Quality standard

Quality statement 1: Same-day referral and appointments

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

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.

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: No routinely collected national data for this measure has been identified. Data can be collected from information recorded locally by provider organisations, for example from local referral pathways and service agreements.

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: 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.

Outcome

Presentations of DKA.

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 audits of admission records.

What the quality statement means for different audiences

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 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.

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.

Definition of terms used in this quality statement

Suspected diabetes

Recognised symptoms of diabetes in children and young people include one or 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

Children and young people with suspected diabetes and their family members or carers (as appropriate) should be provided with information that they can easily read and understand themselves, or with support, so they can communicate effectively with health and social care services. Information should be in a format that suits their needs and preferences. It should be accessible to people who do not speak or read English, and it should be culturally appropriate and age appropriate. People should have access to an interpreter or advocate if needed.

For people with additional needs related to a disability, impairment or sensory loss, information should be provided as set out in NHS England's Accessible Information Standard or the equivalent standards for the devolved nations.