Diabetes care - progress against national priorities: commitments - 2021 to 2026

Priority 5 - Supporting and Developing Staff

To ensure healthcare professionals caring for people living with diabetes have access to consistent, high quality diabetes education to equip them with the knowledge, skills and confidence to deliver safe and effective diabetes care.

Many different health care professionals interact with people living with diabetes and each interaction is an opportunity for the health care professionals to work with the individual to enhance their motivation and optimise their self-management. There is a need therefore to ensure staff have awareness and access to diabetes education to allow them to deliver safe, effective and person-centred care to people living with diabetes.

Action 5.1 Increase the level of consultation and patient engagement skills

Supporting behaviour change

The increasing demand being placed on the whole of the NHS means there has been a change in focus from the more traditional medical model, where healthcare was 'done to' people, to a more collaborative model, where healthcare practitioners work with individuals to prevent illness and to self-manage existing conditions. More than ever, healthcare professionals from across the NHS and social care, are being asked to support people to change and maintain their behaviour to improve their health and wellbeing. The MAP Health Behaviour Change training programme, developed by NHS Education Scotland, has been promoted and rolled out to staff who care for people with diabetes. The training programme brings together the specific skills that professionals can use to support behaviour change, as well as a system for deciding which skills to use and when.

Action 5.2 Increase the level of educator skills and confidence in delivering diabetes education

Scottish Diabetes Education Action Group

The Scottish Diabetes Education Action Group continue to develop and promote education opportunities to staff involved in providing diabetes care. Delivering high quality patient care requires high quality professional education for our health care professionals involved with diabetes care. There is a wide range of knowledge and skills required throughout healthcare in Scotland and we need to be cognisant that different professional training needs can vary depending on location and population need. A national training course for newly appointed Diabetes Specialist Nurses (RD Lawrence Course) has been developed and this methodology could be considered for the multi-disciplinary team in locality or nationally. A clinical hub has been established via the Knowledge Network to collate and share resources for health care professionals.

Online Learning

To support the Think, Check, Act and CPR for Feet Campaigns online education modules were developed and promoted to staff working within the hospital setting to increase their knowledge in these areas within NHS Healthcare Improvement Scotland and NHS Education for Scotland.

Local Staff Education

Managed Clinical Networks continue to play an important role in supporting and upskilling both specialist and generalist staff in diabetes care.

National CGM Support and Training Lead

To support staff to embed Continuous Glucose Monitoring (CGM) into clinical practice a dedicated post, the National CGM Support and Training Lead was established. This post has helped staff in NHS Boards through a number of initiatives including the development of the CGM Patient Pathway and Education Resource, establish networking groups for the DSNs and provided training in local areas on the new technologies as they develop.

Competency Frameworks

Following on from the Podiatry Competency Framework for Integrated Diabetic Lower Limb Care (Scottish Diabetes Foot Action Group and Skills for Health, 2010), a new Capability Framework for Integrated Diabetic Lower Limb Care was published in 2019 to be relevant for the other clinicians in the multidisciplinary foot team. The purpose of this framework is to ensure that all people with diabetes in the UK have their feet cared for by healthcare professionals with appropriate skill sets to improve patient outcomes, such as ulcer-free and amputation-free survival. The Scottish Diabetes Foot Action Group are currently working with the College of Podiatry to ensure that the Capability Framework is available in an interactive on line format to allow clinicians across the country to self-assess themselves in all areas of Diabetes Lower Limb care and identify training needs.

Staff competency frameworks are available for a range of health professionals supporting diabetes care and staff are encouraged to develop their skills in line with relevant specialty competency framework.

Action 5.3 Increase the level of psychological assessment skills

Psychological Support

SIGN Guideline 116 on the management of diabetes, highlights that psychological interventions can improve HbA_1c for people living with diabetes. Action 4.2 provided detail on the PiD-PaD project which aimed to help diabetes staff develop their expertise in understanding and changing health‐related behaviour.

The Scottish Government's Mental Health Strategy: 2017- 2027 guiding ambition for mental health is to prevent and treat mental health problems with the same commitment, passion and drive as physical health problems. It is hoped that through the actions linked to the strategy everyone living in Scotland, including those living with diabetes, can get the right help at the right time.

The ongoing SIGN guidelines which are being developed on assessing optimisation of glycaemic control in type 1 diabetes and the early detection and prevention of type 2 diabetes will incorporate a review of the existing evidence base for psychology in improving care and health outcomes.

Diabetes UK have launched some resources for supporting staff to have quality conversations about emotional health and diabetes. They have also developed a practical guide for healthcare professionals supporting people with diabetes who are experiencing emotional difficulties. These resources offer strategies and tools for how to recognise and have conversations about emotional problems, as well as for providing appropriate support. These resources have been widely promoted as an area of support for staff providing diabetes care.

MAP Health Behaviour Change

The Scottish Diabetes Education Action Group promoted and supported the roll out of MAP Health Behaviour Change training programmedeveloped by NHS Education Scotland amongst staff who care for people with diabetes. The training programme provides staff with a 'route map' to support people to make behaviour changes to improve their outcomes. Based on the Health Behaviour Change Competence Framework it brings together the specific skills that professionals can use to support behaviour change, as well as a system for deciding which skills to use and when.