New guideline launched to improve the quality and safety of treating Type 1 Diabetes
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From: Department of Health
- Published on: 25 June 2018
- Last updated on: 27 May 2019
Minister for Health, Simon Harris TD, today (Monday) launched a new guideline aimed at improving the quality and safety of treating Type 1 Diabetes.
The National Clinical Effectiveness Committee Guideline is the first to be developed in Ireland using the UK’s National Institute for Health and Care Excellence (NICE) contextualisation process; whereby a recent NICE guideline is adapted for use in another country. The recommendations are based on the best research evidence and on national and international clinical expertise.
This initiative was led by a group from the Health Service Executive’s (HSE) National Clinical Programme on Diabetes, supported by the department’s Clinical Effectiveness Unit and a team from NICE. The guideline was quality assured by the National Clinical Effectiveness Committee (NCEC).
Type 1 diabetes is an autoimmune condition that causes destruction of the insulin producing cells in the pancreas. This means that people with type 1 diabetes must self-inject insulin in order to manage their blood glucose and avoid a range of serious short and long-term complications.
Minister Harris said:
“I am very pleased to launch this high quality guideline, which will be implemented in full across the health service and will help to improve the quality and safety of treating the disease across Ireland. About 20,000 adults in Ireland live with this condition and maintaining blood glucose control within normal parameters is very important for their physical and mental well-being. I would like to acknowledge the great work of the National Clinical Effectiveness Committee (NCEC) in advancing patient safety and quality, and the Irish clinical effectiveness agenda, under the chairmanship of Professor Karen Ryan. I would also like to congratulate Dr Kevin Moore, Ms Niamh Smyth and all who worked to bring this guideline to its launch today.”
Chair of NICE, Sir David Haslam, said:
“Developing a national guideline on the treatment of a complex condition like Type 1 Diabetes is a costly and time-consuming process. NICE recognises that significant efficiencies can be made by sharing our products with colleagues in other countries, and supporting them to adapt our recommendations for their own health systems. Our partnership with the National Clinical Effectiveness Committee in Ireland on this project is an excellent example of joint working, which will help ensure that evidence-based care, tailored to the needs to the Irish population, is delivered across the country.”
Dr Kevin Moore, Chair of the Guideline Development Group, said:
“Type 1 diabetes care requires a multidisciplinary approach to care that empowers patients to successfully manage this life-long condition. Current evidence shows variation in how care is delivered across Ireland and so this NCEC National Clinical Guideline will standardise the approach with a special focus on patient education and clinical review. Overtime, this will mean better outcomes for patients with type 1 diabetes.”
The National Clinical Effectiveness Committee (NCEC) provides leadership for clinical effectiveness through prioritisation and quality assurance of National Clinical Guidelines and National Clinical Audit. Sixteen NCEC National Clinical Guidelines on a range of conditions and healthcare processes have already been published. Extending and implementing the suite of NCEC guidelines remains a priority of national health policy.
ENDS
Notes to the Editor:
National Clinical Effectiveness Committee (NCEC)
Clinical effectiveness is a key component of patient safety. The integration of best evidence in service provision, through clinical effectiveness processes, promotes healthcare that is up to date, effective and consistent. Clinical effectiveness processes include guidelines, audit and practice guidance.
NCEC Terms of Reference 2015
Apply criteria for the prioritisation of clinical guidelines and audit for the health service
Apply criteria for quality assurance of clinical guidelines and audit for the health service
Disseminate a template on how a clinical guideline and audit should be structured, how audit will be linked to the clinical guideline and how and with what methodology it should be pursued
Recommend clinical guidelines and national audit, which have been quality assured against these criteria, for Ministerial endorsement within the Irish health service
Facilitate with other agencies the dissemination of endorsed clinical guidelines and audit outcomes to front-line staff and to the public in an appropriate format
Report periodically on the implementation of endorsed clinical guidelines.
Information on the NCEC, NCEC documentation and endorsed National Clinical Guidelines is available at: https://health.gov.ie/national-patient-safety-office/ncec/.
National Clinical Programme for Diabetes
The National Diabetes Working Group consists of representatives from relevant diabetes related healthcare professionals and consumers. The group acts as an advisory committee to the National Programme for Diabetes and provides national advice on diabetes management.
The National Clinical Programme for Diabetes commenced in 2010. With the specific aim of saving the lives, eyes and limbs for people with diabetes, goals of 10% reduction in mortality, 20% reduction in cardiovascular events and 40% reduction in both blindness, and amputations have been set. Other Programme targets are that everyone with diabetes should have access to a structured, all-encompassing programme of diabetes care and that increased efficiencies would occur to meet the forecasted 10% annual increase in demand. A Diabetic Retinal Screening programme commenced in 2013 and existing podiatry services were augmented to deliver the integrated model of care for the diabetic foot.
The National Clinical Programme has developed a new national model of integrated care to deliver diabetes care into the future, so as to enhance the continuity and quality of care. This model encompasses disease prevention, management in primary care, specialist support to primary and ambulatory care, specialist care and self-management support, so addresses diabetic care across all the healthcare settings. To support its implementation the programme has overseen the recruitment of primary care posts including clinical nurse specialists, dietitians and podiatrists. Structured Patient Education has commenced with the appointment of a national co-ordinator in 2015, national programmes have begun and a national database, enabling centralised access to diabetes structured group education, is being established.
NICE Contextualisation
The UK’s National Institute for Health and Care Excellence (NICE) provides evidence-based guidance and advice to improve health and social care.
NICE’s Centre for Guidelines develops guidance on the promotion of good health; the prevention of ill health; the appropriate treatment and care for people with specific diseases and conditions; social care and service delivery. The guidelines are evidence-based recommendations for health and care in England on a wide range of topics, from preventing and managing specific conditions to planning broader services and interventions to improve the health of communities; and are used by those working in the UK National Health Service, local government, social care, patients and their families. NICE has published over 250 guidelines since 2002.
Since 2014, NICE has worked with international clients wishing to rapidly contextualise NICE guidelines for their local populations and health care context infrastructure. The process involves a local guideline committee who consider and contextualise NICE’s original recommendations before consultation with relevant stakeholders. NICE quality assures the contextualisation process to ensure the published guidelines meet internationally-recognised standards of best practice, and are also relevant to local contexts.
In 2017 an agreement was reached between NICE and the National Patient Safety Office’s Clinical Effectiveness Unit, on behalf of the NCEC to work together on the contextualisation of NICE’s clinical guideline (NG17) Type 1 diabetes in adults: diagnosis and management (2015).