Article Text

What makes for a ‘good’ or ‘bad’ paediatric diabetes service from the viewpoint of children, young people, carers and clinicians? A synthesis of qualitative findings
  1. Katherine Curtis-Tyler1,
  2. Lisa Arai2,
  3. Terence Stephenson3,
  4. Helen Roberts3
  1. 1School of Health Sciences, City University London, London, UK
  2. 2School of Health and Social Care, Teesside University, Middlesbrough, UK
  3. 3UCL Institute of Child Health, London, UK
  1. Correspondence to Dr Katherine Curtis-Tyler, School of Health Sciences, City University London, Northampton Square, London EC1V 0HB, UK; katherine.curtistyler.1{at}


Background There is mounting evidence that experience of care is a crucial part of the pathway for successful management of long-term conditions.

Design and objectives To carry out (1) a systematic mapping of qualitative evidence to inform selection of studies for the second stage of the review; and (2) a narrative synthesis addressing the question, What makes for a ‘good’ or a ‘bad’ paediatric diabetes service from the viewpoint of children, young people, carers and clinicians?

Results The initial mapping identified 38 papers. From these, the findings of 20 diabetes-focused papers on the views on care of ≥650 children, parents and clinicians were synthesised. Only five studies included children under 11 years. Children and young people across all age groups valued positive, non-judgemental and relationship-based care that engaged with their social, as well as physical, health. Parents valued provision responsive to the circumstances of family life and coordinated across services. Clinicians wanting to engage with families beyond a child's immediate physical health described finding this hard to achieve in practice.

Limitations Socioeconomic status and ethnicity were poorly reported in the included studies.

Conclusions In dealing with diabetes, and engaging with social health in a way valued by children, parents and clinicians, not only structural change, such as more time for consultation, but new skills for reworking relations in the consultation may be required.

  • Paediatric Practice
  • Diabetes
  • Adolescent Health
  • Health services research
  • Qualitative research

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:

Statistics from

Supplementary materials

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.