The best practice tariff for paediatric diabetes presents a major opportunity for childhood diabetes specialists to attract important funding for under-resourced services. But to capitalise, clinicians must demonstrate they are meeting national guidelines and delivering best practice, says John Sanderson.
At present, many paediatric centres across the UK are unable to report the effectiveness of their services accurately or efficiently, and as such, risk missing out on the valuable additional funding available through the BPT. To progress, and in the process secure enhanced payments for meeting payment by results criteria, healthcare professionals would benefit from embracing simple, disruptive technologies that can help them manage, monitor and develop childhood diabetes services quickly and painlessly.
The ability to demonstrate that national standards are being met is pivotal to attracting BPT funding. But the 2009/10 national audit of childhood diabetes revealed that 96 per cent of children and young people with diabetes may not have received all the care processes recommended by NICE2.
The claim is not an absolute – it is a case of ‘may not’ rather than ‘have not’. The uncertainty is in part due to acknowledged problems that paediatric units have in recording the information. The National Paediatric Diabetes Audit report confirms that patient records in paediatric centres remain predominantly paper-based, making data collection ‘difficult and often incomplete’. Critically, the report asks: “Why, in the 21st Century, do organisations providing paediatric diabetes services not provide staff with electronic resources for proper data recording and audit of care?” 2
This is a question that commissioners and clinicians within the NHS must address as a matter of priority.
It is estimated that around 10 per cent of the NHS budget is spent on the treatment of diabetes3. Research from the London School of Economics showed that management of the disease cost the UK £13.8 billion in 2010, with soaring in-patient costs – driven by the treatment of diabetes complications – a key contributor.
The importance of paediatric diabetes services, therefore, cannot be understated – and the need to implement patient management systems that can help provide a clear, integrated and holistic view of patient activity is critical.
To advance, services for paediatric diabetes – whether in secondary care or in the community setting – must be built upon joined-up and more accessible patient information. A structured electronic information record that gives healthcare professionals across the local system real-time access to vital details of patients with childhood diabetes will be critical for the ongoing management of the condition.
Shared data at the point of clinical care will not only significantly improve outcomes for patients, but can also play an important preventative role in helping ensure patients’ conditions are managed optimally as they move into adulthood. Moreover, in an environment plagued by a general lack of resources, the aggregation and interpretation of such information can prove invaluable in creating the evidence-base for the ongoing funding of services through the best practice tariff.
Technology is increasingly being used to facilitate this information – with the promise of BPT funding a major motivation. The NPDA report says it hopes the forthcoming introduction of the BPT will provide added incentive to those units who, to date, have not been able to submit data to the national audit. Significantly, it adds, companies that do not submit data “will not qualify for BPT.”
The challenge for clinicians is to improve the standard of care in childhood diabetes and ensure they provide appropriate care for patients. To do this, they must first provide evidence of appropriate care to help unlock the necessary funding.
At present, technology represents the best chance that clinicians have to bolster resources for the management of paediatric diabetes. It can play a major role in improving services for childhood diabetes – enabling HCPs to benchmark and demonstrate their performance against national guidelines and in the process improve efficiencies, enhance the patient experience and drive better health outcomes.
The more proactive HCPs are already benefitting from web-based solutions that are enabling them to manage paediatric diabetes patients in a completely scalable fashion – from single specialists on a paediatric ward, to specialist diabetes departments in a child hospital and major region-wide implementations. When such systems are provided on a Software-as-a-Service (SaaS) basis, no local IT resources or servers are required – simply standard internet access over the secure NHS N3 network.
The introduction of the Best Practice Tariff is encouraging more paediatric diabetes specialists to consider the valuable role technology can play in enhancing service delivery. For those that have already embraced it, the results are better for the NHS, better for HCPs and, most important of all, better for patients.