The Health, Care and Wellbeing Overview and Scrutiny Sub-Committee was scheduled to consider preventable emergency admissions and the early diagnosis of Type 1 diabetes and Diabetic Ketoacidosis (DKA) in children. The Sub-Committee was also scheduled to review its work programme for the upcoming year and consider the Forward Plan of Key Decisions.

Preventable Emergency Admissions and Early Diagnosis of Type 1 Diabetes and Diabetic Ketoacidosis (DKA) in Children

The Sub-Committee was scheduled to receive a presentation from the NHS Humber Health Partnership regarding preventable emergency admissions and the early diagnosis of Type 1 diabetes and Diabetic Ketoacidosis (DKA) in children. This presentation was scheduled to cover trends in emergency admissions for DKA in children within the East Riding, pathways for early identification and diagnosis, and the transitions between primary care, acute services, and community follow-up. It was also scheduled to address learning from admissions and quality improvement actions, communication with families and schools, and system oversight and governance arrangements.

Type 1 diabetes is an autoimmune condition where the body's immune system destroys insulin-producing cells in the pancreas, leading to insulin deficiency. Without insulin, the body breaks down fat, leading to weight loss, increased urination and thirst, tiredness, and potentially Diabetic Ketoacidosis (DKA). DKA is a life-threatening complication of diabetes characterised by dehydration, high glucose levels, and high ketone levels, which can lead to shock, renal failure, and coma if untreated.

The presentation was scheduled to highlight that DKA is a serious condition, and that early diagnosis is crucial as Type 1 diabetes progresses rapidly. It was noted that approximately 33% of children diagnosed with Type 1 diabetes nationally present with DKA at diagnosis, with this figure rising to around 41% for children aged 0-4 years. The presentation was scheduled to outline the steps involved in getting a diagnosis before DKA occurs, including family recognition of symptoms, contact with health services, GP triage, and healthcare professional suspicion and testing. The four key symptoms of Type 1 diabetes, summarised by the Diabetes UK 4Ts campaign (Toilet, Thirsty, Tired, Thinner), were to be discussed, alongside emerging and easily missed presentations in very young children, gastrointestinal, respiratory, behavioural, and weight-related symptoms that can obscure the metabolic problem.

The referral pathway for children and young people suspected of having Type 1 diabetes was scheduled to be detailed, including symptoms such as polyuria, polydipsia, excessive tiredness, weight loss, heavier nappies, and new onset bedwetting. The importance of early identification in primary care was to be emphasised, with a recommendation to check capillary glucose promptly when diabetes symptoms coexist with vomiting, abdominal pain, hyperventilation, dehydration, or reduced consciousness. The presentation was also scheduled to discuss the Yorkshire and Humber region's performance in preventing DKA at diagnosis, with a significant percentage of children having had healthcare professional contact in the previous two weeks, and a high proportion being diagnosed at first contact.

The presentation was scheduled to explore learning from DKA admissions through a quality improvement loop, involving reviewing the preceding 7-14 days, identifying modifiable system factors, and providing feedback to relevant practices and services. Communication with GPs post-diagnosis and transitions between services were also to be covered, highlighting potential failure points in recognition, access, testing, referral, communication, and follow-up. The role of DigiBete, an online diabetes support and education platform for children and young people, their families, and healthcare professionals, was to be discussed, including its use for school care plans and providing access to information and contact details. The first year of care for newly diagnosed patients was to be outlined, detailing patient-centred sessions at diagnosis, first-week care, and follow-up appointments over the first year. The presentation was scheduled to conclude with practical actions for the East Riding, including standardising a clear pathway for suspected childhood Type 1 diabetes, equipping primary care with capillary glucose testing and confidence, educating across services on symptoms, learning from DKA-at-diagnosis cases, and closing the loop with timely feedback and tracking actions.

Health, Care and Wellbeing Overview and Scrutiny Sub-Committee Work Programme 2026/27

The Sub-Committee was scheduled to receive an update on its work programme for 2026/27. The agenda indicated that there were no proposed changes to the existing work programme.

Forward Plan of Key Decisions

The Sub-Committee was scheduled to receive a report from the Interim Executive Director of Corporate Resources detailing key decisions falling within the Sub-Committee's terms of reference for the period July to December 2026. One key decision was noted as having been added to the Forward Plan: the Procurement of Integrated Sexual Health Services 2027, which was due for consideration by The Cabinet on 1 September 2026. The Sub-Committee was asked to determine whether it wished to consider this item prior to a decision being taken. The Forward Plan also indicated a decision on the Adult Social Care Commissioning Strategy 2026-2031, scheduled for The Cabinet on 17 November 2026, and a decision on the Term Service Contract for the Supply, Installation, Inspection, and Maintenance of Mobility Equipment, scheduled for The Cabinet on 16 March 2027.

CQC Improvement Overview and Scrutiny Sub-Committee Minutes

The Sub-Committee was scheduled to receive the minutes from the CQC Improvement Overview and Scrutiny Sub-Committee meeting held on 8 September 2026 for information. These minutes detailed discussions on the restructure of Adult Social Care, including workforce planning, leadership, recruitment, and retention. They also covered the role of the Adult Social Care Improvement Board, the progress of the improvement journey, and the work of the Improvement Advisor. Discussions were scheduled to include the service's resilience, continuity, sustainability, and the ongoing period of enhanced intervention from the Department of Health and Social Care. The minutes also highlighted work on co-production and the development of effective two-way communication and engagement with residents.