Concerns over future of paediatric diabetes service in Midlands

Fears are mounting that the paediatric diabetes service in midlands could close due to staff shortages.

This week, the parents of the 145 young people with diabetes being treated at the service based at the Midland Regional Hospital in Mullingar, received a letter from the head of the service, Professor Michael O'Grady, warning that for the second time in three years it is facing the risk of closure due to a shortage of staff.

Urging parents to once again “use their collective voices to save your local diabetes service”, Prof O'Grady says that while clinics will continue for now, they will do so without a diabetes nurse or dietician.

Consultant Paediatric Endocrinologist at Midlands Regional Hospital Mullingar Professor Michael O'Grady has stated that the service is under resourced and that the single specialist nurse who had been doing the job of two, cannot return to work in the clinic, due to an unsustainable workload.

The service is used by a significant number from Offaly, and Birr councillor Cllr Clare Claffey has called on the HSE to provide the needed resources to protect the service.

Claffey said as a mother and carer to her Type 1 Diabetic daughter Kelly she was “really disappointed to once again receive distressing news~”.

Claffey continued: “I know from experience, Type 1 Diabetes is a serious and extremely difficult condition to manage and as parents we need all the specialist support and advice we can get. The service provide by Professor O’Grady and his nursing staff is second to none and it’s shocking that he has yet again been forced to tell worried parents that the service will be restricted, not because of any lack of demand, but because of HSE mismanagement.”

Professor Michael O’Grady is Consultant Paediatrician and Paediatric Endocrinologist in Mullingar. He is the HSE National Clinical Lead for Pediatric Diabetes. He states that the recommended staffing from a diabetes nursing perspective is one per 50 patients, with essential Dietician cover also required at a ratio of one per 150 patients. Since September 2023, one Advanced Nurse Practitioner has been tasked with a diabetes nursing workload intended for 2.6 nurses, based on the above ratios.

Clare Claffey said: “It’s just not acceptable that the HSE are failing to support vital services like this. I am calling on the HSE to respond to this dangerous situation by allocating enough resources to protect the life-saving paediatric diabetic service in Mullingar. “

In a statement, the Midlands Regional Hospital Mullingar said while recruitment has been successful for the Diabetes service, it was unable to “release the successful candidate” due to the pressures on the unscheduled care service in the hospital.

It added that given the specialist nature of the position, there is also a challenge to secure agency cover.

The statement stressed that the “provision of high quality paediatric diabetic services is a priority of the Regional Hospital Mullingar”.

It said consultant paediatrician numbers have been increased in recent times with two permanent posts filled in the last year.

However, it admitted that the national and international scarcity of specialist trained paediatric nursing staff had posed “significant challenges to the continuity of paediatric services at Regional Hospital Mullingar in recent years”.

The paediatric diabetes team consisting of an Advanced Nurse Practitioner, a Clinical Nurse Manager, a Clinical Psychologist and a Dietician (half time) were fully staffed in recent years, it said, stating that provided “an excellent service for children in the Midlands with Diabetes”. However, it said this was unfortunately “now challenged by reduced staffing levels”.

“There are a number of opportunities for paediatric nurses to join the team in MRHM and these posts are currently advertised,” it added.

“The management of the Regional Hospital Mullingar have been working to ensure continuity of the Paediatric Diabetes Service and have recently progressed contingency plans to cover periods of leave availed by staff.”

It said an interim plan was discussed with the clinical lead at a meeting last week and the hospital management “provided a commitment to finalise a solution towards addressing the longer term staffing needs of this service which ensures stability and avoids any impact for paediatric diabetes patients and their families”.

“The hospital does not underestimate the challenges of a child with diabetes and the importance of this service and recognise the importance of the staff supporting this service on a daily basis,” it added.