The Diabetes Specialist Nurse or DSN role has been around for 60 years. It was developed, and continues to develop to specifically meet the needs of people with diabetes and their families, and to provide experience and expertise as part of dedicated diabetes teams and to support other health care professionals in the care they provide.
DSNs are crucial in supporting independence and in helping people self manage their diabetes more effectively. They play a vital role in preventing expensive complications, in supporting people with complex needs and, critically, in providing primary care teams with specialist expertise that reduces emergency hospital appointments.
Through the carrying out of the work force survey, we have been able to gain a picture of how many DSNs we have to support people, where they work and what levels of expertise and experience they have.
Unfortunately, we know from the survey and through other means that the number of DSNs is reducing, and that in some cases where DSNs are retiring or moving, their posts are being frozen, in some cases simply to make or support a cost saving. The survey shows that:
- 43% of vacant DSN posts are unfilled due to cost savings initiatives in trusts
- 1 in 5 DSNs will retire by 2016, with massive spikes in retirement of staff every 5 years
This Diabetes UK audit of 587 DSNs revealed a vacancy rate of 16%. When this is examined in relation to the estimated 1,363 filled DSN posts in the UK (assuming the same vacancy rate of 16%) this would mean 218 vacant posts across the UK.
At a time when numbers of people with diabetes are increasing, a decrease in the number of diabetes specialist nurses is very concerning. This will mean longer waiting times for specialist support, more unnecessary amputations, more people losing their sight and far poorer health outcomes.
This is simply not acceptable.
In addition to our work force survey, Diabetes UK and TREND UK have undertaken complementary work to gather the views and experiences of people with diabetes and their families with regard to the contribution that their DSNs make to the management of their diabetes and the impact this has on their lives. These important surveys not only highlight the loss of a reducing work force in terms of what they currently provide, but also reflect the long term impact that this has on the lives of people with diabetes.
Barbara Young
Chief Executive
Diabetes UK
You can download the full report from the right-hand column.
Key Findings
- DSNs face a severe threat to their work force in the current NHS climate
- Patients report that seeing a DSN, even once or twice, instigates total change to independent condition management.
- 60 DSNs recorded 94 vacant posts in this survey (40 DSNs recorded 50 posts in 2009, so this is increasing). 59% of missing posts are categorised as ‘frozen’
Settings and Role
- 47% of DSNs work solely in a hospital
- 20% of DSNs work solely in the community
There was a decrease in the proportion who work across both areas
- 9% work in paediatric or adolescent care
- 90% work with general adult, though almost a quarter of these work in both general adult and adolescent care
- 60% of DSNs deliver structured patient education, however just 20% of hours are dedicated to this activity59% of DSNs are working in inpatient care (an increase of 18% from2009 data)
Qualifications
Within the survey, DSNs had on average two further qualifications in addition to their basic qualifications, demonstrating a high level of training and development
- 64% have a diabetes diploma/certificate (74% in 2009)
- 27% have undertaken ad hoc degree modules (54% in 2009)
- 15% have undertaken ad hoc masters modules (18% in 2009)
- 41% have undertaken non-medical prescribing courses (40% in 2009)
- 68% have more than one post-basic qualification
Experience
- 63% of DSNs work full time, more than or equal to 37.5 hours per week (57% in 2009)
- The average length of DSN experience in this survey was 10.1 years experience as a DSN (9.6 yrs in 2009)
- 88.5% are Band 6 or 7 (83% in 2009)
- 40% of DSNs in the survey are due to retire within the next 10 years (44% in 2009)