"Diabetes Care Planning"

It is coming up on 4 years from I was last seen at Craigavon Area Hospital (CAH) by a Consultant for my diabetes care. Covid-19 has been used as an excuse and it has been 6 months of calls to the appointments team being told, "it won't be long, probably in the next month or 2' for review. I feel the issues with Southern Health & Social Care Trust (SHSCT) and diabetes appointments are not due to Covid-19, however they have been exacerbated by Covid-19. Other trusts don't seem to have the same issues from discussions with friends who have T1DM or colleagues who I have worked with in teams across other areas. 

I work in another trust within diabetes care and the team I work with are appalled at the length of time since being seen by at clinic. 

Due to staffing shortages, nursing staff are pushed to their limit, however, are helpful when you are able to get through. I am incredibly thankful for the help from Ciara with the new insulin pump set up and follow up from this. Any time I phone other areas, I have been told that Ciara deals with pumps - and seems to be the only one who deals with them at present.

The pressure on the nursing staff is evident as admin triage calls.

SHSCT staff also do not have access to Glooko - a system that with the closed loop insulin pump system would allow for a full review compared to Clarity alone with dexcom - as a patient I strongly feel this system would benefit other patients with less insight to the complexities of a closed loop system and what the reports tell you.

Glucometers and other CGM/ flash glucose monitors also link with it meaning there is less guess work when looking as to why someone had a hypo or hyperglycaemic episode. I sincerely hope SHSCT consider gaining access to this system as the number of patients on technology is only going to increase (NICE now recommend T1 are offered CGM).

Insulin pump consumables - shambles doesn't even cover this service at present. Numerous emails and phone calls later and finally a response to organise cannulas and reservoirs. Previously there has only been 1 person doing this service (who was excellent) but unfortunately is off at present, leaving someone to learn the job very quickly (and do it on their own).

Other friends have had the same issue of trying to get supplies and stories on social media private groups of people going back to injections due to the fact they have no supplies (including young children). Member of Legislative Assembly (MLAs) and Diabetes UK have got in touch which is what it has taken for SHSCT to take action on this. No other trust seems to have this issue with consumables.

SHSCT needs to invest in more staff- maternity leaves need covered with secondments as a minimum and more staff need to be employed within this service before the remaining staff break. 

I am a patient who has access to diabetes info and advice outside of my care, however, what about the patients who do not have this privilege. Who will be blamed when complications arise due to no care - patient or medics or system?  The cost of diabetes complications is enormous to the health service - investment to help prevent these surely should be top of the priority list. For example, Study in France- gave every patient a Freestyle Libre 2 sensor- hospital admissions reduced by 50% within months.

SHSCT is so far below national guidance and standard, the care is simply unacceptable. 

Please note this is not a complaint against the individual nurses or Drs who are part of this team- they are working incredibly hard to get through the high numbers of patients. This is about the service, lack of planning, investment and insight to help improve care as well as a general lack of support for patients due to this.