Tier 3 community specialist care
Tier 3: Community specialist care
Referrals will be triaged to tier 3 team members for:
- Type 2 insulin or GLP-1 initiation & follow up for patients attending Tier 1 practices
- Pre-conceptual advice for people from Tier 1 practices, more complicated Type patients from tier 2 practices + all type 1 patients
- Group 2 licence holders for annual reviews only
- Short term cover for Tier 2 patients if GP practice has lack of expertise/new staff.
- Suspected autonomic neuropathy
- Rapid access to avoid admission /recurrent severe hypoglycaemia
- Persistent elevated Hba1c for last 12 months despite active titration of treatment
- Referral from severe hypoglycaemia requiring 3rd party intervention for recovery (ie ambulance)
- Referral from West call or CDU
- Intensive support by DSN/Dietician after non-elective admission.
- Hypoglycaemic unaware patients
- People with Type 1 Diabetes to be offered at least a yearly care plan review.
- People who have had an amputation
- Moderate / high risk podiatry: foot prevention team
Mentor support and management of the HCP training model for tier 1 and 2
- Type 2 insulin/ triple therapy mentor support in the form of Tier 3 DSN facilitation clinics or Consultant virtual clinics
- email and phone support
Provision of structured patient education
- Type 2 structured patient education (X-PERT)
- Type 1 structured patient education (DAFNE)
- Hospital in-patient