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Tenth annual Quality in Care awards recognise best diabetes practice in the UK and Ireland

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. It is partnered with Sanofi and supported by the Association of British Clinical Diabetologists (ABCD), Association of Children’s Diabetes Clinicians (ACDC), Children and Young People’s Diabetes Network, the Diabetes Inpatient Specialist Nurse (DISN) UK Group, the Diabetes Specialist Nurse Forum UK, Diabetes Research & Wellness Foundation, Diabetes UK, JDRF the type 1 diabetes charity, Primary Care Diabetes Society, Training Research and Education for Nurses in Diabetes (TREND-UK), Young Diabetologists and Endocrinologists’ Forum and the United Kingdom Clinical Pharmacy Association. This year’s QiC Diabetes Awards were announced in an online ceremony live-streamed in October, which can be watched at www.qualityincare.org/diabetes/2020. New awards included: Prevention, Remission and Early Diagnosis; Patient Care Pathway, Secondary and Community; and Diabetes Education Programmes – People with Diabetes. Results in the paediatric categories will be published in Diabetes Care for Children & Young People. Here, we summarise the results in the overall and adult categories. 

Best Practice in Dissemination and Sustainability


This award recognises people and teams who have previously been recognised within QiC Diabetes. Qualifying initiatives have successfully disseminated and sustained best practice for a minimum period of 2 years, for the ultimate benefit of people with diabetes and/or their families and carers.

Winner

Sustaining improved outcomes for young adults: The Liverpool model
Liverpool University Hospital NHS Foundation Trust (Royal Liverpool University Hospital)

In 2017, the Young Adult Service at the Royal Liverpool University Hospital won a QiC Award for a significant reduction in non-attendance rates, increased numbers achieving glycaemic targets, reduced diabetes-related emergency admissions and substantial cost savings. This was achieved through restructuring the service pathway, improving communication and engagement with young adults, and establishing a peer-support platform. Further changes have resulted in continued improvements in service-related and clinical outcomes for young adults with diabetes. NICE has highlighted it as an example of best practice and NHS England has used it in defining standards of care for young adults.

Highly commended

Carbs & Cals books, app and teaching resources
Carbs & Cals/Chello Publishing Ltd

Carbs & Cals specialises in books and apps for diabetes, weight loss, portion control and healthy eating. Using thousands of food photos to count carbs and calories is revolutionary and simple. Nationally recognised as the leading carb-counting resource for type 1 diabetes (T1D), Carbs & Cals has published 12 books since 2014, including resources for type 2 diabetes (T2D), weight loss, gestational diabetes and Black, Asian and minority ethnic communities. The self-funding project works to ensure more people can self-manage diabetes and other conditions.

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


This category recognises initiatives that deliver emotional wellbeing support for people with diabetes of all ages and/or their families and carers. Initiatives are not limited to people with “diagnosable/classifiable” psychological problems.

Winner

Collaboration with IAPT to improve diabetes pathways – simple innovation!
North East Essex Diabetes Service (NEEDS)/Suffolk GP Federation

The association between diabetes and mental health is well recognised, widely referenced in the literature and witnessed first-hand by clinicians in their day-to-day working. North East Essex collaborated with the local Health in Mind/Improving Access to Psychological Therapies (IAPT) team to improve access, care and outcomes for those living with diabetes in the region. Initially, IAPT therapists were invited to diabetes patient education events but this led to the development of new clinics, a specific diabetes/well-being course and much more. The main outcomes were improved access, improved psychological well-being scores and better diabetes self-management.


 

Highly commended

Talking Type 1 – making diabetes psychology accessible for everyone
Talking Type 1 (All Wales Diabetes Improvement Group)

Talking Type 1 Diabetes Burnout is the first guided self-help resource for people who live with T1D and have diabetes-specific psychological issues. It was co-produced by a diabetes specialist clinical psychologist and people living with T1D around the world. It is free for patients in Wales with T1D. Feedback from staff has been positive, and there has been significant interest in and demand from both services and people living with T1D outside Wales. Talking Type 1 Diabetes Burnout aims to meet significant unmet psychological need and lack of adequate staffing.


 

Diabetes Education Programmes – People with Diabetes


This award recognises initiatives to advance the skills and knowledge of people with diabetes.

