It was during a placement at Ormskirk Hospital that James initially got involved in a line of research that would open up endless learning opportunities and see him published in Diabetic Medicine.
Student doctor James Lay, now in this final year, first offered his help with formatting guidelines to a foundation doctor on the ward during some quiet hours on call. He was then introduced to one of the supervising consultants and invited to carry out data collection and analysis to help move the research closer to publication.
The research in question followed up on previous work that looked into whether the implementation of a best practice tariff (BPT) and a national peer review programme achieved their goal of delivering consistent, high quality diabetic care regardless of where it is delivered.
James combed through regional information from paediatric diabetes units as well as extracting data from the National Paediatric Diabetic Audit.
“What we found was a marked improvement in the quality of care in correlation with a significant increase in staffing levels across admin, consultants, dietitians, specialist nursing staff and psychologists between 2010 and 2014, when the initiative was introduced. However, there was no such improvement from 2014 to 2018, where there wasn’t the same push on staffing.”
What this means is that there is still significant variability in how transition services were planned and delivered for children entering the adult care service.
"This leads to delays in psychosocial development and increased prevalence of mental health issues such as depression, anxiety, and eating disorders, compared to their non-diabetic peers.”
For James, the project involved months of work, receiving and digitalising paper surveys, communicating with the team, and recording and analysing the data. "I was researching all of the functions I needed in Excel and experimenting with SPSS to perform the statistical analysis I need. Of course, this was all whilst revising and preparing for 4th year final exams, OSCEs and LOCAS."
Alongside the technical learnings, James deepened his understanding of diabetic care and the disparities facing children at such a crucial stage of their lives.
There’s a desperate need to establish a systematic approach to ensure good practices are in place including strong collaboration between paediatric and adult service providers to ensure care is patient-centred.
- The main findings are summarised in James' poster: Quality indicators of staffing levels in paediatric diabetes care (PDF).
- The piece was published in June 2020 and can be viewed online on pubmed.gov
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