Despite the important healthcare they deliver, there is much we don’t know about the diverse specialist diabetes workforce. In 2010 Diabetes UK (funded by NHS diabetes) carried out an audit to gain a broad understanding of the range of specialists in diabetes. The audit looked at diabetes specialist nurses, dietitians, and podiatrists, gathering the following results:
DSNs
- There was a decrease in the proportion working across both Hospital and Community, indicating further fragmentation of services
- An average DSN in this survey has 2.2 post-basic qualifications
- The amount of DSNs with no clinical leadership hasn’t changed since ’09 (11%), but Nurse leads have increased (32% vs 9%) where Consultant leadership has decreased (83% vs 62%)
- 60 nurses reported 94 vacant posts – almost twice that recorded in ’09 – and there was an increase in the proportion of these vacant due to “Cost savings” (43%, compared to 34% in ’09)
Dietitians
- The average specialist diabetes dietitians in a dietetic service in whole time equivalent is 1.85, or just under 2 full-time members of staff - below Diabetes UK’s recommended minimum staffing levels
- 70% of dietetic services do no work in diabetes prevention, despite strong evidence of the impact of this on lifestyle change and prevention of diabetes
- 43% of dietetic services state their staff spend less than 3 hours a month on continued professional development
- This survey paints a picture of services struggling to cope with the expansion expected of their services, whilst not being afforded the resource (staff and training) to ensure that these developments are made cost-effective.
Podiatrists
- 512 podiatrists gave 233 job titles, with only 4 in 10 specifying diabetes in their job title – though these are podiatrists working commonly with diabetes, as they spent 70% of their time working with diabetes
- The ideal diabetes specialist podiatry workforce would work across both Hospital and Community settings – 50% of this sample work across both settings
- 1 in 10 podiatrists in this survey work in isolation from Foot Protection Teams and Multidisciplinary Teams – including 7% of those working predominantly with high ulcer risk patients
- Just 2% of podiatrists in this survey were Band 5 (non-specialists); yet 27% of the vacant posts were at this level. This may indicate that podiatry services are recruiting non-specialists in order to cope with efficiency savings in their teams.
