Designed to enable unregistered nurses to understand their role in supporting people at high risk of developing diabetes and type 2 diabetes. This practical course enables unregistered nurses to return to practice and use the learnt skills under the mentorship of a practice nurse or chosen supervisor. The course includes the HCA PITstop competency assessment tool, adapted from the Trend competency framework for unqualified team members (Trend, 2016)
Day 1 programme includes the care pathways for high risk and type 2 diabetes, and the screening tests associated with the annual reviews, how to maintain the Practice ‘diabetes box’ containing blood glucose/ketone monitoring equipment and hypoglycaemia treatment, the scope of practice of HCAs in diabetes care and the competency assessment/mentorship requirements.
Day 2 programme includes details of the local structured education for people with type 2 diabetes, the Diabetes Prevention Programme for people at high risk and any local lifestyle referral options. It covers five elements of healthy living: sleep, social engagement, stress, moving and diet and how to motivate patients to achieve their goals.
Working in partnership with the West London RIPEN (Reflective Interprofessional Education Network), to develop their advanced HCA workforce, we designed the HCA PITstop course for Non-Registered Nurses.
The course was to meet the specific needs in local primary care systems with a focus on recall, motivational interviewing and development of a “diabetes box”, and linked competencies to put these into practice
Dr Yasmin Razak, RIPEN & Diabetes Transformation Lead, was particularly impressed with the quality of the training materials used by the Pitstop team and how the skills taught could support Primary Care.
Feedback from the successful pilot reflected the incredible buzz in the room from all the participants.
The best course I have been on. I was provided with so much clinical knowledge and understanding that no course has provided before.
Both PrePITstop programmes join PITstop as RCGP accredited courses. The assessor panel continue to be impressed with the quality of the resources submitted, describing the courses as excellent quality, with no changes required. The 1-day and 3-day PrePITstop courses are proving to be popular, as they both incorporate key STP requirements, including the three targets (HbA1c < 58mmol/mol, cholesterol < 5mg/dL, blood pressure < 140/80mm/Hg), increased attendance to structured patient education and active participation in the diabetes foot care pathway by primary care teams.
The 1-day course is great for GPs who are not necessarily the diabetes lead in their practice but want a good diabetes update on most aspects other than injectables. As one GP in East Kent emailed:
I have read on your website that you offer a 1 day pre-PITSTOP intensive course.
Insulin is one of the top five high-risk medications worldwide. This two-page handout links to the key documents and www.diabetesonthenet.com 'Six steps to insulin safety' e-learning module. All healthcare professionals supporting people on insulin must keep up-to-date with insulin safety advice.
The new partners prioritised diabetes as one of the first long-term conditions to tackle. They sourced and attended PITstop in 2015, then returned with a plan of action involving audit and proactive follow-up, combined with a goal for 75% of the practice clinical workforce to attend diabetes training in 2016. Hillingdon Clinical Commissioning Group were keen to support the training initiative and a variety of training was marketed and delivered, including a 3-day PrePITstop and 1-day key message PrePITstop, a PITstop course and two half-day introduction to PITstop workshops for clinicians who already held a qualification in enhanced diabetes service delivery.
Audit and mentorship have been key to the success of Shakespeare Health Centre, to help embed the skills. PITstop inspired them to return to clinical practice with the resources, ideas and motivation to make a difference to patient services and outcomes.
We exhibited at the Diabetes Professional Care conference, Olympia on 16th & 17th November. Jon and I were joined by Dina Kapoor, clinical pharmacist from Shakespeare Medical Practice in Hayes. Both Dina and Jon have attended the PrePITstop and PITstop courses so were well placed to discuss the training with attendees. The conference was well attended and feedback from the attendees was extremely positive. We had a great deal of interest from commissioners, diabetes lead clinicians, medicines management leads and individual healthcare professionals.
PITstop was adapted following a request from Susan Quinn, DSM from Central Manchester University Hospitals NHS Foundation Trust, who was searching for a practical training course focusing on insulin management and support for women with gestational diabetes and with type 2 diabetes (during preconception and pregnancy). Greenwich University gave permission for the learning outcomes to be adapted and new case studies were developed appropriate to midwifery.
The 2015 NICE NG3 pregnancy guidance and local guidelines, helped the DSMs justify treatment options, including when to start and titrate insulin. The PITstop insulin care pathway and general rules were relevant to women with type 2 diabetes requiring insulin when planning pregnancy.
PITstop prescribing guidance is for nurses that do not prescribe (non-prescribers), non-medical prescribers and GPs supporting non-prescribers. The guidance highlights the importance of clearly defining your role in advanced diabetes care and knowing when prescribing colleagues must be involved (non-prescribers), and the importance in defining your scope of prescribing practice with diabetes-related medication (non-medical prescribers). The RCN are not planning to write any guidance on this and plan to provide links to recognised guidance from experts in the field, as it is published. The main PITstop messages are relevant to any primary care clinician, but the focus is for PITstop-trained clinicians to use the PITstop resources, including the insulin and GLP-1 care pathways and the general rules, alongside local and NICE guidelines.
The guidance, in our student folder and available to download from the website, evolved in response to an email last year from Sharon Lee, Primary Care Workforce Facilitator for South Kent Coast clinical commissioning group, which highlighted the issue.
This year sees the launch of half and one-day Continuing Professional Development (CPD) PrePITstop and PITstop courses in response to primary care workforces’ focus on CPD events. Our PrePITstop CPD programme is suitable for students who have attended a Foundation level course and have chosen to continue to deliver essential diabetes care to a high standard and not progress to insulin and GLP-1 initiation. The PITstop CPD is for those who have already attended PITstop.
Bexley in South London has commissioned CPD one-day courses from Anne for the past four years, as well as continuing to run PrePITstop courses for newcomers and GP registrars, and accessing the national PITstop course in Kent. So we were able to use our experience in Bexley to write the 2016 CPD programmes.