Together study: version 1
Research type
Research Study
Full title
Running title: Together study: Better care for young adults with diabetes using group clinics Long title: Can group clinics offer a better way to meet the complex health and social care needs of young adults with diabetes in an ethnically diverse, socioeconomically deprived population?
IRAS ID
212811
Contact name
Shanti Vijayaraghavan
Contact email
Sponsor organisation
Barts and the London School of Medicine and Dentistry, Queen Mary University of London
Duration of Study in the UK
2 years, 8 months, 30 days
Research summary
Summary of Research
Together Study: Better care for young adults with diabetes using group clinics.
A person with diabetes, usually receives medical care that relies on one-to-one time with health care professionals. This style of health care may not meet a patient’s needs related to their condition or the wider impact it has on their life as a whole. The experience of living with diabetes is a difficult one, and at particular times of life, e.g. young adulthood, a person’s diabetes rarely stands alone from other challenges (e.g. leaving home, starting work, having financial worries). Current NHS care may not meet these wider challenges and therefore patients may not attend appointments, find looking after their condition is increasingly difficult, and have unexpected stays in hospital or develop diabetes complications.
We are going to design and test out health care services that better meet the needs of people using them. Past research suggests that medical care delivered in a group setting may be one way to do this. The findings of recent research suggest that “group clinics” may be particularly successful for young adults, minority ethnic groups or people who have previously been poor clinic attenders.
In this project, we will invite people aged 16-25 years living with diabetes, patient representatives, health care professionals and community-based organisations to help us design group clinics for people with diabetes, in a process called “co-design”. We will then run these co-designed group clinics for young adults with diabetes alongside their existing medical care at Newham Hospital (part of Barts Health NHS Trust). We will compare the group clinics to ‘traditional’ clinics at Newham and other hospitals and researchers will use different tools (e.g.observation, financial analysis, questionnaires and comparison to other studies), to understand the difference that group clinics make.
Summary of Results
Young adults living with diabetes have poor experiences of the health care that they receive. Only one in five young adults reach national targets for diabetes monitoring and treatment, leading to higher rates of diabetes complications and hospitalisation than among older adults. We studied whether or not building a new model of care using group clinics, in which several young adults with diabetes come together in a clinic appointment, could improve their experience of care. We also wanted to know how group clinics could become part of normal care within diabetes services in the NHS. We studied background literature and data to understand what is known already about group clinics and the care of young adults with diabetes in the NHS. Next, we involved young adults and their health-care teams in designing group clinics, and then we delivered these in two hospitals in ethnically diverse and socioeconomically deprived communities. We assessed the experiences of young adults attending group clinics by directly observing the clinics and interviewing those involved. Young adults attending the group clinics had mostly good experiences of them, in particular from being able to share common knowledge and experience, and from developing strong relationships with each other and the health-care team delivering the clinics. The group clinics supported young adults with wider aspects of their health and well-being, including their emotional health, rather than just their diabetes. Only one-third of those invited to group clinics attended, and this group felt that they would still benefit from one-to-one clinic appointments. Building group clinics into existing NHS infrastructure was difficult.More research is needed to develop the group clinic model further and understand whether or not it can help improve the health of young adults with diabetes and whether or not this would be at a cost that is acceptable to the NHS.
REC name
HSC REC B
REC reference
17/NI/0019
Date of REC Opinion
23 Feb 2017
REC opinion
Further Information Favourable Opinion