Nicola Milne, Diabetes Specialist Nurse Clinical Lead at Greater Manchester Diabetes Clinical Network, and a Diabetes Support Lead at Brooklands and Northenden Primary Care Network, talks to us about her work with people living with diabetes.
My main role is currently as the Diabetes Support Lead, in the diabetes support team (DiAST) for a primary care network (PCN) in south Manchester.
The role is based on the document called Best Practice in the Delivery of Diabetes Care within the PCN, which grew the concept of the DiAST model of care and involves mentorship and support for all healthcare professionals (HCPs) and direct care for people with more complex diabetes needs.
Working in diabetes care
I moved from working as a midwife to a practice nurse in 2002 and was asked to take a role in diabetes which, until that time, had been an area of very little interest to me.
I also was sponsored to undertake a Certificate in Diabetes Education qualification. During this time, a new GP with an extended role in diabetes joined the practice and established some innovative diabetes clinics.
My interest in diabetes flourished from there. I was keen to ensure the practice delivered the most optimal care for people and their families living with diabetes.
I left the practice in 2018 to establish and developed a community diabetes team in central Manchester, but I have since returned to primary care which has always remained close to my heart.
Gold standard diabetes care
The most challenging aspect of my role is similar to that faced by so many HCPs just now, in terms of the disproportionate balance between workload and capacity. How do we best deliver gold standard diabetes care and education whilst ensuring adequate support for HCPs?
However, there are so many rewarding aspects to my role. The rewards come from seeing HCP colleagues grow and develop in terms of knowledge and confidence in diabetes care delivery, and helping to empower people with diabetes in my direct care to achieve their goals. It also comes from seeing strategic changes that improve education and outcomes, and when a previously 'hardly reached’ person engages in their diabetes care.
For me, there are probably two current achievements that are heightening my motivation just now.
Firstly, I was a finalist at the 2022 Diabetes Quality in Care Awards for work within the community for myself and my diabetes specialist nurse (DSN) colleague, Francesca Di Rosa, in terms of maintaining delivery of diabetes education and support during Covid-19.
Secondly, I was privileged to be a co-author, along with five multidisciplinary colleagues, for the document which is where the DiAST role was conceived. It is exciting that I am now working in this very role and being one of the forerunners in terms of looking at translating the evidence for this DiAST role into practice.
Working with Diabetes UK
I’ve worked with Diabetes UK in multiple ways over the last decade or so.
My proudest moment would have to be as Chair of the Professional Organising Committee for the Diabetes UK Professional Conference in Liverpool in 2019. I felt this served as a great acknowledgement of the role of practice nurses in diabetes care. I am currently a primary care nurse representative on the Council of HealthCare Professionals and a Diabetes UK Clinical Champion.
My current role as a DiAST lead was originally for one year only, but I’m delighted that it is now to continue for the foreseeable future. I was proud to present the first-year outcomes of the role at the Diabetes UK Professional Conference in Liverpool in April 2023.
Positive moment and self-care
I think there are so many positives on the horizon for diabetes care, including the ever-advancing technologies, remission outcomes for type 2 diabetes, and research advancing type 1 diabetes understanding, and possible prevention.
It is also important to include the ways we are working with more of a collaborative multidisciplinary approach, to include mainstream psychological support. My word of encouragement would be to simply do what you can and to share any good practice that you have with others.
Always important, but often omitted, is self-care. For me, I enjoy spending time with my family and friends who have always been so supportive of my work. I enjoy walking and I could mention supporting a famous Manchester football team but then over the last couple of years, I’m not sure that you could call this having been relaxing!
