Feeling let down by NHS Hospital Diabetes Clinic

Hi @eddie1968 I think many areas of the NHS are stretched to breaking point. I had a rheumatology appointment after badly fracturing my wrist (I have osteoporosis but the fracture was a severe trauma and not a stress fracture due to osteoporosis) and waited 6 weeks for my initial appointment where I had bloos tests etc. and was given an appointment to return for the results six weeks larer. This appointment was cancelled and I was given another appointment which has also been cancelled and I now have one for the end of June; seven months after I first saw the rheumatologist. I will ring and complain if that is cancelled as sometimes that is the only way to get anywhere. I have to say A&E and the fracture clinic were brilliant; thank you West Suffolk Hospital.

Back to diabetes: I have never even seen a doctor, just the diabetic nurse. However, I was a biomedical scientist so fairly clued up about the chemistry of diabetes (think I know more of that than my diabetic nurse!) and learnt about my diet etc from this website and the forums; thank you all for your invaluable contribution! Read the forums on here and do all the right things and ask for 6 monthly reviews if you are improving your figures/symptoms so that your medication can be assess more often.

Good luck.

eddie1968 said:

Hi. I live in the Greater Glasgow and Clyde area. I was diagnosed in 2010 and was taking oral meds till Dec 2013 and was referred to my local hospital, placed under a Consultant and started on insulin and titrated up.

I can't fault the DSN team if I want new equipment or prescriptions for insulin and strips but I have only been seen by my Consultant once a year since referral.

When I was under the care of my GP practice nurse for my diabetes I got more frequent check ups and blood/urine tests. Now I only get an annual Diabetic Review with my practice nurse.

I was under the impression I would be seen and assessed about every six months at least. Every time I get an appointment for a six month review from the hospital I am bumped down the list another six months and this results in a yearly appointment in effect.

I don't feel I am getting the appropriate level of help and hospital services are declining in this area and that I am not the only person in this position here.

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Eddie, forgive me if my memory is flawed here, but I recall you having these deferral issues before? Did you ever call the Consultant's Secretary as I think may have been suggested?

I know, just from random reading of the forum that you've had a tough several months of late, one way or another. If you feel calling your Consultant's Secretary would be fruitless, could you consider asking your GP to call for you? I think with everything that's gone on, including your recent ulcer, it could be good to have a specialist review.

I don't know if your area uses a MDT (Multi-Disciplinary Team) approach for diabetes cases, but it feels to me you could benefit from a decent overview/overhaul to try to ease some of the "stuff" that crops up. A little less firefighting could help the stresses and strains, for sure?

I read you have an excellent relationship with your GP, maybe he is your best ally and route to the level of care feel you need?

Hi. You have been very unlucky with your support. My surgery manages T1 as well as T2 so I can see the DN almost whenever I want, but my current gap is 1 year as I'm well controlled. Prior to that it was every 6 months. Does your surgery do diabetes support?

eddie1968 said:

I have spoken to my DSN about appointments being shelved and with other illnesses concurrent I was too poorly to contact the secretary, they keep giving me different doctors as well. I think the best strategy is asking my GP to contact them on my behalf as he has a better clinical picture than me. I am however disappointed with the service in my area. Thanks. I am thinking of contacting my MSP who can make enquiries to the Scottish Government on my behalf.

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Actually, if your MSP is anything like the one I wrote to several years ago, he/she will probably contact your hospital management team to find out more about the system and more about your situation.

Basically they are overworked and understaffed at any diabetic clinic (or maybe any clinic!) My six month appointments are creeping up to 7 or more months. I am without a DSN at the moment because she retired and no one else feels able to take over her insulin pump patients (they all have their own specialities).

Last year I was due a bone density scan and had to phone them when it was overdue (passed from pillar to post trying to speak to the correct person). I was told that, due to a lack of staff (an osteoporosis specialist nurse leaving and another not being allowed to see patients on her own until fully trained), there was a 9 month waiting list. I was asked if I'd like to make a complaint which I did (an unofficial one). I was seen more quickly due to that complaint.

