Leigh Sturgeon, Project Manager for the Transition & Young Adults with Diabetes Service, talks about the importance of youth workers.

There has been emerging evidence of the role of youth workers in chronic disease management such as diabetes, however only a small number of NHS hospitals have employed youth workers due to lack of funding and awareness.

After the fierce competition of a bidding process led by our Diabetes and Endocrinology Consultants Khin Swe Myint and Sankalpa Neupane and Senior Business Manager Chris Drewett, the team was awarded funding for the Transition & Young Adults with Diabetes (TYAD) pilot project from NHS England in January 2023. As part of the project, we are very fortunate to have our youth team (pictured left to right) Babita Neupane, Rachael Whitwood and Brigid Rawlinson working with us.

Their role is to provide additional support and care to young people who transition from the paediatric to adult service. They aim to identify patients who are less engaged or disengaged and are at risk of developing life-threatening complications or having diabetes-related emergency hospital admissions.

They provide enhanced support as a point of contact to improve their clinic engagement and reduce hospital admissions and identify patients needing psychological support. The youth workers joined this exciting new team consisting of consultants, nurses, dieticians and a clinical psychologist and are considered as an integral part of the Diabetes team.

Engaging patients

The youth workers worked on strategies to improve engagement. They contact young people at least once before clinic, not just to remind them of their upcoming appointment, but also offering any support that they might need, such as transportation, to help encourage and motivate them to attend. For those known to be poor clinic attenders, a second message or calls are also made closer to the clinic date.

The youth team routinely attend the Under 25 clinic to meet the young people with diabetes in the clinic waiting area, introduce themselves and explain their role and the support they can provide. This not only helps improve personal rapport but also motivates young people to engage with the service better. They will also visit admitted patients on the wards.

The youth workers have also been actively supporting young people with their social and mental health. They regularly refer young people to social prescribing services, wellbeing services and the clinical psychologist. They also offer them the option of having a visit in the community in a neutral space for a chat and a hot/cold drink. In addition, they help issue food bank vouchers for those in need.

Patient social events

The youth workers organise various social activities and events in the community, such as drop-in sessions, pizza-making evenings, coffee meets and quiz and pizza evenings. Following direct feedback from young people, they are also planning to hold an additional activity, “walk and talk’’ in a local park followed by refreshments.

The team organise these events in a flexible manner and hold them over the weekends and late evenings as well, so that all young people who are keen to join in, including those who have work and educational commitments during normal working hours, are given the opportunities to attend these social activities.

Youth workers have also recently set up a peer support group called “Meet ‘n’ Mingle’’, where young people get an opportunity to spend longer with other young people with diabetes, who they know will understand the burden of diabetes better, and to help relax and chill.

Patient feedback

Young people have fed back that youth workers have given them the confidence not just to help navigate the healthcare system but also to advocate themselves, and to learn to live with and self-manage their diabetes better. Feedback includes: “Keep doing what you are doing”, “Always on hand whenever I need to talk” and “I would be at a disadvantage without their support”.

Youth worker Babita said: “Young people find contacting youth workers a lot easier and they are less apprehensive. This is because we are a familiar face to them and are an easy link to the Elsie Bertram Diabetes Centre. I also found out that various social and mental health issues had been significantly contributing to the poor engagement with the diabetes service, so it was natural that we started providing them with direction to social and mental health support. Their engagement with the service has improved significantly.’’

Brigid added: “I enjoy getting to know the young people as individuals and hearing about their hopes and dreams for the future alongside supporting them with their diabetes.”

Rachael said: “It gives me great pleasure and a sense of achievement to see such a positive change in the young people we have connected with.”

Result of our efforts

All this work is paying off. Since coming into post, the youth workers’ encouragement and support for patients has improved “Did Not Attend” (DNA) rates and, by increasing clinical engagement and therefore better health outcomes, has also helped reduce the number of young people with diabetes-related admissions.

In the first year of the pilot, the DNA rate fell from a baseline of 17% to 10% and the number of DNAs were nearly half of the previous year with rates continuing to fall. Likewise, diabetes-related admissions are falling with a projection of 22 this year compared to 44 last year, which is a significant financial saving.

The evidence from the first year of the pilot project clearly shows that our diabetes youth workers are having a significant positive impact to young people with diabetes and also the service. The team is working hard with the Trust and ICB for continued funding when the project ends in March 2025.