Hypos can strike twice

Funded by the National Institute for Health Research (NIHR) Applied Research Collaboration East Midlands, awarded £200,000.

Key contact: Professor Niro Siriwardena

This is a non-randomised stepped wedge study with a mixed-methods process evaluation study which aims to evaluate the effect of implementing the ‘Hypo’s can strike twice’ intervention to patients with diabetes and hypoglycaemia attended by East Midlands Ambulance Service NHS Trust in the East Midlands region.

Team	Prof Niro Siriwardena, CaHRU, University of Lincoln Mrs Amanda Brewster, Public and Patient Involvement representative from Healthier Ageing PPI (HAPPI) group Mr Keith Spurr, Public and Patient Involvement Mrs Pauline Mountain, Public and Patient Involvement representative, HAPPI group Mrs Sally Dunmore, East Midlands Ambulance Service NHS Trust (EMAS) Mrs June James, Diabetes Nurse Specialist Rob Spaight, EMAS Dr Leon Roberts, EMAS Dr Murray D. Smith, CaHRU, University of Lincoln Ms Despina Laparidou CaHRU, University of Lincoln Dr Elise Rowan, CaHRU, University of Lincoln Prof Kamlesh Khunti, Leicester Diabetes Centre, University of Leicester Prof Graham Law, CaHRU, University of Lincoln
Team/Consortium	University of Lincoln Healthier Ageing PPI group University of Leicester East Midlands Ambulance Service NHS Trust
Overarching aim	To evaluate the effect of implementing the ‘Hypo’s can strike twice’ intervention to patients with diabetes and hypoglycaemia attended by East Midlands Ambulance Service NHS Trust in the rural East Midlands region.
Objectives	To investigate the effect of implementing the ‘Hypo’s can strike twice’ on: 1. Repeat ambulance calls and attendances for hypoglycaemia; 2. Recorded referrals to an appropriate healthcare professional (e.g. GP, nurse); 3. Completed care bundle for hypoglycaemia (proportion of patients with all of blood glucose recorded before treatment, blood glucose recorded after treatment and treatment given for hypoglycaemia; 4. Costs of implementation ‘Hypo’s can strike twice’ intervention vs costs of health service resource use; 5. To conduct a process evaluation to explore how ‘Hypo’s can strike twice’ exerts its effects and can be scaled up if effective by understanding implementation, mechanisms of impact, and contextual factors using interviews and surveys
Methods	Non-randomised stepped wedge design with mixed-methods process evaluation.
Outcomes	If the new process of care is found to work, this will help prevent recurrence of “hypo”, improve patients’ future health, reduce unnecessary calls to ambulance services or transport of patients to the Emergency Department, and thus reduce pressures and costs for ambulance services and hospitals nationally by over £1 million.
Outputs	Peer reviewed research and conference presentations. Publications
Impact	Improved ambulance to community hypoglycaemia care pathways for diabetes have been approved nationally by the Association of Ambulance Chief Executives and National Ambulance Services Medical Directors (NASMed), and, if shown to be effective, could reduce repeat hypoglycaemia, ambulance attendances, hospitalisations and costs.