Finian McGrath (Dublin Bay North, Independent) | Oireachtas source

I thank the Deputy for raising this issue and for the opportunity to provide an update to the House on services for children and teenagers with type 1 diabetes in the Cork area. Regarding paediatric diabetic services generally, the Deputy may be aware that the HSE developed a model of care for paediatrics and neonatology in Ireland to underpin the delivery of healthcare for children, both in the present and into the future. Key steps in its development were wide consultation with all healthcare professionals, involvement with parents and parent groups, a detailed analysis of the current clinical activity of all paediatric medical and surgical subspecialties, including paediatric endocrinology and diabetes, and a study of how paediatric clinical care is distributed with reference to international best standards. The HSE model of care for paediatrics includes the proposed model of care for paediatric diabetes services.

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High-quality diabetes care is complex and requires intensive consultant-delivered care. It is recognised that diabetes care provided by a multidisciplinary team, including clinical nurse specialists, dietetics, social work and clinical psychology, results in fewer days in hospital, a higher level of participation in diabetes self-care practices, decreased readmission rates and delayed development of complications. Diabetes technology also provides an opportunity to improve control and quality of life in selected patients and is expanding rapidly, with continuous subcutaneous insulin infusion, or pump therapy, increasingly used in the paediatric population.

The model for service provision proposes that all hospitals providing acute paediatric care will have staff trained in the acute care of newly diagnosed diabetes. Children whose diabetes is diagnosed in level 1 hospitals that do not have access to a paediatrician with endocrinology training will be referred to their nearest diabetes multidisciplinary team once they have been stabilised in accordance with local agreed guidelines. In addition, the HSE has advised that seven clinical guidelines have been published and disseminated to the delivery system to guide and support service delivery to this patient cohort.

Regarding services in the Cork area specifically, CUH is a centre for paediatric diabetes and provides care for patients in the south west. More than 400 paediatric patients attend the diabetes service in CUH, with one to two new cases of insulin-dependent diabetes mellitus, IDDM, diagnoses per week. The paediatric diabetes service in the hospital has provision for two consultants, 2.8 diabetes nurse specialists and one dietician. The second consultant post is currently being recruited for and the candidate is expected to take up the position in January 2020. CUH is working actively to expedite this start date and, in the interim, is seeking to secure a locum consultant endocrinologist. In addition, it has recruited a locum consultant paediatrician to support the paediatric endocrinology service commencing in June.

Approval for recruiting additional posts for paediatric services in Cork was given in this year's national service plan. The posts include a psychologist, social worker and dietician. These posts will support the delivery of the model of care for paediatrics in CUH.

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