Abstract

Design: Electronic survey of Paediatric Diabetes Units across England. Purpose: The medical care of children and young people (CYP) living with diabetes in England involves three services spanning community and hospital settings. Paediatricians working in Paediatric Diabetes Units (PDUs) are responsible for confirming/making the diagnosis, informing family practitioners (primary care) of newly diagnosed patients and active management including monitoring compliance with diabetic retinopathy (DR) screening. Diabetic Eye Screening Programmes (DESPs) independently identify and invite eligible CYP to DR screening. A recent national audit of data returned from PDUs, identified that only 65% of eligible CYP had been recorded as having undergone DR screening. This may reflect lack of integration of services. We aimed to investigate integration between PDUs and DESPs through this novel survey of practice. Methods An electronic survey of Head Clinicians of British PDUs is being distributed through the National Children & Young People's Diabetes Network between 16th January 2017 and 17th March 2017. Results Interim findings from 39 (24%) responses in the first week of the survey are presented and will be updated once the survey has been completed. Most PDUs (n=38; 97%) have electronic patient registers, and 79% (n=31) use software for data management. All PDUs inform primary care services about new diabetic patients. 72% are able to directly refer their patients to DESPs whilst the remainder rely on primary care to make the onward referral. Only 31 (79%) PDUs have access to DR screening result. All (n=31) receive some feedback from DESPs, in 55% (n=17) as paper feedback (e.g. letters or printed lists) only. Six PDUs (19%) reported obtaining DR screening results to be somewhat or very difficult. 97% (n=38) of responders consider DR screening results useful for counselling their patients on the importance of compliance. Conclusions These findings indicate variable integration of diabetic eye care across England as a result of limited direct communication between PDUs and DESPs. This potentially risks screening uptake and the useful role of DR screening results in managing CYP living with diabetes.