Diabetes services urged to adapt to the ‘new normal’ post COVID-19 spike

Diabetes teams have learnt how to adapt to new ways of working amid COVID-19 but must re-engage with people who may feel “lost” in the system, a new report has stated.

Trend Diabetes, Diabetes UK and ABCD came together to draft the document entitled ‘A Collaborative OverView and Insight into Diabetes Services before and after the COVID-19 Pandemic‘.

It looked at how things within the health service have changed and how the future may look once the pandemic is over.

The Group was led by Consultant Nurse Lesley Mills from the Warrington and Halton Hospitals NHS Foundation Trust and the report was authored by June James, Nurse Consultant at Leicester’s Hospitals NHS Trust and Co-founder and Co-chair of Trend Diabetes.

It also consisted of Diabetes Specialist Nurses, Consultants, GPs and representatives from Diabetes UK. Together, they wanted to see how both healthcare professionals and people with diabetes were managing with virtual clinics, which were introduced in March when the country went into lockdown.

During this time outpatient clinics were cancelled across the NHS and remote consultations were brought in. The idea of the report was to ascertain whether the changes have been embraced or whether further adjustments are required.

Pandemic service feedback

To gather the findings, a small group of people with diabetes and healthcare professionals were asked to give feedback about how services provided during the pandemic were viewed.

Now the country is starting to open back up and care delivery is beginning to bear some resemblance to the pre-Covid-19 days, the Group felt that it was “unlikely” most teams or people would want to revert back wholly to the “traditional ways of service delivery”.

It was thought that diabetes teams may want to consider a mix of face-to-face and virtual consultations in the future; this system blends aspects of the traditional service and the technology available to operate virtual clinics. However, those involved in the report agreed that mental health services may not work as well being carried out remotely.

The survey findings found that should virtual consultations continue, then healthcare professionals say they require more training in the technology required to do this successfully.

Overall, though the virtual consultation feedback was wholly positive with pie charts documenting how the majority of people were in favour of them.

One person living with diabetes said: “The IT System sometimes lags and this makes conversations more difficult to have. Virtual appointments are much more convenient in relation to less travel time and childcare issues.”

Another said they thought their diabetes specialist nurse was “excellent” and another that they thought the service required an “upgrade to work properly”.

The comments from healthcare professionals reflected many of those from people with diabetes, with several clinicians saying that internet connectivity was poor, which impacted the consultation.

Another healthcare professional advised: “Learn as you go, take time before the clinic/appointment to prepare and make sure it’s clearly communicated to your people with diabetes that it’s a video call.”

Lesley concluded that service changes “may not return to the old ways of service delivery”, but she said it is likely everyone will adapt to a “new normal”.

She also advised that hospitals should keep a COVID-19 “hot facility” functioning and isolated within its footprint, while the remainder of the “cold” services should continue to recover. There even remains the small possibility of single hospitals dealing with all COVID-19 cases functioning as a regional hub.

If a second wave hits, June warned that it is “imperative” diabetes services continue to function rather than being completely shut down again.

She wrote: “The ability to flex into a predominant ‘virtual service’ will build in a degree of flexibility to allow this to happen. This should be considered in the design of any new service.

The Group concluded that diabetes teams have learnt how to adapt to new ways of working and it is important that these skills are not lost. In many ways they have helped healthcare professionals to streamline services and to ensure that those people who really need to be seen face to face can be seen in a timely manner. However, some individuals with diabetes may feel they have been “lost” in the system during the pandemic, so it is important the healthcare professions re-engage with them when introducing new ways of working.

To read the report in full, click here.

Photo by National Cancer Institute on Unsplash