Winner

SEREN Connect: holistic young adult diabetes education
NHS Collaborative, NHS Wales

SEREN Connect is a comprehensive education programme to address a long-standing gap in service provisions for young adults living with T1D. It helps teams to support every child with diabetes in Wales. The transition from young person to young adult and the difficulties of trying to self-manage health is hard at this notoriously turbulent time. SEREN Connect provides tools for healthcare professionals to deliver information on age-appropriate topics that directly or indirectly impact the lives of young adults living with T1D. It aims to influence and improve services across Wales, via paediatric and adult colleagues.


 

Highly commended

The Know Diabetes Service: supporting patients through innovation
North West London Health and Care Partnership

The Know Diabetes website was created in 2015 to provide information about user group activities. Since 2017, MyWay Digital Health and Dynamic Health Systems have partnered to redesign and extend the Know Diabetes Service to: support over 300,000 people with diabetes, previous gestational diabetes or nondiabetic hyperglycaemia; encourage sustained behavioural change using personalised proactive communications; promote public awareness of diabetes; provide information to high-risk ethnic groups; increase access to formal education programmes with a single point of referral; and support self-management. The relaunched service had over 70,000 users in 3 months and positive feedback.
 

Diabetes Education Programmes – Healthcare Professionals


This award recognises initiatives to advance the skills and knowledge of healthcare professionals to support effective and efficient management of people with diabetes.

Winner

Insulin education for all: a pop-up online resource
Faculty of Medicine, University of Southampton

The free online Understanding Insulin course was developed to benefit insulin users worldwide. There was a need to improve insulin knowledge among healthcare professionals, people with diabetes and their carers, as insulin-related errors are common in the UK and internationally, increasing the risk of adverse complications and poor health outcomes. In the National Diabetes Audit, 49% of patients on insulin had experienced an insulin-related error.


 

Commended

Developing world-class D&E training: the Health Education West Midlands model
Health Education West Midlands

Trainee representatives, training programme directors and the specialist training committee set out to establish a world-class diabetes and endocrinology training programme in the Health Education West Midlands region. The methods, which facilitate high-quality, cost-effective speciality training, are replicable nationally and internationally. Mechanisms used include: curriculum mapping of training days to ensure full content coverage; defining and standardising training representatives’ roles and responsibilities; digitising processes around training days and administration; innovative education approaches, including simulation; additional educational opportunities to promote holistic training; and a COVID-19 responsive approach to training and learning, tracking trainee opportunity.
 

Commended

Making insulin treatment safer (MITS) through reflective case-based discussions
Queen’s University Belfast

This project supports newly-qualified doctors, final-year medical students on a preprescribing programme and other insulin-prescribing professionals to examine their insulin prescribing for inpatients via case-based discussions. The case-based discussions are facilitated by a MITS trained doctor, nurse, pharmacist or person with T1D (patient advocate). The aims are to empower prescribers to: handle the inherent complexity and uncertainty of prescribing insulin; work well with different disciplines and levels of seniority; respect patients’ rights to be involved in their own care; and consult other people and information sources.

Type 1 Specialist Service


This category recognises initiatives that deliver specialist support for adults with T1D and have demonstrated positive impact on the diagnosis and management of T1D and associated secondary complications.

Winner

Growing up, moving on – supporting young people leaving paediatric services
Cwm Taf Morgannwg University Health Board

Prince Charles Hospital in Wales is in an area of marked social deprivation, but the paediatric unit has recorded some of the best outcomes in the National Paediatric Diabetes Audit for several years. Following critical feedback from young people moving to adult services, the paediatric team engaged their colleagues in adult services to address issues that led to disengagement and deterioration in outcomes. This process began in 2016 and, within a year, NHS Wales hailed the model an example of good practice. Evaluation and changes were accomplished through reconfiguration of existing work patterns and without additional costs.

Patient Care Pathway, Secondary and Community


This category recognises innovative patient care pathway initiatives 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

Cardiometabolic care: a pharmacist-run diabetes clinic in general practice
The Paula Carr Diabetes Charitable Trust

Patients with diabetes in the Medway CCG area were 88.6% more likely to have a heart attack and 85.7% more likely to have a stroke than the general population, while targets for blood pressure and cholesterol were below the NHS England average. These findings prompted a service re-evaluation. Glycaemic support is inadequate to manage macrovascular complications, but a multifactorial management approach can reduce cardiovascular mortality by about 50%. A pharmacist prescriber ran a pilot service for 8 months using a cardiometabolic approach to review glycaemic control, blood pressure and chronic kidney disease in five practices.