I can understand you being unhappy about appointments being cancelled - and I can certainly understand why you haven't yet phoned your consultant's secretary. Can't you arrange 3 monthly meetings with your DSN, preferably on clinic days when you can get instant HbA1c results? It's better than nothing and, to be honest, the DSNs tend to know more than many doctors.

When my partner was diagnosed, she was sent to the hospital by our GP due to +++ ketones and high BM's up to 30. They sent her home with metformin even though she was quite poorly at this point. She has only had one follow up appt with the hospital and discharged despite being moved onto insulin within 9 months. The care she has received has been really poor, she's had little input into how to calculate how much insulin is needed and it is mostly guess work - luckily I have some medical training but this isnt enough. Not one medical professional has given any support in terms of what to eat/diet control or exercise and little input into medication. She gets a phonecall from the DSN once in a blue moon, I totally understand your frustrations!

chloebeth said:

When my partner was diagnosed, she was sent to the hospital by our GP due to +++ ketones and high BM's up to 30. They sent her home with metformin even though she was quite poorly at this point. She has only had one follow up appt with the hospital and discharged despite being moved onto insulin within 9 months. The care she has received has been really poor, she's had little input into how to calculate how much insulin is needed and it is mostly guess work - luckily I have some medical training but this isnt enough. Not one medical professional has given any support in terms of what to eat/diet control or exercise and little input into medication. She gets a phonecall from the DSN once in a blue moon, I totally understand your frustrations!

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That is absolutely terrible; diabetes can be a life threatening condition and and with the correct help people can usually avoid the worst of the complications; I assume she is a T2? The people who have dealt with her are not doing their job and I think she would be within her rights to make a formal complaint and ask to be referred to someone who would help her.

Arab Horse said:

That is absolutely terrible; diabetes can be a life threatening condition and and with the correct help people can usually avoid the worst of the complications; I assume she is a T2? The people who have dealt with her are not doing their job and I think she would be within her rights to make a formal complaint and ask to be referred to someone who would help her.

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Actually they've never been able to agree upon what type she is and will never give us a definitive diagnosis! At first it was we'll have to wait and see, then it was T2 and then it was T1 and then back to T2 and so on and so forth, for now, they've just stated that they "dont know" but we have very little correspondence with any of the diabetes team!

eddie1968 said:

I have spoken to my DSN about appointments being shelved and with other illnesses concurrent I was too poorly to contact the secretary, they keep giving me different doctors as well. I think the best strategy is asking my GP to contact them on my behalf as he has a better clinical picture than me. I am however disappointed with the service in my area. Thanks. I am thinking of contacting my MSP who can make enquiries to the Scottish Government on my behalf.

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Tell your GP how you are feeling eddie ..

chloebeth said:

Actually they've never been able to agree upon what type she is and will never give us a definitive diagnosis! At first it was we'll have to wait and see, then it was T2 and then it was T1 and then back to T2 and so on and so forth, for now, they've just stated that they "dont know" but we have very little correspondence with any of the diabetes team!

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Ask to see a consultant; has she had she relevant blood tests done rather than just the routine ones?

Arab Horse said:

Ask to see a consultant; has she had she relevant blood tests done rather than just the routine ones?

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This was the consultant! But we only saw him once and then he did all of his correspondence through the DSN... I'm thinking of asking for further tests to be done x

Only one sentence ,after my consultant retired RUBBISH help

Glad to hear that. Well done!

eddie1968 said:

Update. I have an appointment at the hospital clinic with my DSN next Thursday. I voiced my concerns about the lack of support and she explained why appointments were being put back. She will keep monitoring me for a while so I'm happy I complained.

