NHS England Getting It Right First Time programme has shared a report on improving care and support for children and young adults living with diabetes to highlight the use of digital, wearable tech, digital self-management tools, and digitally enabled pathways.
A review drawing on national audit and activity datasets, along with local insight, identified “excellent practice in many places”, GIRFT programme lead and NHSE national director for clinical improvement, elective recovery, and UEC Tim Briggs revealed. “But it also shows that variation is driven less by clinical complexity than by system design: diffuse accountability, inconsistent standards, workforce and infrastructure pressures, and a persistent failure to turn good data into sustained action.”
Practical recommendations are offered in response, calling for stronger ICS-wide leadership and accountability, a unified data and intelligence function, and measurable minimum standards to be delivered across neighbourhoods and provider settings. “By addressing these issues collaboratively across systems, we can hope to build a more equitable, resilient, and effective diabetes service that supports every child and young adult to achieve the best possible outcomes,” Partha Kar, joint adult diabetes clinical lead and GIRFT Type 1 diabetes and technology lead noted.
Findings suggest the need for a move to continuous support enabled by digital and wearable technologies, and a focus on ensuring digital infrastructure is fit to support safe and efficient hybrid closed loop care. In Type 1 diabetes, there is inconsistent access to technologies, NHSE shares, along with limited standardisation in the review of cloud-based data that serves to limit optimisation and proactive support. Digital tools and peer support functions are “not routinely embedded”, it continues, and poor IT infrastructure and limited analytical capability constrain abilities to use available data for proactive case finding or service improvement. Risk stratification tools are not yet used consistently or embedded into routine MDT workflows, NHSE notes, and unlinked patient-level data means key signals such as tech use or emergency admissions cannot be linked in the early identification of risk.
Recommendations for ICBs cover the need to commission a unified ICS-wide data and intelligence function for the 0-25 diabetes pathway offering a “single, shared and accessible version of the truth that generates actionable insight”. Progress should be supported through partnerships with national clinical networks, nationally commissioned audit programmes, and partnerships offering digital self-management, structured education, and peer support.
Digital or AI-supported tools should be used to help integrate key risk indicators and generate a risk-flagged list of individuals to be offered targeted support within an agreed timeframe, NHSE recommends. Standardised risk flags should be applied in the shared care record with processes in place at system level to ensure these are visible across all services, and metrics should be kept of engagement with digital self-management tools to identify individuals not engaging with available support. Disaggregated data should be used to help reduce disparities in uptake, and steps should be taken to ensure financial or digital barriers don’t prevent individuals from safely using technologies by providing access to digital equipment and data.
NHSE further suggests every young adult be given a personalised written or digital care overview mapping their care and expected review frequency, including accessible points of contact for urgent advice and crisis management. NHS-endorsed tools such as DigiBete are recommended for inclusion within standard operating procedures, and novel roles within MDT teams such as technology assistants and digital navigators should be adopted to free-up clinical capacity.
Dita Aswani, GIRFT clinical advisor for CYA diabetes, praised the “admirable level of engagement from stakeholders” in all 42 system reviews, adding: “What came through was optimism, drive, compassion, and a sincere desire to improve patient care and outcomes. I thank everyone for their time and preparation, honesty, engagement, and – now that the findings are shared and the report published – their energy in addressing their local ICB priorities.”
Wider trend: The role of digital in children and young people’s health and care
NHS England has published a preliminary market engagement notice with a total value of up to £110 million, hoping to inform the future of children’s digital health services. The engagement aims to determine whether the market can meet the needs and requirements of the programme, to understand an appropriate budget range for any potential solution sought, and to gather information on potential routes to market. “A new delivery area has been established within the digital prevention services portfolio of the NHSE Transformation Directorate to bring together the products and services used for preventative child health, and to deliver a more ambitious vision of using digital and data to transform how prevention services for children are delivered and improve the health of children and young people in England,” NHSE states.
Sheffield Children’s NHS Foundation Trust has reflected on achievements from 2025/26, highlighting work on quality, access, and innovation, and “significant, evidenced improvements” to services for families. Efforts to improve clinical record keeping are delivering safer care, higher-quality documentation, and better efficiency, the trust states, with a “high engagement approach” taken to embedding changes, involving site walkarounds led by the deputy medical director, CNIO, and associate director for health records. The full roll out of the Careflow Narrative EPR has reportedly helped to improve access to real-time patient information, reduced duplication, and strengthened auditability.
Gloucestershire Hospitals NHS Foundation Trust has implemented a digital baby diary in women’s and children’s services, introduced a digital system for children and young people with diabetes, and plans to replace its imaging systems in Autumn. The trust is moving from its existing picture archiving and communications system and radiology information system to systems from Intelerad and Aptvision, secured through the West of England Imaging Network procurement framework alongside partners in the region. The trust board shares that procuring the systems in this way is hoped to make sharing of images and workflows across the region easier, and provide clinicians access to more complete imaging histories. Go-lives are due to take place in Autumn 2026, with teams working to ensure they can be introduced “as smoothly as possible”, and a testing phase to be completed prior to go-live.
