NHS England publishes clinical guide for managing diabetes and COVID-19
NHS England publishes document for diabetes teams (hospital and community) during COVID-19.
The Clinical guide for the management of people with diabetes during the coronavirus pandemic does not comprehensively cover all diabetes services that any particular provider may be delivering, but does provide a framework for considerations and priorities. Please be advised that the guide is continually being updated, so if the links in this story do not work, the latest version can be found on this page on the NHS England website.
The guidance urges doctors who have “general responsibilities” in relation to COVID-19 to “seek and act on national and local guidelines”.
It also reminds healthcare professionals that they also have a responsibility to ensure that “essential diabetes care continues with the minimum burden on the NHS”.
It suggests that clinicians may also need to work outside specific areas of training and expertise, while the General Medical Council (GMC) has already indicated its support for this in the exceptional circumstances currently being faced.
The document said: “Diabetes may not seem to be in the frontline with coronavirus but we do have a key role to play and this must be planned. In response to pressures on the NHS, the elective component of our work may be curtailed. We should seek the best local solutions to continue the proper management of diabetic patients while protecting resources for the response to coronavirus.”
People who require hospital admission and medical management can still be admitted, but treatment must be expedited immediately to avoid delay and minimise length of stay.
The guidance stipulates that a consultant must be designated as ‘lead consultant’ which is an “essential role during crisis management” and it cannot be performed by the consultant ‘on-call’. They must be free of clinical duties and the role involves co-ordination of the whole service from ED through to liaison with other specialties and managers.
At the moment 18% of hospital beds are occupied by someone with diabetes, but it is highly likely people with diabetes will experience more severe manifestations of coronavirus infection, so this proportion is likely to increase beyond 18% over the next few weeks or months. Inpatient diabetes services will therefore need to continue (and potentially increase capacity).
Outpatient attendances should be kept to a safe minimum and virtual clinics and telephone updates are welcomed. It has been recommended that group-based face-to-face contacts should be avoided and Some services should not be postponed or cancelled if at all possible, due to acuity and potential impacts, such as risk of amputation in the context of active diabetic foot disease.
To read the document in full, click here.
Picture credit: Fusion Medical Animation