 

Highly commended

WISDOM: West Hants Improving Shared Diabetes Outcome Measures. A blueprint
West Hants Community Diabetes Service

WISDOM was developed in September 2017 in response to below average CCG National Diabetes Audit outcomes for the three treatment targets for T2D. The project evolved from a blueprint for Primary Care Network management of diabetes to a sustainable component of the new community service contract (April 2020). WISDOM focuses on professional culture change, rapid clinical results and wider adoption across the locality. It illustrates how a large, population-level intervention can deliver measurable results within 2 years, change existing commissioned activity and influence neighbouring CCGs. Dorset and Southampton CCGs have both adopted this intervention.
 

Commended

Norwich Inpatient Diabetes Service (NIPDS): supporting staff, empowering patients, preventing glycaemic harms
Norfolk & Norwich University Hospital NHS Foundation Trust

A multidisciplinary inpatient diabetes service model was developed to improve care. This comprised a succession of interventions in service delivery, systemic changes and staffing levels, implemented over 18 months. The aim was to amplify outcomes via the augmentative effects of each single intervention. Outcome data demonstrated significant success in supporting staff, protecting at-risk patient groups, empowering patients via education, and preventing glycaemic harms. The qualitative improvement outcome, cost-effectiveness and sustainability were acknowledged by significant additional funding to expand the inpatient diabetes service  team. Data from this work supported the recent Joint British Diabetes Societies Inpatient Care Group guideline for diabetes inpatient specialist nurses.
 

Prevention, Remission and Early Diagnosis


This category recognises the impact of preventative initiatives to help people and their families and/or carers to live healthier lives and reduce the risk of developing diabetes, and of early diagnosis, and diabetes management including initiatives that result in diabetes remission.

Winner

All Wales quality assured brief intervention pre-diabetes pilot
Cardiff and Vale UHB/Swansea Bay UHB on behalf of All Wales Diabetes Implementation Group

This innovative pilot project delivers a targeted approach to prevention of T2D in Wales using the criteria of HbA1c, hypertension, obesity and age >45 years, followed by a brief intervention utilising unregistered practice-based staff trained by registered dietitians in a Nutrition Skills for Life course. An All Wales diabetes prevention pathway was developed to enable the scalability of this initial primary care cluster work. Evaluation showed this to be an effective model, with 62% of participants going from pre-diabetes to normal glycaemia. The health economic review predicted the cost per QALY gained to be −£5,300.

Commended

Scalable, flexible and cost-effective diabetes prevention
Discover Momenta Ltd

Discover Momenta has worked for 20 years to develop, evaluate and disseminate behavioural healthy lifestyle programmes for delivery by trained non-specialists. The aim was to create a scalable and replicable, evidence-based T2D prevention programme to achieve world-class health outcomes cost-effectively across multiple commissioning/delivery contexts. Momenta’s programme has been independently evaluated as achieving the best health outcomes (weight-loss and HbA1c reduction) of all NHS diabetes prevention programme providers. It is demonstrably the most cost-effective. Its success has led to further programmes in T2D remission and cardiovascular disease prevention, launched in September 2020.
 

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

Nick Cahm

Nick Cahm was recognised for his outstanding support of patients with T1D, communicating with all levels of the NHS and with pharmaceutical companies.


 

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

Dr Rose Stewart

Dr Stewart has been integral to changing the approach to diabetes in Wales. She has educated and enlightened and provided powerful leadership to encourage embedding psychological health and well-being in all work being carried out in Wales. This has never been more important than this last year.


 

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, and recognises 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

Vicki Alabraba

Vicki is a diabetes specialist nurse at Liverpool Diabetes Partnership. Liverpool’s diverse population means there is a need for innovative ways to provide support and information to patients. Vicki has embraced the world of social media through Twitter, Facebook, Instagram, webpages and recently Tik Tok, using her expertise and enthusiasm to keep patients and carers motivated in self-management. She has used opportunities such as VE day to remind service users that the Diabetes Partnership is still there to support them and promotes diabetes-related calendar events such as Insulin Safety Week.


