North Derbyshire Community Diabetes Specialist Nurse Referral Criteria

Aims

•  To support patients with Type 1 and Type 2 Diabetes, with complex needs, in achieving optimum glycaemic control, through short term specialist intervention.

•  To provide telephone support and advice to health care professionals/ patients/ carers.

•  To work in partnership, with patients with diabetes, providing individuals with a plan of care that is updated as required as progress is reviewed and evaluated.

•  To provide an integral part of the whole care pathway for diabetes; bridging the gap between primary care and secondary care

•  To support patients, carers and health care professionals in structured educational programmes and informal sessions.

Referral Criteria

•  Patients with Type 2 Diabetes with suboptimal glycaemic control, despite intensive management with maximum tolerated oral therapy following North Derbyshire Guidelines for advice on treatment changes.

•  Patients with Type 2 Diabetes with suboptimal glycaemic control, on insulin therapy for advice on treatment adjustments or changes.

•  Patients with Type 1 Diabetes with suboptimal glycaemic control who are unable or unwilling to attend secondary care services

•  Patients with Type 1 Diabetes who require additional support and education to manage their condition and treatment in the community.

•  Those requiring support to overcome barriers to self care of treatments and condition.

•  Management of Diabetes when other treatments initiated (eg. Corticosteroids) have destabilised patient's control

•  Patients with issues concerning recurrent hypoglycaemia or unexplained hyperglycaemia

•  Patients that are frequently admitted to hospital (eg. With DKA)

•  Patients who would benefit from specialist support and advice in relation to specific activities of daily living due to their diabetes eg. Exercise/ travel/ sick day rules

•  Patients treated with insulin therapy who are required to starve prior to procedures.

Referral Process

•  All referrals should be completed using Community Diabetes Nurse referral form with a current medication printout attached.

•  Please ensure all patients are aware of referral and wish to be seen

•  Lead Diabetes Specialist Nurse will triage written referrals.

•  Patient will be contacted and offered a mutually convenient appointment locally.

•  Failure to attend first appointment may result in patient's discharge from the service.

•  Home visits may be requested for housebound patients requiring specialist support. These may be offered as a joint appointment (eg. with Community Matron). However the responsibility of routine diabetes management of housebound patients lies with the GP practice.

•  It is helpful if patients are blood glucose monitoring prior to referral and have adequate strips on repeat prescription (2 -3 boxes a month may be required)

•  This is a not an emergency service. Service provided Monday - Friday 9am - 5pm

•  Patients are discharged back to GP Surgery once management plan is in place.

(October 2014)

Telephone Direct line: 01629 817878

Fax: 01629 817890