Quality statement 3: Structured education programmes for adults with type 1 diabetes

Quality statement

Adults with type 1 diabetes are offered a structured education programme 6–12 months after diagnosis. [2011, updated 2016]

Rationale

Adults with type 1 diabetes need to acquire a large range of new skills and knowledge, such as how to manage their insulin therapy. Patient education enables self-management, which is important in diabetes management. It allows adults with type 1 diabetes to adapt their diabetes management to changes in their daily lives and to maintain a good quality of life. The first few months after diagnosis involve considerable adjustment, so although information should be given from diagnosis, a more intensive structured education programme will be more beneficial 6–12 months after diagnosis.

Quality measures

Structure

Evidence of local arrangements to ensure that adults with type 1 diabetes are referred for a structured education programme 6–12 months after diagnosis.

Data source: Local data collection.

Process

a) Proportion of adults with type 1 diabetes who are referred for a structured education programme 6–12 months after diagnosis.

Numerator – the number in the denominator who are referred for a structured education programme 6–12 months after diagnosis.

Denominator – the number of adults diagnosed with type 1 diabetes in the last 12 months.

Data source: Local data collection. National data are collected in the Quality and Outcomes Framework indicator DM014 and the National Diabetes Audit.

b) Proportion of adults with type 1 diabetes who attend a structured education programme after a referral.

Numerator – the number in the denominator who attend a structured education programme.

Denominator – the number of adults with type 1 diabetes who are referred for a structured education programme.

Data source: Local data collection. National data are collected in the National Diabetes Audit.

c) Proportion of adults with type 1 diabetes who complete a structured education programme.

Numerator – the number in the denominator who complete a structured education programme.

Denominator – the number of adults with type 1 diabetes who attend a structured education programme.

Data source: Local data collection.

Outcome

Patient satisfaction with ability to self-manage their type 1 diabetes after attending a structured education programme.

Data source: Local data collection.

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

Service providers (such as GPs and secondary care providers) ensure that systems are in place for adults with type 1 diabetes to be offered a structured education programme 6–12 months after diagnosis.

Healthcare professionals (such as GPs, diabetologists and diabetes specialist nurses) ensure that they offer a structured education programme to adults with type 1 diabetes 6–12 months after diagnosis.

Commissioners (clinical commissioning groups) ensure that they commission structured education programmes for adults with type 1 diabetes.

What the quality statement means for patients, service users and carers

Adults with type 1 diabetes are offered a course to help them improve their understanding of type 1 diabetes and how to manage it in their everyday life. This should cover checking their blood glucose levels, using insulin and advice about having a healthy lifestyle. The course should be offered between 6 months and a year after they are diagnosed.

Source guidance

Definitions of terms used in this quality statement

Structured education programme

Should include the following components:

  • It is evidence-based, and suits the needs of the person.

  • It has specific aims and learning objectives, and supports the person and their family members and carers in developing attitudes, beliefs, knowledge and skills to self-manage diabetes.

  • It has a structured curriculum that is theory-driven, evidence-based and resource-effective, has supporting materials, and is written down.

  • It is delivered by trained educators who have an understanding of educational theory appropriate to the age and needs of the person, and who are trained and competent to deliver the principles and content of the programme.

  • It is quality assured, and reviewed by trained, competent, independent assessors who measure it against criteria that ensure consistency.

  • The outcomes are audited regularly.

Further information on these components can be found in the Department of Health's Structured patient education in diabetes: report from the Patient Education Working Group.

An example is the DAFNE (dose-adjustment for normal eating) programme.

[Adapted from NICE's guideline on Type 1 diabetes in adults: diagnosis and management, recommendations 1.3.1 and 1.3.4]

Equality and diversity considerations

Structured education programmes should meet the cultural, linguistic, cognitive and literacy needs in the local area. Information should be provided in an accessible format (particularly for people with physical, sensory or learning disabilities and those who do not speak or read English) and educational materials should be translated if needed.

Alternative programmes of equal standard should be made available for people unable to participate in group education.