Housebound patients with diabetes needing support with insulin—a project to improve service standards

An increasing number of people require support to manage their diabetes due to other conditions that affect their ability to self-care, such as dementia and arthritis (Diabetes UK, 2010). Community staff have a growing caseload of people who require this support. It is therefore important that they have the knowledge and skills to give the right care to people with diabetes, which could even involve delegation of insulin administration. This article briefly describes a project being conducted within a clinical commissioning group (CCG) in East Kent with the aim of improving the community nursing team's insulin administration service for vulnerable homebound adults with diabetes.

Community nursing teams in East Kent are commissioned (on a ‘block’ contract) by the CCGs to provide services to patients who are housebound, including the administration of insulin. Most patients are prescribed a once- or twice-daily insulin regimen but can often be discharged from hospital on three or four insulin injections per day. Blood glucose levels are checked at the time of insulin administration. However, these patients often do not have a comprehensive annual review, which in turn, makes it difficult to set individualised targets for them.