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New Initiative to Address Inconsistencies in Diabetes Care

The Royal College of Physicians (RCP) announced the imminent launch of a programme to improve and standardise diabetes care in hospitals across the UK .

The Diabetes Care Accreditation Programme (DCAP) aimed to set quality treatment standards and measure service performance through external peer assessment, the College said.

Since the inception of the National Diabetes Inpatient Audit, launched in 2010, some improvements to in-patient care have been noted by Diabetes UK, but the charity's 2018 report, Making hospitals safe for people with diabetes, found that serious medication issues affected 260,000 patients with diabetes, with 1 in 25 people with type 1 diabetes experiencing hospital-induced diabetes ketoacidosis as a result of under treatment with insulin in 2017.

Moreover, the report highlighted a lack of any universal standard for measuring hospitals' performance and a lack of confidence by junior doctors and other frontline staff in managing diabetes .

Setting Standards

Those issues prompted Diabetes UK to partner with RCP's accreditation unit to address standardising care and providing quality assurance. Dr Daniel Flanagan, the clinical lead for the accreditation unit, said it would "allow hospitals to look, in detail, at how they provide diabetes care and how they compare against others".

The new DCAP standards, due to come into effect on 31 May, were developed by the Joint British Diabetes Societies Inpatient Group (JBDS-IP), the Association of British Clinical Diabetologists, the Diabetes Inpatient Specialist Nurse UK group, and diabetes patients who took part in a pilot programme. They combine elements from national guidance, including the 2017 Diabetes UK report, the National Diabetes Inpatient Audit, the NHS's Getting it Right First Time programme, and guidelines drawn up by the JBDS-IP.

Esther Walden, senior clinical advisor at Diabetes UK, said: "The pilot programme showed that DCAP helped teams review their services and identify gaps in care provision, further develop collaborative working, and increase their ability to evidence the care being provided." 

The RCP said that accreditation in diabetes care could act as a form of assurance to service users, managers, referrers, and commissioners about the service provided. Dr Flanagan said: "If a hospital is accredited, they will be able to say to people with diabetes: 'If you are admitted to our hospital, you will be given a high standard of care that we are proud of'."