Specialist community diabetes team

Published Date: 10th May 2017

Publication Authors: Wooding A, Garnett I, Timm L

​Aim

To identify appropriateness and reasons for home visits in people with diabetes referred from a local Clinical Commissioning Group (CCG) to Knowsley Community Diabetes Team.

Methods

The case records of all patients referred for a home visit from Knowsley CCG (population 161,000) over a 16 month period were examined.

Results

Seventy six referrals involving 66 people were identified (31 male, mean age 74 ± 11.5 years, 58 Type 2 diabetes, mean duration diabetes 16 ± 14 years, mean HbA1c 81 ± 21mmol/mol, 63 insulin treated). 91% of referrals were considered appropriate. Poor glycaemic control (81%) was the most common reason for referral. Other reasons were hypoglycaemia (11%), erratic control (4%), enteral feeding started (3%), new diagnosis. Changes to medication/insulin were recommended in 68% of cases, blood glucose monitoring or lifestyle changes were recommended in 26% and 1 patient was admitted to hospital. Four patients remain active on the caseload, 3 requiring in excess of 10 visits. The remaining 72 referrals generated 181 visits, 50% of patients required 1 visit, 36% required 2-4 visits, 8.4% required 5-10 visits and 4.2% needed 10-13 visits. 40% of patients had support from other agencies e.g. district nurses or carers and 14% were resident in care homes. Most home visits generated follow up phone contacts.

Conclusion

The majority of home visits were appropriate. Visits are resource intensive each visit taking approximately 2h. With increasingly frail and complex patients CCGs and diabetes teams should ensure that adequate resources for home visits are available.

Wallymahmed, ME; Wooding, A; Morrell, D; Garnett, I; Timm, L; Harvey, J; Ooi, C. (2017). P173 An audit of home visits by a specialist community diabetes team: a service in demand for the frail and complex patient with diabetes . Diabetic Medicine. 34 (S1), 86o

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