SEREN Connect is an education programme that will help healthcare professionals support young people and young adults living with type 1 diabetes (T1D) who are moving between healthcare services and other concurrent life transitions. As an education programme, SEREN Connect is less focused on what T1D is and more about what it is like living with T1D.
SEREN Connect was launched in September at the NHS Wales Diabetes Professional Conference 2019, after 3 years in development. Teams using it have an opportunity for positive learning that aims to build better connections between:
- Paediatric and adult services
- Young people and their healthcare teams
- The young person and their T1D.
A time of great change
Emerging adulthood is a time of great change in young people’s lives. For those living with T1D, these changes can impose great difficulty on the task given to them of self-managing their condition in all aspects of life. If we really want to see a change in outcomes, it is essential to improve the relationship a young person has with their T1D during this notoriously challenging time.
For people with diabetes to achieve what is expected of them, there needs to be the belief that they can manage diabetes in every aspect of their lives. T1D creeps into all facets of life and there is more to management than leaving the clinic, taking insulin, eating healthily, counting carbs and turning up at the appointment given in the next clinic letter.
Programme development and focus
The SEREN working group, which produced the award-winning paediatric structured education programme that is used across Wales, has been responsible for developing SEREN Connect. The course was shaped by the experiences of and through input from young people and young adults living with T1D as well as parents and families affected by T1D from Wales and beyond.
The SEREN working group worked with young adults to identify key themes that need to be addressed at this life stage. They ascertained what information about managing T1D was most needed and developed activities to build confidence in young people, see Box 1. All disciplines working in diabetes care across the seven health boards in Wales contributed, including paediatric and adult diabetes consultants, paediatric and adult specialist nurses, paediatric and adult specialist dietitians and clinical psychologists. Advice was sought from podiatry, Diabetic Eye Screening Wales and GP colleagues. The programme aligns with recommendations in the All Wales Standard for People with Diabetes Moving from Paediatric to Adult Services within NHS Wales (2017).
The development team found that much of the information that was previously available said ‘talk to your healthcare team’. This is not always helpful or practical, especially when the information that is needed is not direct clinical or treatment advice. SEREN Connect fills a gap, creating a safe and proactive space in which healthcare professionals and young people can:
- Discuss key issues openly and honestly
- Share lived experience
- Acknowledge triumphs and hurdles
- Normalise life with T1D.
Providing information early on
Healthcare professionals recognise that when a person with diabetes hits crisis point they are already disengaged and in ‘burnout’. SEREN Connect provides the information and advice a young person needs before this point as a staple part of diabetes care. It does not replace clinical appointments, but enables staff to deliver age-appropriate education to prepare young people for life with T1D as a young adult. As a result, clinic consultations can focus on areas in which the young person needs further support, changes to treatment, and more clinical aspects of care. It is hoped this will result in more quality conversation between the young person and healthcare professional and improve engagement.
SEREN Connect is split across four group education sessions delivered over a 2-year period by a multidisciplinary team that consists of a mix of paediatric and adult practitioners. Staff members delivering the course receive a fully comprehensive curriculum and facilitator guide, see Figure 1, an education delivery pack that can be used to prompt and promote discussion during sessions, and
take-away messages in the form of booklets, see Figure 2.
Implementation across Wales
Healthcare professionals in Wales have been receiving facilitation skills training and are being supported by the NHS Wales Transitional Coordinator to roll out the first sessions across local health boards. Early feedback has been very positive:
‘I felt because some things never impacted me personally, I never educated myself about them. I think it’s so good to think young people will have this SEREN Connect information. This was all things I had to learn myself, the wrong way!’ Young adult
‘I think this is the gap that’s been missing for us as healthcare professionals!’ Adult diabetologist
A holistic approach
The hope is that SEREN Connect will change the way services view how diabetes care can be delivered, providing a more holistic approach focusing on what happens in life around T1D. Young people need to learn how to navigate life, making a little bit of space for T1D in everything they do. Services that can offer dedicated space and time for this will provide a vital part of much-needed support for young adults.
With its unique focus on ‘life with T1D’, SEREN Connect heralds a new approach for diabetes education; it is enabling new conversations as well as improving learning for people with T1D and healthcare professionals. With this resource to help them, teams can prepare emerging adults for the many challenges that arise as they become independent young adults – and ensure they are ready to meet these challenges successfully.
NHSEI National Clinical Lead for Diabetes in Children and Young People, Fulya Mehta, outlines the areas of focus for improving paediatric diabetes care.
16 Nov 2022