Our shortlisted entry, ‘Comprehensive reviews for patients on insulin, including the use of continuous monitoring technology’, was selected following a rigorous judging process and has been recognised as a standout example of patient safety which extends beyond clinical excellence – it is about fostering a culture of openness, learning, and collaboration while harnessing the power of technology to create safer, more resilient systems.

The 2026 awards judging panel was made up of a diverse range of highly influential and respected figures within the healthcare community, including; Stella Vig, Deputy National Medical Director for Secondary Care and Quality at NHS England, Charlotte Aston, National UEC Director at GIRFT UEC National team, Afifa Qazi, Chief Medical Officer at Kent & Medway NHS & Social Care Partnership Trust, Andrew Raynes, Chief Information Officer at Royal Papworth Hospital NHS Foundation Trust, Palmer Winstanley, Chief Executive at Barnet Hospital, Nathan Askew, Chief Nurse at Alder Hey Childrens’ NHS Foundation Trust.

The project

Background

Housebound people with type 2 diabetes who require insulin administration by district nurses may not receive routine diabetes review in line with national standards. This may increase the risk of undetected hypoglycaemia and hyperglycaemia and add to district nursing workload and deferred visits.

Aim

To implement and evaluate a joint district nursing–practice nursing diabetes review process for housebound patients receiving insulin administration by district nurses, using short-term continuous glucose monitoring (CGM) or flash glucose monitoring (FGM) to optimise insulin regimens, improve safety and support equitable access to review while releasing district nursing capacity.

Method

A quality improvement (QI) project (January – August 2025) was undertaken across three GP practices in Oxfordshire. Practice nurses completed structured diabetes reviews (home visit, telephone or video) with input from district nurses regarding functional and cognitive context. All patients used CGM or FGM for 10 days (repeated in some cases) to identify 24-hour glucose patterns and inform regimen changes through updated prescriptions and district nurse administration directions. Outcomes included glycaemic findings, treatment changes, district nursing visits and invasive procedures, and patient or relative feedback.

Results

Thirty patients were reviewed. Previously unrecognised hypoglycaemia was identified in 8/30 (27%) and previously unrecognised hyperglycaemia in 13/30 (43%). Insulin regimens were changed for 23/30 (77%) (11/30 reduced; 11/30 increased; 2/30 discontinued). District nursing activity reduced by four visits per day (32 to 28), with four fewer injections and 32 fewer capillary blood glucose tests per day. Seventeen surveys were returned; 94% reported a positive impact and only 53% recalled a review within the past two years.

Conclusion

A joint district nursing–practice nursing review model supported safer and more individualised insulin management for housebound people with type 2 diabetes, identified previously unrecognised glycaemic risk and reduced district nursing workload in this cohort. Wider implementation may improve equitable access to diabetes review and help district nursing services manage demand.

Senior Matron for Community Nursing Gabbie Parham said:

“We are delighted to be shortlisted for the HSJ Patient Safety Awards in recognition of the medicines safety improvements we have made with our patients, in addition to our recent award of BJN ‘Sustainability Nurse of the Year’ for this project.”

Winners will be announced at the awards ceremony on 28 September 2026 at The Telford International Centre. The event shines a light on outstanding teams who are improving patient safety across health and care.

For more details on the 2026 HSJ Patient Safety Awards shortlist, visit Website: HSJ Patient Safety Awards.