Integrating a diabetes service within the Adult Cystic Fibrosis Service at Blackpool Victoria Hospital, UK

ABSTRACT

Objectives: In 2018 a new Adult Cystic Fibrosis Diabetes (CFD) servicewas established within the Blackpool Victoria Hospital Adult Cystic Fibrosis Service (BACFS). Over 3 years the number of patients in the BACFS has increased, reflecting an increase in patients with CFD requiring more diabetes specialist time (see table). Demands on the service were further impacted during the COVID-19 restrictions;however, this also inadvertently enhanced engagement between patients and the CFD service. Methods: 1. Designated CFD Clinics 2. Annual review 3. Policies and resources 4. Ongoing education of patients and clinicians (Table Presented) Results: 1. Designated clinics 2 Weekly CFD multidisciplinary team (MDT) review including Libre View discussions, new & transition patient clinics, follow-up clinic alternating with 2 weekly nurse-led clinics All patients with CFD have a Libre sensor fitted and share data 2. Annual review Due to COVID-19 restrictions, Libre view used for screening of CFD 2 weekly CFD MDT meeting to discuss Libre View data Discussion at CFD MDT re diagnosis & treatment 3. Policies and resources Local and National protocols followed to screen for CFD and initiate early treatment Established resources for new patients starting insulin 4. Ongoing education of patients and clinicians Upskilled CF team regarding CFD annual review Contribute to journal club, local meetings and education for other specialities Joint working agreement with antenatal service at BVH Conclusion: There have been challenges to establish a CFD service around staffing hours, accommodation and cross cover. COVID-19 had further impacted this but the introduction of virtual working has increased patient contact without the need for face-to-face consultations. Further development is centred on working with local paediatric centres for the transition of patients and introduction of virtual, structured group education.