Data to enable NHS trusts and systems to understand how they care for people with diabetes while in hospital – and help them target improvements accordingly – has been published on the Model Health System (MHS) by the Getting It Right First Time (GIRFT) team.
A range of metrics looking at diabetes care, amputations, surgical and medical care and other hospital-wide metrics concerning inpatients with diabetes are now available on the MHS portal, in the first medical specialty compartment shared by GIRFT.
Clinical teams and managers can access local and system-wide data on such metrics as length of stay (LoS) for patients admitted for hypo- and hyperglycaemia, medical conditions such as pneumonia, the number of patients with diabetes readmitted after surgery for a variety of conditions including total knee replacement and fractured neck of femur, or length of stay for people with diabetes who need a major amputation.
In many cases, comparative data for patients without diabetes is also provided to allow an understanding of how the presence of diabetes affects patient outcomes.
Professor Gerry Rayman, GIRFT’s joint clinical lead for diabetes, said: “The GIRFT programme is all about learning from data and we know how sharing information like this can help to drive change and tackle variations in practice and outcomes.
“I’d urge everyone working in providers across the country to sign up for Model Health System and tap into this important resource. The difference it can make to care of people with diabetes in hospital is immeasurable.”
The new compartment supports implementation of the GIRFT national report for diabetes, published in November 2020, which recommended that every hospital should have a specialist team dedicated to caring for inpatients with diabetes to ensure better outcomes.
Around 3.2m people in England are diagnosed with diabetes and the number of diagnoses has been consistently rising over the past 20 years. The GIRFT report outlined that up to 20% of all hospital beds are occupied by patients with diabetes, with most (92%) admitted for other conditions and illnesses.
There are an estimated 330,000 operations (100,000 emergency) carried out on people with diabetes each year, but their LoS is three days longer than patients without diabetes, or four days for those admitted as an emergency. The NHS spends around £2.5bn every year on caring for diabetes inpatients.
In the 2020 report, GIRFT recommended that all hospital trusts should have clear, audited perioperative pathways from preassessment through to discharge. A GIRFT-led pilot in 10 trusts – called Improving the Perioperative Pathway of Patients with Diabetes (IP3D) – has now demonstrated how the care of patients with diabetes can be improved before, during and after surgery through the recruitment of a Perioperative Diabetes Specialist Nurse (PeriopDSN) and the adoption of a Diabetes Perioperative Passport to help prepare patients for admission to hospital.
A recent independent evaluation of IP3D showed improvements in patient safety, fewer complications, less time spent in hospital and a better overall patient experience, and GIRFT is now aiming to engage with other trusts and systems to support further take-up of IP3D.
The 2020 report also pledged to monitor trust performance on inpatient admissions via the Model Health System. The new addition of the GIRFT data to MHS will help teams across England identify where improvements can be made and benchmark their performance against their peers. For example, trusts which enrol in the IP3D programme can use the MHS data to track metrics such as length of stay and readmissions.
Professor Partha Kar, GIRFT joint lead for diabetes and national clinical advisor for diabetes for NHS England, said: “Our national review showed clearly that people with diabetes who go to hospital are more likely to experience complications which lead to them staying longer in hospital or which put them at higher risk of harm. Thankfully, the data is showing that some positive progress is being made, but there is still more work to be done.
“We are delighted to be able to now share our GIRFT data and metrics on the Model Health System, helping to flag where there are issues and support teams in making improvements to reduce national variations in care.”