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Have you had your appointment yet, Eddie? If so, how did it go?

eddie1968 said:

Hi. I live in the Greater Glasgow and Clyde area. I was diagnosed in 2010 and was taking oral meds till Dec 2013 and was referred to my local hospital, placed under a Consultant and started on insulin and titrated up.

I can't fault the DSN team if I want new equipment or prescriptions for insulin and strips but I have only been seen by my Consultant once a year since referral.

When I was under the care of my GP practice nurse for my diabetes I got more frequent check ups and blood/urine tests. Now I only get an annual Diabetic Review with my practice nurse.

I was under the impression I would be seen and assessed about every six months at least. Every time I get an appointment for a six month review from the hospital I am bumped down the list another six months and this results in a yearly appointment in effect.

I don't feel I am getting the appropriate level of help and hospital services are declining in this area and that I am not the only person in this position here.

Click to expand...

eddie1968 said:

Hi. I live in the Greater Glasgow and Clyde area. I was diagnosed in 2010 and was taking oral meds till Dec 2013 and was referred to my local hospital, placed under a Consultant and started on insulin and titrated up.

I can't fault the DSN team if I want new equipment or prescriptions for insulin and strips but I have only been seen by my Consultant once a year since referral.

When I was under the care of my GP practice nurse for my diabetes I got more frequent check ups and blood/urine tests. Now I only get an annual Diabetic Review with my practice nurse.

I was under the impression I would be seen and assessed about every six months at least. Every time I get an appointment for a six month review from the hospital I am bumped down the list another six months and this results in a yearly appointment in effect.

I don't feel I am getting the appropriate level of help and hospital services are declining in this area and that I am not the only person in this position here.

Click to expand...

Hi Eddie, your post was a while back but I've just saw it. I am also type 1 within greater glasgow & Clyde. I also attend the consultant once a year but then 6 months later have a review 27th the practice nurse @ my GP. Hope you got your appointments sorted.

Hi! I am also within Glasgow & Clyde. It is my impression they are as many, overworked/stretched. When I first lived here in 200-2004 as a student, I went to the same clinic. Moved away for ten years, the difference is big in ow many are in the waiting room, it seems so busy, but there does not seem to be more than one nurse? There are more doctors but my appointment also gets moved.Have it once every year or if lucky every 6th month.Cant remember.Just remember whatever date I am given it will be moved back by several months anyway. I do think especially the nurses,every one I have ever had there, are very good.They are just drowning in the workload. Hope you feel it is getting better.At least there are places like this and advice to read in books etc.When I was diagnosed internet was years away.I am so happy for that, and for things like and I am repeating myself,sorry, the Libre that measures constantly.Actually, if only money was spent on that and we got it free I would happily see my doctor once every three years (what I mean is spend the money that pays the doctor to pay for the libre.)

M80 said:

Hi! I am also within Glasgow & Clyde. It is my impression they are as many, overworked/stretched. When I first lived here in 200-2004 as a student, I went to the same clinic. Moved away for ten years, the difference is big in ow many are in the waiting room, it seems so busy, but there does not seem to be more than one nurse? There are more doctors but my appointment also gets moved.Have it once every year or if lucky every 6th month.Cant remember.Just remember whatever date I am given it will be moved back by several months anyway. I do think especially the nurses,every one I have ever had there, are very good.They are just drowning in the workload. Hope you feel it is getting better.At least there are places like this and advice to read in books etc.When I was diagnosed internet was years away.I am so happy for that, and for things like and I am repeating myself,sorry, the Libre that measures constantly.Actually, if only money was spent on that and we got it free I would happily see my doctor once every three years (what I mean is spend the money that pays the doctor to pay for the libre.)

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Hi M80 which clinic do you attend? I attend RAH in Paisley

I am at Gartnavel. I was briefly at the one in Paisley, it was the same nurse som made little difference.She has retired now.The new nurse is good, she stays I suspect only at Gartnavel.Or I hope so anyway there seems to be enough patients..