Community Diabetes Nurse Specialist

The Community Diabetes Specialist Nurse is responsible for delivering a structured insulin optimisation programme to reduce the number of patients requiring District Nurse (DN)-administered insulin and improve overall glycaemic outcomes across the DN insulin caseload.

The role provides advanced diabetes expertise and collaborative working between the Community Diabetes Specialist Nurse (CDSN), District Nursing teams, and wider multidisciplinary team.

The post-holder leads the systematic review of patients receiving DN-administered insulin, identifies those suitable for optimisation, and implements evidence-based interventions to prevent over-medication of patients, improve glycaemic control, and promote safe patient self-management. This includes the use of technologies such as Freestyle Libre, medication optimisation, carer training, and structured patient education.

The role oversees case identification, ongoing glucose data review, and multidisciplinary case discussions. It ensures safe clinical decision-making, supports DN staff in developing enhanced diabetes skills, and strengthens triage and discharge processes to prevent unnecessary long-term DN involvement.

This role is central to transforming community diabetes care through collaborative working with other external agencies, improving patient independence, reducing hypoglycaemia and hyperglycaemia risk, and aligning DN practice with NHS community transformation priorities.

All the following are to be carried out while working in close collaboration with members of the multi-disciplinary team led by a Consultant. To demonstrate clinical expertise within the speciality and work autonomously, managing own allocated clinics independently and seeking guidance/support when necessary.

Patient Identification & Clinical Triage: Systematic identification, triage, and prioritisation of DN insulin-dependent patients suitable for insulin optimisation. Including the completion of baseline data for all selected patients and timeliness and accuracy of patient categorisation.

Insulin Regimen Optimisation & Clinical Intervention: Delivery of safe, evidence-based insulin simplification and medication optimisation. Reduce the frequency of insulin administration and support conversion to simplified once-daily regimens or change to oral anti-diabetes agents.

Use of Diabetes Technology such as flash glucose monitoring or continuous glucose monitoring: Implementation and monitoring of CGM for data-driven optimisation. The post holder will successfully set up patients to use a remote monitoring device and connect it to the community project cloud. Remotely review Time in Range (TIR) data to reduce DN visits linked to monitoring blood glucose levels.

Multidisciplinary Collaboration & Clinical Governance: Effective coordination of multidisciplinary review processes and adherence to safe clinical governance.

Patient & Carer Education / Self Management Enablement: Improving patient independence and carer capability to reduce reliance on the DN Service for insulin administration.

Workforce Development & DN Team Upskilling: Strengthening DN team capability in diabetes care and triage. Improve DN triage accuracy for new insulin referrals and reduce inappropriate DN insulin referrals from hospital discharge.

Service Efficiency & Caseload Reduction: Reduce DN insulin-related workload to improve service capacity.

Data Management, Monitoring & Reporting: Accurate data collection, monitoring, and reporting of project outcomes. Delivery of final evaluation report at the end of the project.

Quality Improvement & Sustainability: Embedding long-term improvements in DN insulin pathways and community diabetes care. Implementation of sustainable triage and optimisation processes and reduction in new inappropriate DN insulin referrals.

Our people are our greatest asset. When we feel supported and happy at work, this positivity reaches those very people we are here for, the patients. Engaged employees perform at their best and our Equality, Diversity & Inclusion (EDI) initiatives contribute to cultivate a culture of engagement. We have four staff networks, a corporate EDI Team and a suite of programmes and events which aim to insert the 5 aspirations:

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