A newly published NHS study is calling for further improvements in inpatient diabetes service provision due to workforce capacity failing to match rising demand and increasing clinical complexity.

The latest Getting It Right First Time (GIRFT) report identifies the lack of a national bedside inpatient diabetes audit since 2019 as a critical gap in evaluating and improving inpatient diabetes care.

To determine whether there have been changes in service provision of inpatient diabetes care over the last five years, a national survey was conducted across NHS hospital trusts in England between July 1, 2024, and March 31, 2025.

The survey assessed inpatient diabetes prevalence, workforce staffing, infrastructure and information technology, care pathways and systems to improve patient safety. Findings were compared with previous national audits, including the National Diabetes Inpatient Audit (NaDIA; 2010–2019) and the 2024 National Diabetes Audit -Integrated Specialist Services (NDA ISS) survey.

Responses were received from 136 hospitals, representing 102 (77%) of 132 NHS hospital trusts in England with a diabetes service. Most hospitals reported a continued increase in inpatient numbers since 2019.

Although approximately 85 per cent of hospitals reported access to Diabetes Inpatient Specialist Nurses (DISNs), nearly two-­ thirds had no weekend DISN service. Access to diabetes physician support and out-­ of-­ hours specialist advice was limited.

The use of networked glucose monitoring systems was widespread, but their use for quality improvement was inconsistent. Trusts with higher specialist staffing levels demonstrated shorter lengths of stay and fewer 30-day emergency readmissions.

The study stated: “Despite improvements in inpatient diabetes service provision since 2019, substantial variation remains, with workforce capacity failing to match rising demand and increasing clinical complexity.

“The absence of a national bedside inpatient diabetes audit since 2019 represents a critical gap. Reinstating a national bedside audit and integrating service-­level evaluation with patient-­level

outcomes should be prioritised to support safe, effective and equitable inpatient diabetes care in England.”

The study, Changing trends and variation in service delivery for inpatient diabetes care in England, can be read here.