 

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 delivers excellence in education 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 will be seen as a champion for education in his or her area.

Winner

Lizbeth Hudson

Lizbeth has always gone the extra mile to help children, young people and parents to understand the information around diabetes care. She is kind and caring and always has time for people – even when she is so very busy. Sandwell has consistently had the best HbA1c results for the past 5–6 years and yet is a very deprived area, which makes managing diabetes harder. Lizbeth has achieved great results in difficult circumstances.


 

The People’s Award


This is a special award, supported by Diabetes UK, which recognises someone very special who has supported/cared for people with diabetes in 2020.

Winner

Lis Warren

Lis has lived with T1D for over 5 decades and, now retired, seems to have a full-time ‘job’ dedicated to helping others with diabetes. Much of what Lis does is in the background: she doesn’t seek the limelight yet is happy to present and talk at courses and events for healthcare professionals. It is the tireless work she does within the charities, Trusts and CCGs for which Lis deserves recognition, making sure patients are represented wherever possible, especially where policies are being set. She also chairs meetings and runs charity stands. Everything is done with positivity.


 

Diabetes Team of the Year


Teamwork plays a critical and growing role in high-quality diabetes care. This award recognises the value of outstanding multidisciplinary team achievements and contributions that help better prevent, diagnose or treat diabetes and support self-care management to improve the experience and outcomes for adults, children, young people and emerging adults with diabetes and/or their families and carers.

Winner

Paediatric diabetes quality improvement – be brave and fail fast
Sheffield Children’s NHS Foundation Trust

In the 2014–15 National Paediatric Diabetes Audit, Sheffield was one of the top 10 units in the UK, with 38.4% of patients achieving an HbA1c <58 mmol/mol (national average: 22.0%) and a mean HbA1c for the clinic population of 62.8 mmol/mol (national average: 70.6 mmol/mol). Benchmarking against 2016–17 data showed that outcomes were deteriorating when those nationally were improving, so an application was made to join the Royal College of Paediatrics and Child Health National Diabetes quality improvement initiative pilot to bring about changes. Outcomes for newly-diagnosed patients in the 2 years since compare favourably to preceding years and other paediatric units.


 

Commended

Diabetes inpatient nurse team integrated quality improvement project
Cornwall Foundation Partnership Trust & Royal Cornwall Hospital

The 2016 National Diabetes Inpatient Audit identified a number of management, clinical and patient safety issues resulting in harm. A diabetes inpatient nurse team quality improvement project was initiated to improve quality and safety for adult diabetes inpatient care, focusing on key issues. The team worked across organisational boundaries, systems and teams, delivering significant improvements to diabetes inpatient care and safety. Substantial funding has been secured for the team to continue to improve and drive diabetes inpatient care and safety.
 

Unsung Hero

Winner

Katie Courtney and Ava Morgan, creators of Hypo Dino

These two young girls covered an important area and showed a remarkable achievement in creating the Hypo Dino book on their own initiative. Their story is very powerful and these two young people are extraordinary.


 

Winner

Dr Rose Stewart

Rose demonstrated that individuals can really drive change. The Talking Type 1 project was a great programme with impressive outcomes and Rose was the leader on this, making a real difference to patients’ lives. This was Rose’s second 2020 QiC Diabetes Award, as she was also winner of NHS Wales Outstanding Contribution for Services in Diabetes.
 

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

SEREN Connect: holistic young adult diabetes education
NHS Collaborative, NHS Wales

See Diabetes Education Programme – People with Diabetes for description.
 

Spirit of the Time

Winner

ArT1st: celebrating talents of the type 1 diabetes community during the COVID-19 Pandemic
ArT1st Team

‘ArT1st’ was created in November 2019 by Professor Partha Kar to develop artistic peer support within the T1D community, with a live event planned for June 2020. The COVID-19 pandemic put the event on hold. The lockdown adversely affected mental health so, to help lift the mood and reduce social isolation, the ArT1st team launched an online project for the community to send in art contributions. More than 150 were received from countries worldwide over 8 weeks. There was much interaction on social media and many positive comments. Friendships developed and artistic collaborative projects resulted. The live event is still planned.

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