Diabetes Service Running on 12 Percent Resources

I had a semi formed blog post about a diabetes debacle around the death of a transmitter but then a local diabetes issue is finally getting some media attention so I’ve put Death of a Transmitter on hold till next week. This week I’m going to get up on my soapbox because this is an issue in my area. 

Diabetes Ireland published a press release on Monday last 15 July, about the lack of resources in the diabetes service run by University Limerick Hospital. Can you really call it a lack of resources if those resources are only at 12% of what it should be? Would you even call that a service?

The diabetes clinic in UL hospital is the closest clinic to where I live and would have been the clinic I was referred to if I had been newly diagnosed when I first arrived in Ennis, Co Clare thirteen years ago. However, I was connected with the diabetes community shortly after arriving and I’m also lucky to be able to travel further to a diabetes clinic. But many people with type 1 diabetes don’t have that choice and have to attend the service that is closest to them. 

Here’s another BIG BUT!!! Why should people have to travel further to get the service they NEED!?! This is a NEED not a wishlist item. When you are diagnosed with any type of diabetes you NEED a team of diabetes health specialists to help you take care of your diabetes!!!! 

I’m calling on the CEO of UL Hospital, HSE Mid West Area Manager, Minister for Health: Simon Harris, all of the county and city councillors in Limerick City, Limerick County, Clare, Tipperary and Kerry and also our national public representative TD’s in Limerick City, Limerick County, Clare, Tipperary and Kerry to join us in establishing a diabetes service in the midwest that we can be proud of. 

A 12% Diabetes Service!

University of Limerick Hospital is running a diabetes service with 12% of the resources they should have (88% deficit according to the National Survey of Diabetes Care Delivery). 12%! That is a really small number!!!

No Diabetes Dietitian 

Type 1 diabetes is a chronic, life long condition and people living with it need specialist diabetes care to support their daily self-management. A dietitian is essential in supporting the individual to know how the food they eat is affecting their blood glucose levels and how to adjust their insulin intake to meet daily needs. UL hospital has ZERO dietitians. They should have 5!

No Structured Diabetes Education for Patients with Type 1 Diabetes

The National Clinical Guidelines for Adults with Type 1 diabetes recommends that all people with Type 1 diabetes complete structured diabetes education with a dietitian within 6 months of diagnosis and be offered carbohydrate counting (Recommendation 3.4)  – this is not happening for people with Type 1 diabetes attending any of the six hospitals of the University of Limerick Hospital Group.

Assoc of British Dietitians

Assoc of British Dietitians

0.5 consultant endocrinologist between 3 hospitals

This 0.5 Endocrinologist post is shared with Ennis hospital and Nenagh. The National Survey of Diabetes Care Delivery highlighted that UL hospital should have 4.2 consultant endocrinologists. 

The result of the lack of resources:

Diabetes complications are the direct result of a poor standard of care. The lack of resources is leading to an increase in the number of people with diabetes developing complications, such as kidney disease, blindness, foot ulcers and limb amputations. We see the evidence of this in Limerick from the increasing numbers of hospital admissions due to foot ulcers and amputations for two years running and possibly a third. But also, as Diabetes Ireland pointed out, the increase in the need for additional posts in UL hospital’s nephrology and cardiovascular services. Limerick have increased the number of consultant posts in these services to 5 but only 0.5 consultant post in diabetes.

Diabetes complications can be prevented by investing in the diabetes service! A 12% diabetes service will not achieve that and it is not acceptable!

We want to live better for longer, not having access to dietitians or structured diabetes education is reducing our odds of achieving this. 

Why is this issue important to everyone?

It’s your tax euros! And they are not being used wisely. It costs a lot more to treat the complications of diabetes than it does to provide a fully resourced service. Investing in diabetes care saves money. 

How many People with Type 1 Diabetes Does This Affect?

The estimated number of people with type 1 diabetes in the midwest is estimated at 4,700. 

University Hospital Limerick diabetes clinic cares for people with type 1 diabetes from Limerick, Clare, North Tipperary and North Kerry because it is the largest hospital in the midwest region. Limerick county alone has 1,900 people with type 1 diabetes.

We need a diabetes service that helps us live better for longer. Our health service needs this because it’s needs to cut costs, and equally important our healthcare professionals need this to prevent complete burnout. 

#CareCantWait #PatientSafety #HSE #OurHealthService

Here are a list of people who may be able to help address this issue:

Clare TD’s: Pat Breen, Joe Carey, Timmy Dooley, Michael Harty   

Kerry TD’s: John Brassil, Martin Ferris, Brendan Griffin, Danny Healy-Rae, Michael Healy-Rae   

Limerick City TD’s: Michael Noonan, Willie O'Dea, Jan O'Sullivan, Maurice Quinlivan   

Limerick County TD’s: Niall Collins, Tom Neville, Patrick O'Donovan

Tipperary TD’s: Jackie Cahill, Seamus Healy, Alan Kelly, Michael Lowry, Mattie McGrath   

Minister for Health: Simon Harris

HSE Director General Paul Reid

UL hospital CEO: Colette Cowan

HSE National Clinical Programme for Diabetes: Clinical Lead: Prof Sean Dinneen

HSE Mid West Area Manager, Bernard Gloster

All of our county and city councilors also.

Hope I haven’t missed anyone.

Take care of the patient.jpg