Data linkage to reduce severe hypoglycaemia

Background: The Scottish Ambulance Service (SAS) are working with NHS Fife Diabetes Service with the support of SCI- Diabetes, the University of Dundee, National Services Scotland (NSS) and MSD to better manage hypoglycaemia in their patients with diabetes. The emphasis is on appropriate follow-up of patients who experience a hypoglycaemic event that results in an ambulance call-out. The aim is to improve patient care, increase capacity and upskill attending paramedics.
Methods: From April 2017, the NHS Fife diabetes team has followed a triage process to follow- up and manage people with diabetes who have called out the SAS to manage a hypoglycaemic event. NSS processes ambulance service reports and sends SCI- Diabetes real- time messages where reports contain a blood glucose result <4 mmol/L, indicating a hypoglycaemic event. SCI- Diabetes links the reports to the national diabetes system and presents data back to the Fife team to manage.
Results: NHS Fife callout reports containing a blood glucose <4 mmol/L have reduced when comparing data from launch in 2017 (1044 callouts/674 conveyed), 2018 (758/494), 2019 (784/533) and 2020 (751/486). This shows an average yearly reduction of 26.8% in callouts and 25.2% conveyances, equating to an approximate £267k saving for NHS Fife and the SAS. This could extrapolate to an annual £5.86m cost saving when rolled out across the whole of NHS Scotland.
Conclusion: The NHS Fife diabetes team can now make necessary treatment changes or to provide education to individuals affected by hypoglycaemic events. Plans for wider rollout are currently under development, pending the out-come of this study.