| Sumario: | Background: One in every 250 pregnancies are affected by diabetes. Women with diabetes have an increased risk of obstetric complications and their offspring have an increased risk of congenital malformations, macrosomia and neonatal hypoglycaemia. Microvascular complications can progress during pregnancy. Manchester has no pre-conception service for women with diabetes. From 2014-16, only 32.1% of women had a first trimester HbA1c <48 mmol/mol and only 43.3% of women were taking 5 mg folic acid. Aim: To enhance knowledge and confidence in delivering pre-conception advice for primary care healthcare professionals (HCPs) to ensure that all women with diabetes of child-bearing age in Manchester receive brief awareness advice and guidance on potential complications in diabetes-related pregnancies and how optimise outcomes. Methods: A collaboration between a small group representing primary care, commissioners and secondary care devised the Manchester Primary Care Standard for Pre-Conception advice and support. Launched in July 2018, each GP practice was incentivised to: develop a register of women with diabetes (16-45 years); ensure a GP and practice nurse undertake a CPD accredited (PCDS) e-learning module; import Diabetes UK Information Prescription to discuss and offer at annual reviews and opportunistically. Educational events and additional resources were also implemented. Results: As of 1 August 2019, 66.87% of eligible women with diabetes received pre-conception advice in the previous 12 months compared to nil recorded the previous year. Confidence of HCPs to deliver pre-conception advice has increased from 7% to 73%. Conclusion: The Manchester Primary Care Standard with educational input has increased the delivery of pre-conception advice. Ongoing input is required to increase numbers and confidence further. We await the long-term results in terms of pregnancy presentations and outcomes.
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