DIABE T E S
co-operation and support of the laboratory staff we were able to devise a system which enabled the posting of a kit to families which contained the required sample bottle, instructions for finger prick sample collection and a stamped addressed padded envelope for the return of the sample to the laboratory. The willingness to help and ‘can do’ attitude of the laboratory staff was key in being able to offer this to our service users in a timely way. Despite having considerable previous experience with a similar process, we felt it was important to ensure, as far as possible, that results obtained in clinic or by ‘drive-by’ correlated well with samples received by post. We therefore obtained the permission of a number of children and young people to collect two samples when they attended clinic for HbA1c sampling.
One of the samples was tested on-site in the usual way and the other was posted to the hospital laboratory to assess the effect of delayed arrival and unpredictable conditions in transit, such as sample temperature, might have on sample quality and hence measured HbA1c levels. The results are shown in Results 1 and a very tight correlation can be seen between HbA1c results for samples obtained in clinic tested immediately and samples sent into the hospital laboratory by post. In Results 2 the median and mean HbA1c before and during the pandemic are shown. We were able to obtain HbA1c results for all the eligible patients during the pandemic using our COVID adaptations to normal practice described above and we
Results 1: Results of in clinic HbA1c vs postal sample HbA1c
were pleased to see a slight improvement in HbA1C during the pandemic.
Conclusions
The COVID-19 pandemic has undoubtedly presented significant challenges to all involved in healthcare delivery and reassuringly our data showed no deterioration in glycaemic control and indeed a slight improvement in HbA1c during the first six months of the pandemic. We continue to accumulate data and
service user feedback on the new ways of working employed by us during the first national lockdown in which families were provided with the required support and advice in new and different ways when we were unable to see them face-to-face. With the return to ‘business as usual’ within the NHS we are once again seeing the vast majority of our service users face-to- face in out-patient clinics but the now tried and tested innovative methods employed by us during the first national lockdown are still available to those within our clinic population who find themselves unable or unwilling to attend clinic face-to-face. In the meantime, the option to return to our model of ‘drive-by’ device downloading
and HbA1c sample collection, as well as postal HbA1c samples, for all can be re-implemented immediately should all non- essential face-to-face patient contacts be suspended once again. We believe these simple but innovative and timely interventions have helped us to optimise the ongoing diabetes care we deliver to the children, young people and their families despite the challenges presented by the COVID-19 global pandemic.
CSJ
About the author
Dr. Carrie MacKenzie, a consultant paediatrician, submitted this article on behalf of the Sheffield Children’s Diabetes Team. Dr. Carrie MacKenzie graduated from Dundee University MB chB in 1984 and trained as a junior doctor in Dundee, Edinburgh and Sheffield attaining her MD from the University of Sheffield in 1993. She has been a consultant with the Sheffield Children’s Diabetes Team since 1993 and is now also the quality improvement champion for the team. The Team were winners of the Quality in Care Diabetes Team of the year in 2020. Email:
carrie.mackenzie1@
nhs.net
Results 2 80 l
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