New GIRFT Report sets out practical roadmap to standardise care for young people with diabetes

The Getting It Right First Time (GIRFT) programme, in partnership with the NHS Diabetes Programme, released a comprehensive national report outlining practical steps to standardise and elevate care for children and young adults (aged 0–25) living with diabetes across England

Authored by GIRFT clinical advisor Dr Dita Aswani (Sheffield Children’s NHS Foundation Trust), the 138-page report reflects a far-reaching review across all 42 Integrated Care Boards (ICBs) in England. In England, approximately 56,000 young people aged 0–25 live with type 1 diabetes, and another 9,000 live with early-onset type 2 diabetes.

The report highlights that young adulthood (ages 19–25) is a particularly vulnerable window where declining parental support and shifting life circumstances frequently lead to rising HbA1c levels, increased emergency hospital admissions, and a loss of confidence in self-management.

Core recommendations for Integrated Care Boards (ICBs)

To tackle significant regional disparities in care quality and health outcomes, the report sets three primary strategic mandates for ICBs:

• Leadership and accountability:

  • Establish an Integrated Care System (ICS)-wide governance framework for the 0–25 diabetes pathway, backed by explicit clinical leadership at both the ICB level and across commissioned services.

• Unified Data and intelligence:

  • Commission a single, shared, and accessible ICS-wide data platform to provide actionable insights into service delivery and patient performance.

• Standardisation of care:

  • Define and implement nationally agreed minimum standards of care grounded in evidence and clinical consensus.

Six targeted domains for quality improvement

The report identifies six critical areas where unwarranted variation is most severe and targeted intervention can yield the greatest impact on safety and equity:

1. Diabetes health outcomes:

   • Improving HbA1c control across patient cohorts.

2. Essential health checks:

   • Ensuring consistent completion of annual routine care processes.

3. Emergency admissions:

   • Reducing avoidable hospital visits through early support and preventive measures.

4. Access to technology:

   • Fairer distribution and uptake of Hybrid Closed Loop (HCL) continuous monitoring and insulin systems.

5. Young adult care (Ages 19–25):

   • Improving support during the transition from pediatric to adult healthcare services.

6. Systems governance and workforce:

   • Strengthening team capability, clinical leadership, and local operational frameworks.

Stakeholder support

Dr Dita Aswani highlighted the optimism and commitment shown across all ICB system reviews, noting that local teams engaged deeply with the data despite ongoing organisational and financial pressures.

Colette Marshall (Chief Executive of Diabetes UK) welcomed the report’s recommendations, emphasising that tailored, coordinated care is crucial—especially for high-risk groups navigating the shift to adult care or managing type 2 diabetes.