Quality statement 1: Same-day referral and appointments

Quality statement

Children and young people presenting in primary care with suspected diabetes are referred to and seen by a multidisciplinary paediatric diabetes team on the same day.

Rationale

Multidisciplinary paediatric diabetes teams can confirm a diagnosis of diabetes and provide immediate care. Children and young people whose diagnosis and care are delayed are at higher risk of diabetic ketoacidosis (DKA), which is life‑threatening but preventable.

Quality measures

Structure

Evidence of local arrangements and written clinical protocols to ensure that children and young people presenting in primary care with suspected diabetes are referred to and seen by a multidisciplinary paediatric diabetes team on the same day.

Data source: Local data collection.

Process

Proportion of children and young people presenting in primary care with suspected diabetes who are referred to and seen by a multidisciplinary paediatric diabetes team on the same day.

Numerator – the number in the denominator who are referred to and seen by a multidisciplinary paediatric diabetes team on the same day.

Denominator – the number of children and young people presenting in primary care with suspected diabetes.

Data source: Local data collection.

Outcome

Presentations of DKA.

Data source: Local data collection.

What the quality statement means for service providers, healthcare professionals and commissioners

Service providers (primary care services) ensure that systems are in place for children and young people presenting in primary care with suspected diabetes to be referred to and seen by a multidisciplinary paediatric diabetes team on the same day.

Healthcare professionals (such as GPs) immediately refer children and young people presenting in primary care with suspected diabetes to a multidisciplinary paediatric diabetes team, to be seen on the same day.

Commissioners (NHS England regional teams and clinical commissioning groups) commission services that make sure children and young people presenting in primary care with suspected diabetes are immediately referred to and seen by a multidisciplinary paediatric diabetes team.

What the quality statement means for children and young people and their parents and carers

Children and young people who see their GP with suspected diabetes are immediately referred to and seen by a team that specialises in caring for children and young people with diabetes. The symptoms of diabetes include feeling very thirsty or tired, needing to urinate more often than usual, or recently losing weight without trying to.

Source guidance

Definition of terms used in this quality statement

Suspected diabetes

Recognised symptoms of diabetes in children and young people include one of more of the following: increased thirst, increased urination, excessive tiredness and recent unexplained weight loss. A plasma glucose level above 11 mmol/litre indicates the presence of diabetes.

[Expert consensus and Diabetes UK]

Equality and diversity considerations

Particular care should be taken when communicating with children and young people with diabetes and their family members or carers (as appropriate) if they have, for example:

  • physical, cognitive or sensory disabilities

  • difficulties speaking or reading English.