Background

Insulin is often required in Type 2 diabetes (T2D) to control glycaemia. Most people are referred to specialist care (endocrinologist and credentialed diabetes nurse educators (cDNE)) for insulin initiation [1] which may contribute to delay. There is limited understanding about how General practitioners (GPs) and practice nurses (PN) could collaborate with specialists in order to play a greater role in insulin initiation.

Aim

To develop a framework to investigate the impact of professional roles and organisation of care on collaboration around initiation of insulin for people with T2D.

Method

A literature search exploring professional roles, organisation of care and the impact on collaboration in healthcare was conducted.

Results

Organisation of care for patients with T2D who are identified in general practice as requiring insulin can occur in secondary, intermediate or general practice settings. San Martin-Rodriguez identified four interactional determinants that contribute to successful collaboration: willingness, trust, communication and mutual respect [2]. These determinants are influenced by the way care is organised (e.g. prioritisation of work tasks, size and location of team members, opportunities to observe each other’s competence) and the roles of health professionals (e.g. professional identity and power, team philosophy and negotiation). Communication is critical across both of these domains.

Conclusion

The literature on health professional collaboration in insulin initiation is limited. Increased initiation of insulin in the general practice setting may depend on changes in health professional roles. Acceptability of this to the four health professions involved and barriers and facilitators to collaboration merits further investigation.