The Intermediate Diabetes Specialist Service (IDSS) supports diabetes patients in the community where primary care requires specialist input to manage more complex care.

The IDSS consists of a team of diabetes specialist nurses (DSNs), diabetes specialist dietitians, healthcare assistants and diabetes consultants. The service works with patients to ensure management of the three-treatment targets (HbA1c, blood pressure and cholesterol) and support self-care. The nine care processes are recorded and patient’s GP is alerted if there are any overdue tests or patients referred to other services were possible.

Sharing the patient’s EMIS record

The service uses EMIS community, enabling direct access to the patient’s EMIS record; this helps to inform clinical decision-making. It is important to receive explicit patient permission for the sharing of the record.

Triage

All referrals will be clinically triaged by the service within 24 hours; the three outcomes following triage are:

• management by the Intermediate Diabetes Specialist Service 
• referral back to the primary with advice or a treatment plan (within 72 hours of referral)
• onward referral to secondary care as appropriate.

Clinics

Please note: face-to-face clinics are currently suspended due to Covid. The intermediate diabetes service is providing virtual video and telephone consultations.

Diabetes clinics usually take place at a variety of locations throughout Islington depending on where the patient lives. Domiciliary visits are also provided. 

Eligibility criteria

Inclusions

Patients registered with an Islington or Haringey GP (this includes patients who reside in other boroughs but are registered with an Islington or Haringey GP) who

• have type 2 diabetes requiring initiation of insulin or GLP1 who are on three maximum tolerated oral hypoglycaemic agents with raised HbA1c > 7.5% (>59mmol/mol)
• are on insulin and requiring review for 
  • hypoglycaemia
  • change in the type of insulin regimen
  • HbA1c raised >7.5%  (>59 mmol/mol) despite insulin titration   
• have type1 diabetes who disengage or DNA hospital care
• where home visits are required

Exclusions

• please do not refer to the service if the patient is being managed in secondary care
• house-bound patients who reside outside of Haringey or Islington, despite being registered with a Haringey or Islington GP practice

How to refer

The following clinicians can refer to this service: GPs, Nurses, Practice-based Pharmacists

Locations

External Links