Thousands of children and young people are having their lives transformed with new technology to manage their type 1 diabetes.

A total of 42.5% of under-18s with type 1 diabetes are now using hybrid closed loop pumps which take readings from a continuous glucose monitor and use an algorithm to tell an insulin pump how much insulin to deliver. It does this 24 hours a day.

A commonly reported experience from families is that the technology is “life changing” for the whole family. Before its introduction, parents may have been awake several times in the night checking and correcting blood sugars. Also, episodes of ‘hypos’ have reduced, which is when blood sugar levels drop too low and people can experience symptoms such as blurred vision, and overall blood sugar control is much better. 

The hybrid closed loop pumps are also helping the health and social care system deal with increased pressures. Admissions to hospital are reduced, as families and young people become more able to stabilise the condition.

Chris Cooper (pictured right), the Network’s clinical lead, said: “This is the biggest development in diabetes care in decades, benefitting lots of Greater Manchester families.

“Much of its success has been down to the hard work of the specialist paediatric diabetes teams, who carry out intense training with young people, families and schools.”

The Children and Young People Network has been involved with the prescribing of the new technology to under-18s and will be working with the Diabetes Network on the roll out to priority groups, following new national guidance. These include adults with type 1 diabetes who have high HbA1c/ poorly managed diabetes and people with T1D who are pregnant or planning to become pregnant

Network's clinical director retires

This month sees the retirement of one of our long-standing clinical leads.

Jim Bruce, pictured left, is leaving after many years spent building the Network into a hard-working, high-achieving team which has improved services for thousands of young people.

Dr Peter Elton, the Greater Manchester and Eastern Cheshire Strategic Clinical Networks' (GMEC SCNs) clinical director, said: "It has been great having Jim as a leader. 

“His leadership has enabled the Network to develop a focus on the main causes of childhood illness and help our services respond to the pressure straining our present capacity. It has been an enormous pleasure having Jim as a colleague."

Julie Cheetham, the GMEC SCNs’ director, added: “Jim has been a real constant during the life-time of the Children and Young People’s Network. His drive and passion to improve the lives of our children across Greater Manchester is second to none, his professionalism and leadership has been paramount and I wish him well in his retirement.”

Mr Bruce was consultant paediatric and neonatal surgeon at The Royal Manchester Children’s Hospital and clinical head of the children’s division.

He has been involved in strategic planning for Greater Manchester and the North West region, including planning for the new Royal Manchester Children’s Hospital, Making it Better, Healthier Together and many other projects.

Clinical lead honoured to become professor 

The Diabetes Network’s long-standing clinical lead Dr Naresh Kanumilli (pictured right) is celebrating after being awarded the title of visiting professor at the University of Bolton.

Dr Kanumilli found out the news earlier this month and said he was delighted to be joining the university’s team.

He added: “I’m honoured and excited to be asked to be part of the University of Bolton.

“I’m especially honoured to be involved in their endeavor to set-up a new medical school and be part of the faculty in delivering high quality education in Greater Manchester.”

The faculty of medicine offers education and training to equip future healthcare professionals with the knowledge and skills they need to excel in their chosen careers and to make a difference in the lives of their patients.

Dr Kanumilli is a GP in the Northenden Group Practice and has been involved in a number of projects over the years, including the NHS Diabetes Prevention Programme, T2D remission, development of the Greater Manchester strategy for diabetes and numerous pathways/models of care. He is also a community consultant in diabetes at Manchester University NHS Foundation Trust. 

The Network would like to congratulate Dr Kanumilli on his appointment, which is very well deserved, and we look forward to continuing our great working relationship with him.  

City region's 24/7 service in the spotlight

NHS leaders visited Greater Manchester this month to find out more about its mechanical thrombectomy service.

Professor Stephen Powis, NHS England’s National Medical Director, and National Stroke Clinical Director, Dr David Hargroves, visited Salford Royal Hospital to see the great work happening, as part of their country-wide tour of facilities to support the national ambition of ensuring all patients have access to 24/7 services, as well as the aim of seeing intervention rates increase to around 10% of all strokes. The current rate is 4% nationally.

The delegation was given a presentation by the Network’s clinical director, Dr Shivakumar Krishnamoorthy, together with Salford clinicians, about the region’s high performing stroke pathway.

They also heard about how the service was established and developed so that it now operates around the clock.

The NHS England team was joined by the Network and members of the Trust’s executive, plus stroke, radiology, critical care and anaesthetic services, as well as local leaders from the Greater Manchester Integrated Care Partnership and the Stroke Association.

Professor Powis was evidently impressed by the tour as he declared they were the best facilities they had seen on the 12 visits they had completed so far.

The NHS England team was very positive about what had been achieved in Greater Manchester and discussions focused on how the service could increase procedure rates to 10%. They are currently on 5.5%, but with an upward trajectory.

The day was a team effort and highlighted how closely everyone works within the Network to provide a life changing service.

Marking Pulmonary Rehabilitation Awareness Week 2024

One of the Network’s clinical advisors helped mark this year’s National Pulmonary Rehabilitation (PR) Awareness Week with a LinkedIn blog promoting the service in Greater Manchester.

PR is an exercise and education programme which is quietly transforming lives across the region. Designed for people with long-term lung disease who experience periods of breathlessness, the sessions improve muscle strength and overall fitness levels, with many who take part reporting they are able to walk further and feel less tired.

Below, you can read the blog which was written by Jonny Lee (pictured right), senior practitioner physiotherapist at Trafford Local Care Organisation and one of our clinical advisors.

Jonny's blog

“The overall aim of PR is to improve the quality of life of both patients and their carers, and to reduce the reliance on healthcare providers through the promotion and development of self-management and long-term lifestyle changes. A significant body of evidence supports the benefits of PR, particularly in the management of people with chronic obstructive pulmonary disease (COPD).

PR is also known to be a cost-effective intervention. The principal benefits are:

1.    Reduction in breathlessness

2.    Improved exercise capacity

3.    Improved functional independence

4.    Improved health-related quality of life

5.    Reduction in healthcare usage

Following the completion of pulmonary rehabilitation, patients will be provided with an agreed plan to continue the progress in various forms, such as physical activity schemes within a gym, swimming or group-based exercises, including dancing or singing!

In Greater Manchester, we have some of the best PR services in the country. 

Two of them have achieved accreditation (Trafford and Heywood, Middleton and Rochdale) out of only 14 in the country to reach the standard. 

We have looked at new ways of promoting the service and have a website - www.pulmonaryrehabgm.co.uk - which is designed to help both patients and health professionals to understand what the six-week programme is and who it is aimed at.

The website was launched a year ago and has led to an increase in referrals, as well as a rise in more appropriate referrals.

Other work we have carried out to promote PR and improve lives includes the production of an education booklet which patients can use to read more about the programme and how to make positive changes to their fitness.

Monthly collaborative meetings are now being held to enhance and expand services and share best practice - a recent example being improvements to the referral process and cleansing of waiting lists.

Services are also providing additional classes in new venues to make sure all communities can access sessions.”

Pictured above: a promotional poster for last year's Keep Active, Breathe Better campaign, promoting pulmonary rehabilitation services in Greater Manchester.