Written by Richard Shepard, NPDA Project Coordinator, and Amani Krayem, NPDA Project Manager
NPDA has consistently identified inequalities in paediatric diabetes care
The most recent NPDA Annual Report 2024/25 found that children and young people living in more deprived areas continue to have poorer blood glucose control and lower access to diabetes technologies. In the UK, 77% of people living with diabetes say that the rising cost of living is negatively impacting how they manage their condition (Diabetes UK).
While the NHS covers many key aspects of diabetes care, the report estimates that the average out of pocket monthly cost of caring for a child with diabetes is £425.85. This includes expenses such as compatible smartphones for diabetes technologies, medical supplies, travel to appointments, childcare and food.
The Poverty Proofing® approach and workshops
Recognising these financial pressures, Children North East developed Poverty Proofing® Health Care to help health services understand how poverty affects patients’ access, participation and experience of care. This programme uses staff training, consultation and evidence-based guidance to identify changes that services can make to reduce financial barriers and improve equitable access. It builds on earlier work with paediatric diabetes services in Gateshead, Hull and Grimsby, which had identified challenges relating to appointments, travel, support and education, financial guidance and access to diabetes technologies - download its 2023 report (PDF)
Poverty Proofing® hosted 24 workshops for all 11 Children and Young People's Diabetes Networks in England and Wales, involving more than 925 members of staff working in paediatric diabetes services.
Each workshop combined training on the Poverty Proofing® Health approach, with discussions on local deprivation, inequalities identified through the NPDA, and the experiences of children, young people and their families.
Teams shared examples of good practice, identified barriers to care within their own services, and developed practical plans to improve access and reduce health inequalities.
I really enjoyed the group activities as each member of the group shared a different perspective and understanding of poverty barriers in their area.
Practical recommendations for diabetes services
The Poverty Proofing® Paediatric Diabetes National Roll-out report, which you can download below, includes recommendations developed with multidisciplinary diabetes teams, such as to:
- support staff to discuss financial circumstances and barriers to accessing care with families
- improve awareness of and access to travel reimbursement
- strengthen signposting and referral pathways to financial, welfare and community support
- reduce unconscious bias and stigma within healthcare services
- improve support for young people transitioning to adult diabetes services
- promote equitable access to diabetes care and technology
- share good practice across paediatric diabetes services.
The programme has already prompted changes in clinical practice.
Most of the time in clinic, people put on their best faces... unless you ask, you don't necessarily pick up what's really going on.
Many of the lessons and practical actions identified through the programme are also relevant to other paediatric specialties. We encourage services to download and share the report and to adapt in their own settings.