title: Report of the 1994 BPA/BDA Survey of Services for Children with Diabetes: Changing Patterns of Care. British Paediatric Association/British Diabetic Association.
abstract: The results of a 1994 survey of consultant paediatricians in the UK were compared with those of a 1988 survey to assess how the organization of services for children with diabetes had changed. We found evidence of a substantial improvement, in line with the recommendations of the 1988 BPA Working Party Report on the Organization of Services of Children with Diabetes. Key features of this improvement included a service rationalization with fewer consultants (325 versus 360) providing care for more children: 45% with a clinic size of over 40 children compared with 23% in 1988. More consultants saw children in a designated paediatric clinic (88 % compared with 63%) and expressed a special interest in diabetes (48% compared with 32%). Eighty-seven % of consultants had a diabetes nurse specialist regularly attending the clinic (vs 61% in 1988) and 91% (vs 75%) reported that a dietitian attended regularly. Although more consultants had a psychologist or psychiatrist attending the clinic, these specialists remained a scarce resource (20% compared with 9% in 1988). Continuing deficiencies in the quality of service for some children were identified with small cohorts of children being managed in general paediatric clinics with inadequate expert support staff; there was a widespread shortage of diabetes nurse specialists and only 30% of those in post worked full time with children. In addition 52% of consultants expressed no special interest in diabetes and 10% did not regularly monitor glycated proteins. Continuing improvement of services for children with diabetes in the UK is needed.
authors.affiliation: Royal College of Paediatrics and Child Health Research Unit, Regent's Park, London.
authors.forename: L C
authors.initials: LC
authors.lastname: Haines
authors.forename: P G
authors.initials: PG
authors.lastname: Swift
mesh_terms: D000293:Adolescent; D002648:Child; D002662:Child Health Services / Q000458:organization & administration / Q000592:standards / Q000639:trends; D003920:Diabetes Mellitus / Q000628:therapy*; D006776:Hospitals, Pediatric / Q000458:organization & administration*; D006801:Humans; D008505:Medical Staff, Hospital; D011787:Quality of Health Care; D012017:Referral and Consultation; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D006113:United Kingdom