Care pathways improve the delivery of effective care, facilitate critical evaluation of that care and strengthen multidisciplinary communication 2. Developing care bundles to improve the safety of care for patients with diabetes should therefore be a priority.
Diabetes and care home residents
Recognising that the prevalence of diabetes among patients in residential care may be as high as 26% and that this group have a high prevalence of complications, the Good clinical practice guidelines for care home residents with diabetes from Diabetes UK, provides a national policy of good clinical practice. They identify barriers to good care and provide an assessment framework for benchmarking.
Improving diabetes care in Scotland
The Scottish Diabetes Framework Action Plan from the Scottish Government updates a previous framework around priorities for improving diabetes care in Scotland. It outlines specific groups of patients and areas for intervention, along with steps to be taken to improve outcomes for these groups.
Implementing guidelines and frameworks
Guidelines and frameworks are a useful driver for improvements in care, however implementing these into practice can be challenging. In their research paper Developing and implementing diabetes care pathways O’Brien and Hardy discuss lessons learned from their experiences of creating and implementing pathways across primary and secondary care in a region of the UK. They include a sample template for other groups to use and adapt.

The Diabetes guide for London from Healthcare for London outlines the current state of diabetes care across London, priorities for improving the quality of care and a model of care to be implemented. It includes identification of key enablers for delivery and provides useful reading for implementation in other regions.

O’Brien S, Hardy J. Developing and implementing diabetes care pathways. Journal of Diabetes Nursing. 2003;7(2):53-56.
Kitchiner D, Davidson C, Bundred P. Integrated care pathways: effective tools for continuous evaluation of clinical practice. Journal of Evaluation in Clinical Practice. 1996;2:65–9

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