Julia Pledger
December 2025
Julia
Pledger
,
RN
Outpatient Department
Bedford Hospital
bedford
United Kingdom
Julia has worked at Bedford Hospital since starting her nurse training in 1977. She then worked on a number of wards as Junior Sister on Pilgrim Ward and Senior Ward Sister on Whitbread Ward before becoming a Diabetes Specialist Nurse in 1987. Julia was involved in the process of redesigning the diabetes service and the introduction of Nurse Clinics in the 1990s, when this was a radical thing for nurses to be doing.
Dr Nick Morrish was the only Diabetologist on the team, and starting nurse clinics gave a significant increase in capacity and allowed time for diabetes educational reviews, which had not happened until then. This improved the care and outcomes of our diabetes patients and enabled them to start looking after their own diabetes. Julia and Nick (Morrish) ran a number of evening meetings for GPs, “Diabetes in the 90s”, which resulted in the formation of the North Beds Diabetes Advisory Group (DAG) – the first multidisciplinary diabetes network group in the area.
In the early 2000s, Julia completed her Master's and was then appointed as the Trust’s first Nurse Consultant. Her research led to improved treatment for our patients with Type 2 diabetes, avoiding insulin for many and using the latest diabetes drugs instead. She was part of the planning of the original diabetes centre in Rye Close, which gave our patients a place they could come to with their queries, knowing there would always be someone there who could help immediately.
She was a core part of the setting up of the first Bedfordshire Retinal Screening Service (countywide with the L&D) and managed the service for several years until it grew and eventually became a distinct entity. She became our first Non-medical Prescriber and set up a high-risk Diabetes clinic for our diabetes patients with early diabetes kidney disease, starting them on vital treatments to prevent progression of their condition. This resulted in patients being treated earlier for this complication and ultimately improving their outcomes to avoid kidney failure.
She was instrumental in setting up the Structured Education programme, DAFNE, locally for patients with Type 1 diabetes, allowing them to manage their diabetes without worrying about what they were eating. This vastly improved their experience of living with diabetes and is now recommended as part of the core management for patients living with Type 1 diabetes.
In 2006, Julia and Nick, with colleagues at LDH and BH, started a working group, independent of both acute Trusts and CCGs, to write a shared-care diabetes guideline for Bedfordshire for use in primary care. This massive undertaking took five years of personal time and devotion from all the editors. The final product of this labour of love, an online website, was launched in 2010. This provided primary care colleagues with free access to clinical information on all diabetes-related matters, including local referral pathways and forms.
She was a key part of the creation of a local diabetes care scheme which, after a prolonged and tortuous process, was eventually commissioned as the Bedfordshire Integrated Specialist Diabetes Service (ICDS) in 2012, with Bedford Hospital and LDH as joint providers. Julia initially led the North Bedfordshire ICDS for Bedford Hospital and later took the lead of South Beds ICDS for LDH as well. This has led to alignment of service models across Beds.
“She has also helped set up the Luton-Beds diabetes MDT to support community services and hospital discharges, and successfully engaged the Luton ICDS clinical team. In 2017, she was a key part of the team putting together a successful bid for national funds to start a Structured Education Programme in the community for patients diagnosed with Type 2 diabetes. She still manages this team, which provides education to people soon after diagnosis (DESMOND course) and later in their diabetes journey (ADAM course), as well as many other local education programmes.
Her team supports all local GPs to provide diabetes care to patients living with Type 2 diabetes, and the model she set up for this ICDS service has been an enormous success – allowing these patients to be managed locally in the community while also providing a huge amount of training to community GPs and other HCPs. The number of initiatives she has been involved in locally is huge, and, as well as improving care for diabetes patients in the county, she has also saved the local healthcare economy many thousands of pounds.
She is a superb colleague and has a flair for attention to detail, which allowed many of the above to succeed and would not have happened without her commitment. She has devoted much of her life to supporting people with diabetes in Bedford. She is due to retire from the health service at the end of March 2026 after 45 years of dedicated service, and she will be enormously missed.
Dr Nick Morrish was the only Diabetologist on the team, and starting nurse clinics gave a significant increase in capacity and allowed time for diabetes educational reviews, which had not happened until then. This improved the care and outcomes of our diabetes patients and enabled them to start looking after their own diabetes. Julia and Nick (Morrish) ran a number of evening meetings for GPs, “Diabetes in the 90s”, which resulted in the formation of the North Beds Diabetes Advisory Group (DAG) – the first multidisciplinary diabetes network group in the area.
In the early 2000s, Julia completed her Master's and was then appointed as the Trust’s first Nurse Consultant. Her research led to improved treatment for our patients with Type 2 diabetes, avoiding insulin for many and using the latest diabetes drugs instead. She was part of the planning of the original diabetes centre in Rye Close, which gave our patients a place they could come to with their queries, knowing there would always be someone there who could help immediately.
She was a core part of the setting up of the first Bedfordshire Retinal Screening Service (countywide with the L&D) and managed the service for several years until it grew and eventually became a distinct entity. She became our first Non-medical Prescriber and set up a high-risk Diabetes clinic for our diabetes patients with early diabetes kidney disease, starting them on vital treatments to prevent progression of their condition. This resulted in patients being treated earlier for this complication and ultimately improving their outcomes to avoid kidney failure.
She was instrumental in setting up the Structured Education programme, DAFNE, locally for patients with Type 1 diabetes, allowing them to manage their diabetes without worrying about what they were eating. This vastly improved their experience of living with diabetes and is now recommended as part of the core management for patients living with Type 1 diabetes.
In 2006, Julia and Nick, with colleagues at LDH and BH, started a working group, independent of both acute Trusts and CCGs, to write a shared-care diabetes guideline for Bedfordshire for use in primary care. This massive undertaking took five years of personal time and devotion from all the editors. The final product of this labour of love, an online website, was launched in 2010. This provided primary care colleagues with free access to clinical information on all diabetes-related matters, including local referral pathways and forms.
She was a key part of the creation of a local diabetes care scheme which, after a prolonged and tortuous process, was eventually commissioned as the Bedfordshire Integrated Specialist Diabetes Service (ICDS) in 2012, with Bedford Hospital and LDH as joint providers. Julia initially led the North Bedfordshire ICDS for Bedford Hospital and later took the lead of South Beds ICDS for LDH as well. This has led to alignment of service models across Beds.
“She has also helped set up the Luton-Beds diabetes MDT to support community services and hospital discharges, and successfully engaged the Luton ICDS clinical team. In 2017, she was a key part of the team putting together a successful bid for national funds to start a Structured Education Programme in the community for patients diagnosed with Type 2 diabetes. She still manages this team, which provides education to people soon after diagnosis (DESMOND course) and later in their diabetes journey (ADAM course), as well as many other local education programmes.
Her team supports all local GPs to provide diabetes care to patients living with Type 2 diabetes, and the model she set up for this ICDS service has been an enormous success – allowing these patients to be managed locally in the community while also providing a huge amount of training to community GPs and other HCPs. The number of initiatives she has been involved in locally is huge, and, as well as improving care for diabetes patients in the county, she has also saved the local healthcare economy many thousands of pounds.
She is a superb colleague and has a flair for attention to detail, which allowed many of the above to succeed and would not have happened without her commitment. She has devoted much of her life to supporting people with diabetes in Bedford. She is due to retire from the health service at the end of March 2026 after 45 years of dedicated service, and she will be enormously missed.