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Notes: This template is designed to provide a concise source of evidence of compliance with the National CYPD Network Self Assessment measures which are mapped to NICE and other national guidance. This document may be requested to provide verification of the Self Assessment and can also be used as evidence There should be a specific governance team or divisional meeting at which this plan is formally reviewed.

Keeping this up to date enables evidence of the current situation to be readily presented to CQC, HIW or other regulatory or commissioning teams.

© RCPCH 2018– shared for use by paediatric multidisciplinary diabetes teams in the UK.

For more resources and information please see

[Name of Trust]

Children and Young People with Diabetes Multidisciplinary Team (MDT)

Annual Report

[Date]

This annual report was agreed by the [Name of CYP Diabetes Team]on [Date]

[Endorsed by Children’s Services Manager/Trust Lead] [Date}

Table of Contents

Introduction

Short description of the achievements during the last reporting year.

SUE – we need to agree what constitutes a year calendar/fiscal of NPDA?

Include details on patient workload (M2)

Under 5s / 6-12 / 13 - 18
Type 1
Type 2
Monogenic

This needs work /is it useful / is it collectable

Challenges for the coming year

Complete as agreed by the MDT

Trust Wide Management Group(H1)

Report on the completeness of the group and the frequency/dates of the meetings and issues discussed as well as actions to be taken [these should be included in the work programme].

Paediatric Ward Staff Training (H5)

Report on the training that has taken placewith dates. Show numbers of staff trained as percentages of overall staff.

Leadership and Core Membership (M1)

Report on any changes in core membership during the preceding year including leavers, new starters and any changes to WTE/PAs.

[Also useful for extended members as they may move to core members in agreed future amendments to the audit questions!]

Ongoing Specialist Training(M1)

Initial training to qualify as a core member is listed in the core membership table in the operational policy. The most recent Continuing Professional Development for those considered exemptis listed below.

You can include all team members to demonstrate continuing education but it should only be most recent, not every course/study day ever taken!]

Core Medical Members

Name / Course/meeting / Date

Core Nursing Members

Name / Course/meeting / Date

Core Dietetic Members

Name / Course/meeting / Date

Other MDT Members

Name / Course/meeting / Date

Clinical Guidelines (M3)

Any new guidelines agreed and issued should be listed here as well as in the operational policy table.

Patient Pathways (M4)

Any new patient pathways agreed should be listed hereas well as in the operational policy table.

Patient Choice of Insulin Pump Therapy (M6)

Percentage of patients on pump therapy to be added. [Use table to show year on year changes as this may be useful for business planning purposes].

Year / No of patients meeting NICE guidance / Percentage on pumps

Any ongoing challenges/successes with pump therapy should be described here.

Continuous Glucose Monitoring (CGM) (M7)

Percentage of patients on on-going, real-time CGM to be added. [Use table to show year on year changes as this may be useful for business planning purposes].

Year / No of patients meeting NICE guidance / Percentage receiving CGM

Any ongoing challenges/successes with offeringCGMshould be described here.

Multidisciplinary Follow-Up Appointments (M8)

Insert latest NPDA annual report data to show current achievement and describe how team plans to address any shortfalls especially with adherence to the changes in the Best Practice Tariff wording requirements.

HbA1C Measurement (M9)

Insert latest NPDA annual report data for current achievement and show how team plans to address any shortfalls.

Dietetic Assessment (M10)

Insert latest NPDA annual report data for current achievement and show how team plans to address any shortfalls.

Psychological Assessment (M11)

Insert latest NPDA annual report data for current achievement and show how team plans to address any shortfalls.

Additional Contacts (M12)

Need to report on the percentage of patients achieving the additional contacts, the challenges for the team in meeting this and any plans to address.

Support for Children in Education (M14)

Describe successes and challenges in achieving the requirements.

Screening of Children and Young People with Diabetes (M15)

Use latest NPDA annual report for current achievement and show how team plans to address any shortfalls.

Transition and Transfer Policy (M16)

Describe number of patient currently in transition. Outline any capacity issues, future planning based on age profiling etc. Any challenges in engaging adult teams?

Patient Information and Support (M19)

Describe any new information produced or reviewed.

Individualised Objectives (M20)

Describe any challenges in ensuring all CYP achieve their objectives.

Diabetes Self-Management Education (M21)

Describe any challenges in delivering age and maturity related self-management education to each child and family.

Record of Care (M22)

Describe any challenges in ensuring all CYP receive records of care.

Patient Reported Experience Measures (M23)

Describe how the most recent PREM results have been presented and discussed at a CYPD MDT meeting.

What action plans for improvement have been agreed and implemented as appropriate including giving feedback on results to CYP and families?

Patient/Carer Experience of Transition and Transfer (M24)

Describe the exercise and whether results have been presented and discussed at a CYPD MDT meeting.

Have any action plans for improvement been agreed and implemented as appropriate?

National Paediatric Diabetes Audit (NPDA) (M25)

Show how the CYPD MDT has reviewed their individual unit report and annually submitted their NPDA results to the CYPDN for discussion and review of progress.

Has the MDT agreed a programme for improvement?

Review of Children and Young People's Admissions (M26)

Show details of hospital admissions for children and young people in the following categories.

No of admissions / No of patients / LOS
Those with newly diagnosed diabetes.
CYP with DKA.
CYP with hypoglycaemia.
CYP for re-stabilisation.

[Add/delete data as required]

Describe how the reviews are held and outcomes recorded.

Did Not Attend / Was Not Brought Policy (M27)

Identify the DNA/WNB rates for the different clinics.

Have DNA/WNB rates been reviewed across all clinics?[include table of data]

Are DNA/WNB rates reviewed across different age bands? [Table could show this]

Have DNA/WNB rates been discussed at the trust/health board management group (ref question H1) [Date?]

Have actions been taken to improve patient surveillance. [List]

Have the DNA/WNB rates been discussed at CYPDN? [Date]

Outline plans to address.

Extra-curricular activity delivered by the MDT

[E.g. camps, education days, weekend away, parent’s group support, focus groups, peer support activities]

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