CLEAR programme brings adult diabetes services together to shape HCL implementation
The CLEAR Type 1 Diabetes Hybrid Closed Loop (HCL) Implementation Programme is bringing together clinical, operational and system expertise to help adult diabetes services deliver HCL technologies safely, equitably and sustainably.
Funded by Insulet Corporation, delivered by the CLEAR team and hosted by East Lancashire Hospitals NHS Trust, the programme will develop a practical model of care, workforce approach and implementation blueprint. CLEAR retains full responsibility for the programme's content, recommendations and outputs.
HCL technologies have significant potential to improve diabetes management and quality of life for people living with type 1 diabetes. Realising that potential, however, requires more than access to technology. Services also need the workforce capacity, patient education, clinical pathways and governance to support its use, alongside approaches that respond to different patient needs.
The programme is addressing these challenges through a collaborative Design Board, bringing participating NHS trusts and wider stakeholders together to explore current practice and agree how care could be delivered more effectively.
Shaping a shared approach
This work is now under way, with the first of three design-phase workshops held through parallel sessions in Huddersfield and Westbury. Participants explored where the current Type 1 diabetes HCL pathway falls short and began shaping what a better pathway could look like.
Across both sessions, three principles emerged repeatedly: standardise the core elements of the pathway while allowing flexibility in how care is delivered, centre the pathway around the patient, and ensure remote or digital options do not widen inequalities.
Together, these principles provide a foundation for developing more consistent care while recognising differences in local populations, workforce capacity and service needs. The outputs from both sessions will feed into the second workshop in early November, where participants will test and build the proposed future pathway, before working towards an agreed model at the third workshop.
From pathway design to implementation
As that model takes shape, clinical engagement, data analysis and workforce modelling will help identify the roles, skills and capacity needed to deliver it. These insights will inform an implementation blueprint covering practical requirements such as governance, education, digital infrastructure and operational delivery.
To understand how the approach works in practice, one participating trust will receive additional support to test and refine the agreed model. Learning from this process will be shared across participating services and used to strengthen the final blueprint, alongside resources to support wider adoption across the NHS.
By connecting collaborative design with practical implementation, the programme aims to develop an approach grounded in frontline experience and adaptable to different services and populations. Its ambition is to help adult diabetes teams translate advances in technology into more consistent, personalised and accessible care.
Thank you to everyone who contributed their time and expertise to the first workshops. Their insights will help shape the next stage of the programme and the practical resources it produces.
To find out more about the programme, contact James Orpin-Wright, Senior Clinical Consultant at 33n, at james.orpin-wright@33n.co.uk or Laura Harries, Managing Consultant at 33n, at laura.harries@33n.co.uk
Funding and independence: The Type 1 Diabetes HCL programme of work is funded by Insulet Corporation. The programme will be delivered by the CLEAR team and hosted by East Lancashire Hospitals NHS Trust. The CLEAR team will retain full responsibility for the development of all materials, oversight of the steering group and editorial decision-making. Insulet has no influence over content, recommendations or outputs generated through this work.
