The HSE National Clinical Programme for Diabetes — which includes the care of children and adolescents with diabetes — was established within the Clinical Strategy and Programmes Directorate. The national clinical leads for diabetes and paediatrics met recently to discuss the issues involved in the care of children and adolescents with diabetes. They set up a working group to assess current services across the country — including the question raised by the Deputy on specialist paediatric nurses, to agree a model of care and to standardise these across the country. This Group is only recently established and its work is continuing.
One proposed national model of diabetes care is based on 8-10 regional networks, with the 3 existing Dublin centres acting as a tertiary hub of excellence and continuing to see one third of the national paediatric/adolescent diabetes population. This model has been proposed by the Diabetes Federation of Ireland. The second model came from the Expert Advisory Group, chaired by Dr. Colm Costigan, Paediatric Endocrinologist in Crumlin Hospital. This proposes that care be centralised for each region in a dedicated paediatric/adolescent diabetes centre looking after at least 150 children/adolescents. Ideally the centre should be in a regional hospital that has an adult diabetes centre to facilitate transition to adulthood; however the final shape of any model will be determined by the Working Group and may possibly be a variation of either of the two earlier models described above.
In parallel officials from my Department and the HSE met with representatives from the DFI at the end of July last. The primary purpose of this constructive meeting was to discuss developments in relation to the care of all people with diabetes.
