Quality standard
Quality statement 2: Joint diabetes and antenatal team care
Quality statement 2: Joint diabetes and antenatal team care
Quality statement
Women with pre-existing diabetes are seen by members of the joint diabetes and antenatal care team as soon as possible after informing their healthcare professional that they are pregnant. [2016, updated 2023]
Rationale
Women with diabetes who become pregnant need extra care in addition to routine antenatal care. Members of the joint diabetes and antenatal care team can ensure that specialist care is provided to minimise adverse pregnancy outcomes. Being seen by the joint diabetes and antenatal care team as soon as possible, ideally by 10 weeks' gestation, can help to ensure that a woman's diabetes is controlled during early pregnancy. It will also help to ensure that the woman's care is planned appropriately throughout her pregnancy. The woman can be seen in person or virtually, as appropriate.
Quality measures
The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.
Process
a) Proportion of women with pre-existing diabetes who are seen by members of the joint diabetes and antenatal care team by 10 weeks' gestation.
Numerator – the number in the denominator who are seen by members of the joint diabetes and antenatal care team by 10 weeks' gestation.
Denominator – the number of pregnant women with pre-existing diabetes.
Data source: No routinely collected national data for this measure has been identified. Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example, from patient records and satisfaction surveys.
b) Average wait time for pregnant women with pre-existing diabetes to be seen by members of the joint diabetes and antenatal care team following referral.
Data source: No routinely collected national data for this measure has been identified. Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example, from patient records and satisfaction surveys.
Outcome
a) Proportion of women with pre-existing diabetes who have had a review of their medication to ensure it is pregnancy appropriate by 10 weeks' gestation.
Numerator – the number in the denominator who have had a review of their medication to ensure it is pregnancy appropriate by 10 weeks' gestation.
Denominator – the number of pregnant women with pre-existing diabetes.
Data source: No routinely collected national data for this measure has been identified. Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example, from patient records.
b) Optimal diabetes care in pregnancy.
Data source: No routinely collected national data for this measure has been identified. Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example, from patient records and patient satisfaction surveys.
What the quality statement means for different audiences
Service providers (such as GP practices and community and secondary care diabetes services) ensure that referral pathways are in place so that pregnant women with pre-existing diabetes are seen, in person or virtually where appropriate, by members of the joint diabetes and antenatal care team. Women are seen as soon as possible after informing their healthcare professional they are pregnant, and ideally by 10 weeks' gestation.
Healthcare professionals (such as GPs, midwives and members of the joint diabetes and antenatal care teams) ensure that women with pre-existing diabetes are referred immediately to the joint diabetes and antenatal care team when they inform their healthcare professional that they are pregnant. The joint diabetes and antenatal care team see pregnant women with pre-existing diabetes, in person or virtually where appropriate, as soon as possible after the pregnancy is confirmed to a healthcare professional, ideally by 10 weeks' gestation.
Commissioners (integrated care systems) ensure that they commission joint diabetes and antenatal care teams that see pregnant women with pre-existing diabetes, in person or virtually where appropriate, as soon as possible after the pregnancy is confirmed to a healthcare professional, ideally by 10 weeks' gestation.
Women with diabetes who become pregnant are seen by members of the joint diabetes and antenatal care team, in person or virtually where appropriate, as soon as possible after telling their healthcare professional, for example, their GP or diabetes specialist nurse, that they are pregnant. Ideally, they will be seen by the time they are 10 weeks' pregnant. The joint team will work together throughout the woman's pregnancy to make sure that her care is planned appropriately.
Source guidance
Diabetes in pregnancy: management from preconception to the postnatal period. NICE guideline NG3 (2015, updated 2020), recommendation 1.3.37 and table 1