group and social media to support people with diabetes. These were used as key information points.

The TDFC community consists of people with type 1 diabetes of both sexes across the country who have a passion for football. Chris used these media to communicate up-to-date advice on the changes in restrictions during the pandemic, provide emotional support for those undergoing changes to their working lives, contact those who were unwell, organise and encourage participation in online social meet-ups, and organise fun activities online (e.g. Zoom meetings, video game tournaments and the toilet roll challenges).

Furthermore, Chris encouraged others to get the COVID vaccine and also advised seeking more information for any concerns or hesitancies people had on getting vaccinated. Chris utilised his influence to encourage thanks towards the NHS and uplift those with diabetes. These have been clear on his and TDFC’s social media platforms:

 

Judges’ Special Award

The Judges’ Special Award (not enterable directly) is judged from all entries received, irrespective of category, for a project that the judges feel deserves national recognition and a platform to be shared with the wider diabetes community.

Winner

The National Diabetes COVID-19 Response Group Collaborative

See Diabetes Collaborative Project of the Year for description.

Unsung Hero award

Winner

Diabetes 101: Creating a Community from a Crisis

See Diabetes Collaborative Project of the Year for description.

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