Where have all the diabetes specialist nurses (DSNs) gone? Like so many other roles, when individual nurses have resigned or retired from their posts, they may not have been replaced. Just recently as I have been reading through some of my journals, I have noticed a recurring theme, which highlights the increasing shortage in diabetes specialist nurses.
A recent workforce survey conducted by Diabetes UK found that there is a significant mismatch between the capacity of the DSN workforce and the rising demands for diabetes services. So how does this affect those of you who work in surgeries as practice nurses? In your experience, do you have the level of support you need to manage those patients with more complex needs? Can you refer a patient to more specialist service readily, or are there delays and frustrations in trying to do this?
In the community team I work within, we are finding demands are constantly increasing, and without a doubt, most if not all of us regularly working well beyond our contracted hours, just as it has been reported in this survey. The survey states that 90% of DSNs do this in order to try and meet the demands of those they are working with and trying to help with managing their diabetes.
To add to this, the Care Quality Commission (CQC) a now require staff caring for people in nursing and residential care homes to be adequately trained if they wish to provide care for people with diabetes. Who is going to give this training? In our Clinical Commissioning Group (CCG), it has fallen to the community diabetes team to do this.
How does it work in your locality? Do you have an intermediate service which supports what you are doing in primary care, or do you know who to contact, when a patient with particularly challenging needs comes to see you requesting expert help?
With the growing number of people with diabetes, it just does not make sense, does it, that the DSN workforce is diminishing? How can we hope to adequately support each one of our patients when that group is growing so rapidly? CCGs need to be more aware of the role that DSNs play in care provision for those with diabetes. It would be good to encourage them, rather than have cost savings thrust at them at every available opportunity
The Diabetes UK survey suggests that diabetes nursing is in crisis and that if numbers reduce any further, it will create serious consequences for those living with diabetes and impact further on wider healthcare provision.
What can we change, particularly when we read that 80% of people within the age range from 40 – 60 years are overweight, and obesity is increasing across the whole population?
It is clear that we are heading for a crisis with obesity and diabetes if nothing changes. Or can we as a population change to prevent such a crisis? We need as both individuals and a population to get to grips with improving our diet and lifestyle, so this trend towards obesity is reversed.
At the current levels of DSN and practice nurses managing diabetes, it will soon become impossible to provide vital care to those with diabetes. Obesity is a problem that will not go away overnight, so there must be greater investment in practice nurses and DSNs now. Education need to be widely available to give people the skills to eat healthier diets and have more physically active lifestyles.
Let’s each take responsibility for our own health, and demonstrate to our patients a more effective way to live healthier lives.
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