{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T17:58:18Z","timestamp":1781200698364,"version":"3.54.1"},"reference-count":22,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T00:00:00Z","timestamp":1775779200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T00:00:00Z","timestamp":1775779200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabet Med"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The Getting It Right First Time (GIRFT) programme national report was published in 2020 with recommendations on how inpatient diabetes care could be improved. To determine whether there have been changes in service provision of inpatient diabetes care since the GIRFT report and to gather feedback from staff on current diabetes care, we conducted a survey of NHS hospitals in England.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A national survey of inpatient diabetes service provision and diabetes staff opinion was conducted across NHS hospital trusts in England between 1 July 2024 and 31 March 2025. The survey assessed inpatient diabetes prevalence, workforce staffing, infrastructure and information technology, care pathways (including perioperative care) and systems to improve patient safety. Findings were compared with previous national audits, including the National Diabetes Inpatient Audit (NaDIA; 2010\u20132019) and the 2024 National Diabetes Audit \u2010 Integrated Specialist Services (NDA ISS) survey.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Responses were received from 136 hospitals, representing 102 (77%) of 132 NHS hospital trusts in England with a diabetes service. Most hospitals reported a continued increase in inpatient numbers since 2019. Although approximately 85% of hospitals reported access to Diabetes Inpatient Specialist Nurses (DISNs), nearly two\u2010thirds had no weekend DISN service. Access to diabetes physician support and out\u2010of\u2010hours specialist advice was limited. The use of networked glucose monitoring systems was widespread, but their use for quality improvement was inconsistent. Trusts with higher specialist staffing levels demonstrated shorter lengths of stay and fewer 30\u2010day emergency readmissions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Despite improvements in inpatient diabetes service provision since 2019, substantial variation remains, with workforce capacity failing to match rising demand and increasing clinical complexity. The absence of a national bedside inpatient diabetes audit since 2019 represents a critical gap. Reinstating a national bedside audit and integrating service\u2010level evaluation with patient\u2010level outcomes should be prioritised to support safe, effective and equitable inpatient diabetes care in England.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dme.70320","type":"journal-article","created":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T03:59:41Z","timestamp":1775879981000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Changing trends and variation in service delivery for inpatient diabetes care in England: A national survey"],"prefix":"10.1111","volume":"43","author":[{"given":"Gerry","family":"Rayman","sequence":"first","affiliation":[{"name":"Getting It Right First Time Programme NHS England  London UK"},{"name":"The Ipswich Diabetes and Endocrine Centre, Ipswich Hospital East Suffolk and North Essex NHS Foundation Trust  Ipswich UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula","family":"Johnston","sequence":"additional","affiliation":[{"name":"Getting It Right First Time Programme NHS England  London UK"},{"name":"University Hospital Southampton NHS Foundation Trust  Southampton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fiona","family":"Earnshaw","sequence":"additional","affiliation":[{"name":"Getting It Right First Time Programme NHS England  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Partha","family":"Kar","sequence":"additional","affiliation":[{"name":"Getting It Right First Time Programme NHS England  London UK"},{"name":"Queen Alexandra Hospital Portsmouth Hospitals University NHS Trust  Portsmouth UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim W. R.","family":"Briggs","sequence":"additional","affiliation":[{"name":"Getting It Right First Time Programme NHS England  London UK"},{"name":"Department of Surgery Royal National Orthopaedic Hospital NHS Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William K.","family":"Gray","sequence":"additional","affiliation":[{"name":"Getting It Right First Time Programme NHS England  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,10]]},"reference":[{"key":"e_1_2_14_2_1","volume-title":"Endotext","author":"Dhatariya K","year":"2000"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-024-06206-4"},{"key":"e_1_2_14_4_1","volume-title":"Diabetes: GIRFT Programme National Specialty Report","author":"Rayman G","year":"2020"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdiacomp.2024.108803"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/dme.14573"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/dme.12282"},{"key":"e_1_2_14_8_1","unstructured":"Centre for Perioperative Care and the Academy of Medical Royal Colleges.Guideline for perioperative care for people with diabetes mellitus undergoing elective and emergency surgery.2023."},{"key":"e_1_2_14_9_1","volume-title":"Improving Inpatient Experiences of Diabetes Management","author":"Pesgrave M","year":"2024"},{"key":"e_1_2_14_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/pdi.1281"},{"key":"e_1_2_14_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l4185"},{"key":"e_1_2_14_12_1","doi-asserted-by":"publisher","DOI":"10.7861\/clinmed.2019-0255"},{"key":"e_1_2_14_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00592-024-02370-6"},{"key":"e_1_2_14_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjdrc-2017-000460"},{"key":"e_1_2_14_15_1","unstructured":"NHS England.National Diabetes Inpatient Audit (NaDIA) \u2010 2019.2020."},{"key":"e_1_2_14_16_1","unstructured":"NHS England.National Diabetes Audit \u2013 Integrated Specialist Survey (NDA ISS).2024."},{"key":"e_1_2_14_17_1","volume-title":"Model Health System: Supporting NHS Teams to Provide High Quality Patient Care and Continuous Improvement","author":"Model Health System","year":"2026"},{"key":"e_1_2_14_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/dme.15151"},{"key":"e_1_2_14_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2023.111062"},{"key":"e_1_2_14_20_1","doi-asserted-by":"publisher","DOI":"10.3390\/bs10080120"},{"key":"e_1_2_14_21_1","unstructured":"NHS England.Supporting hospital teams with safe inpatient diabetes care.2025."},{"key":"e_1_2_14_22_1","doi-asserted-by":"publisher","DOI":"10.15277\/bjd.2018.160"},{"key":"e_1_2_14_23_1","volume-title":"Diabetic Foot Problems: Prevention and Management","author":"National Institute for Health and Care Excellence","year":"2019"}],"container-title":["Diabetic Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dme.70320","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/dme.70320","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dme.70320","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T17:19:09Z","timestamp":1781198349000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/dme.70320"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,10]]},"references-count":22,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1111\/dme.70320"],"URL":"https:\/\/doi.org\/10.1111\/dme.70320","archive":["Portico"],"relation":{},"ISSN":["0742-3071","1464-5491"],"issn-type":[{"value":"0742-3071","type":"print"},{"value":"1464-5491","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,10]]},"assertion":[{"value":"2026-02-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-25","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-10","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70320"}}