Senior medical officers (SMO) (endocrinologist or diabetologist): approximately 1.5 full-time equivalent (FTE) per 10,000 people with diabetes. Additionally all DHBs (unless fewer than 2000 people with diabetes) should have a lead SMO for diabetes with a minimum of 4–5 sessions per week. DHBs with over 10,000 people with diabetes should have a lead SMO whose priority (≥0.5 FTE) job is diabetes. Larger centres should also have registrars in training for diabetes and endocrinology.
Diabetes nurse specialists: approximately 5.0 FTE per 10,000. Ideally, all or most of these nurses will be accredited diabetes nurse specialists (DNS) according to the Aotearoa College of Diabetes Nurses New Zealand Nurses Organisation’s process, and some would be authorised as designated registered nurse prescribers. In addition, nurse practitioners would add value to diabetes services through advanced clinical practice, clinical leadership and mentoring/training of more junior nursing and medical staff. Specialist MDT services are well-placed to provide opportunities for nurses and other members of the MDT developing additional skills in diabetes care through formal training programmes (such as the Waikato Diabetes Service programme), and with adequate resources, training/mentoring of primary care nursing teams by accredited DNS.
